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Biosimilar Bonanza in 2023 (12.9.2022)

Dec 09, 2022 6:00 am

Dr. Jack Cush reviews more than a dozen news and journal articles from this past week on 

  1. Review of 120 pts w/ Catastrophic antiphospholipid syndrome showed that 54% had skin involvement & was 1st APS sx in 35%. Findings: livedo racemosa (45%), necrosis/ulcers (42%), splinter hemorrhages (29%), distal edema (23%), purpura (14%).

  2. SLE preg delivery hospitalizations (77560) was associated with increased risk of CV complications, including preeclampsia [aOR 2.12] , peripartum cardiomyopathy (4.42), CHF (4), arrhythmias (2.2), AKI (7.7), stroke (4.8), VTE (6.9) w/ incr hosp costs

  3. Joint hypermobility linked to depression & anxiety? Longitudinal Study of 6105 kids at age 14 yrs: 19% had generalised joint hypermobility (more in F) *+& assoc w/ depression (OR: 3.53), anxiety (3.14) at age 18

  4. From 1055 new polyarthralgia presentations, 88 (8.3%) Dx w/ psoriatic arthritis. PsA Dx assoc w/ a +FamHx ( OR 4.14), psoriasis (OR=78.94), erosions (OR=5.74), US +power Doppler (OR=7.11). Neg assoc w/ +RF (OR 0.03), +CCP (OR 0.06).

  5. MTX side effects more prominent in PsA than RA pts. Study of 240 PsA & 86108 RA pts starting either MTX or TNFi. TNFi AE same betw PsA & RA, but MTX adverse greater in PsA (44.8% vs. 29.4%), especially N/V, abdominal pain, depression, tinnitus

  6. 3388 pts in J Hopkins Scleroderma study found 29% w/ calcinosis (13.5% these w/ heavy burden calcinosis/HBC). Calcinosis assoc w/ diffuse SSc, disease severity (PH, ILD, CVD, GI, renal crisis, myopathy)(OR 2.9- 6.9) & PM/Scl Abs (OR 17.31)

  7. Comparison of 227 Systemic Sclerosis pts w/ & without ILD shows SSc-ILD to have more muscle Dz [OR 2.55], LVDD [OR 2.36], PAH [OR 9.13], dcSSc [OR 2.86], PLR [OR 1.005], elevated KL-6 [OR 2.03], and anti-Scl-70 [OR 3.1].

  8. Netherlands study of 220 consecutive inflammatory arthritis pts enrolled in electronic remote telehealth monitoring showed that 141 (64%) dropped out, with a median dropout at 17 wks ( moreso in women). Why? Simple is not alway simple...

  9. Systematic review comparing MIS-C and Kawasaki: 14 studies, 2928 pts; major differences- KD pts were younger; MIS-C had more Pulm, GI, Shock, more cardiac (LV, valvular pericarditis, myocarditis), but less coronary lesions & conjunctivitis

  10. Retrospective study of US National Inpatient Sample data 2015-2019 looked at 60,360 gout admissions, roughly 1/4 had Arrhythmias (mostly older pts; AFib (88%), atr flutter (6.2%), VTach (3.2%). Gout-arrhythmia pts had more deaths (adj OR 2.06)

  11. National cohort of 20–39-yr old men - among ~1.3 million, 18,473 Dx w/ gout (incidence 3.36/1,000 PY). Developing metabolic syndr doubled #gout risk (aHR 2.31); MetS at all visits had 4x risk (aHR 3.82) & MetS recovery reduced gout risk by 59%

  12. Sparks editorial -- RA pathogenesis has been linked to pollution, Lung Dz, smoking, silica dust, asbestos, textile dust, brick/concrete laying, pesticides, military burn pits - some w/ strong associ w/ HLA-SE and ACPA, but not ACPA-negative RA

  13. Systematic review of MSK findings in patients with acute lymphoblastic leukemia finds 29 pts with peripheral arthritis (7), axial manifestations (17), and osteolytic lesions (21 pts) & Vertebral Fx (4) Hypercalcemia in 9 cases.

  14. Humira biosimilars became available in EU 10/18; and will soon be available in the USA w/ Amjevita (Amgen) available Jan 2023 & 6 others (Pfizer, BI, Samsung, Coherus, Sandoz, Biocon) after July 2023.

  15. TARGET Trial - Cardiovascular Risk Reduction in Rheumatoid Arthritis 

  16. Bimekizumab Efficacy in TNF-Refractory Psoriatic Arthritis 

The author has received compensation as an advisor or consultant on this subject

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