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Anti-Rheumatic Rx

Clinical Trial Boom or Bust in Severe COVID-19

Oct 20, 2020

A number of recently published clinical trials are further defining the efficacy and outcomes of tocilizumab or remdesivir in treating SARs-CoV-2 infection.



Remdesivir

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Biologic Use for Arthritis Linked With Depression and Anxiety

Oct 20, 2020

In a recent study of patients with inflammatory rheumatic diseases, the initiation of a biologic treatment or switching to another biologic was associated with an increased likelihood of the use of antidepressants and anxiolytics, reported Petros P. Sfikakis, MD, of the National and Kapodistrian

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Outpatient Visits Return to Pre-COVID Rates

Oct 19, 2020

The COVID-19 pandemic dramatically impacted outpatient care - numbers, scope, quality, etc, but a recent study suggests that while COVID has changed the scope of care, the numbers of outpatient visits have risen to near pre-pandemic numbers.

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TNF Inhibitors or non-TNF Biologics - First Best Choice?

Oct 18, 2020

Prospective observational findings from the CORRONA registry of rheumatoid arthritis (RA) patients compared clinical outcomes between initial aggressive therapy using either a tumour necrosis factor inhibitor (TNFi) or a non-TNFi (biological disease-modifying antirheumatic drugs (bDMARDs) and

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FDA Warning on NSAIDs in Pregnancy

FDA
Oct 16, 2020

The U.S. Food and Drug Administration announced today in a Drug Safety Communication that it is requiring labeling changes for nonsteroidal anti-inflammatory drugs (NSAIDs). These changes include new labeling to explain that if women take the medications around 20 weeks or later in their

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RheumNow Podcast – Good Time Charlie…. (10.16.20)

Oct 15, 2020

Dr. Jack Cush sings the news and journal reports from the past week on RheumNow.com.

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Abatacept vs. Upadacitinib in Biologic Refractory Rheumatoid Arthritis

Oct 15, 2020

NEJM reports the results of the SELECT-Choice trial, a head to head study of upadacitinib (UPA) and abatacept (ABA) in biologic refractory rheumatoid arthritis (RA); 12 weeks results showed UPA was significantly more clinically effective than ABA using a DAS28-CRP remission, but ABA had fewer

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Observational study of 123 Spanish rheumatic dz pts w/ COVID-19, finds 54 hospitalized. Admitted pts were 69.7 yrs, and 22% died. Admission was assoc w/ older age, autoimmune dz (vs inflammatory arthritis; OR: 3.55), but not DMARD Rx. https://t.co/UWNyhOKbvF

Dr. John Cush RheumNow ( View Tweet)

Oct 13, 2020

Thrombotic Risk in Rheumatoid Arthritis Linked to Disease Activity

Oct 11, 2020

A large RA cohort study from the Swedish Rheumatology Quality Register shows a higher risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA)  and that risk is linked to RA disease activity. 

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Hydroxychloroquine Shows No Benefit in Hospitalized COVID-19 Patients

Oct 09, 2020

The NEJM reports on a controlled clinical trial showing patients hospitalized with Covid-19 given hydroxychloroquine (HCQ) do not have a lower incidence of death compared to those receiving routine care.



A total of 4716 patients who were hospitalized with Covid-19 were randomly to

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RheumNow Podcast – Bad Disease & Bad Outcomes (10.9.20)

Oct 08, 2020

Dr. Jack Cush Reviews the news and journal articles from the past week on RheumNow.com.

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Biologics Beneficial in Eosinophilic Vasculitis

Oct 08, 2020

Two biologic therapies showed promise in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) in a retrospective European study.



Among 63 patients who were treated with rituximab (Rituxan), remission or partial responses at 1 year were observed

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Sustained Remission Off Therapy Unlikely in GPA

Oct 08, 2020

A French Vasculitis Study Group analysis of their granulomatosis with polyangiitis (GPA) reveals that after 10 years, only 7% of GPA patients achieved sustained remission off therapy (SROT) and have never relapsed.

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IL-1 Inhibition Alters Arthroplasty Rates

Oct 07, 2020

A subanalysis of the CANTOS trial suggests that inhibition of interleukin-1β (IL-1β) can reduce rates of incident hip or knee replacement (THR/TKR) surgeries.

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Fractures from Delays in Denosumab Reinfusions

Oct 07, 2020

Denosumab is effective in osteoporosis when used on schedue, but research suggests that discontinuation leads to rapid reversal of effect; a new observational study has shown that delays in denosumab administration of more than 16 weeks results in an increased vertebral fracture risk,

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Incredible lecture on the highest of therapeutics for rheumatoid arthritis by @BrighamWomens Dr Michael Weinblatt. Love this screen shot of A to Z for therapies prior to the methotrexate era. Z=Zero therapy (do nothing). Incredible advances since then!
Jeff Sparks jeffsparks ( View Tweet)
Oct 06, 2020

Oral Dysbiosis May Antedate Rheumatoid Arthritis

Oct 06, 2020

A study of oral microbiome in anti-cyclic citrullinated peptide (anti-CCP) positive at-risk individuals without synovitis (CCP+at risk) shows dysbiotic subgingival microbiomes and increased abundance of P. gingivalis compared with controls.

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Systemic Steroids Reduce Mortality in COVID-19

Oct 06, 2020

JAMA Internal Medicine reports an analysis of COVID-19 clinical trials showing that critically ill patients with COVID-19 treated with systemic corticosteroids have an overall lower mortality rate.

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Utilization study of 1031 tofacitinib vs 17,803 biologic DMARD Rx-patients shows 14% higher discontinuations w/ TOFA (HR 1.14), but pts who switched to tofacitinib from a bDMARD had longer persistence than pts switched to another bDMARD (HR 0.90) https://t.co/5cqloT

Dr. John Cush RheumNow ( View Tweet)

Oct 05, 2020
Hellenic reigstry of 385 RA pts on DMARDs finds that, compared to remission or LDAS - those in persistent moderated disease activity had 50-80% more serious adverse events. https://t.co/3JA3VaMxeO

Dr. John Cush RheumNow ( View Tweet)

Oct 05, 2020

RheumNow Podcast – Function Follows Form (10.2.20)

Oct 01, 2020

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Regulatory approvals, update on global rheumatology alliance, smoking and psoriasis, gabapentin let down and defining difficult RA.

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Latest data Global Rheumatology Alliance COVID Registry -2121 pts (40% RA, 17% SLE, 9% PsA), 64% on DMARDs, 33% biologics, 5% JAKi, 34% steroid,27% HCQ, with only 7.6 deaths and 39% hospitalized and 81% resolved infection. https://t.co/g0w4QZHmRl

Dr. John Cush RheumNow ( View Tweet)

Oct 01, 2020

Defining Difficult Rheumatoid Arthritis

Oct 01, 2020

‘Difficult-to-treat RA’ is an oft-used term that carries various clinical qualities and therapeutic disappointments. A EULAR Task Force was established to develop recommendations for the management of difficult-to-treat rheumatoid arthritis and as a first step, have put forth their definition of

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Slow Lung Decline Typical in Systemic Sclerosis

Sep 30, 2020

The interstitial lung disease that develops in a subset of patients with systemic sclerosis tends to be heterogeneous, with the majority of patients experiencing a slow pattern of decline in lung function, analysis of outcomes in the European Scleroderma Trials and Research (EUSTAR) database

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Hydroxychloroquine Fails as Pre-exposure Prophylaxis for COVID-19

Sep 30, 2020

Numerous previous studies have questioned the efficacy or protection afforded by hydroxychloroquine (HCQ) for COVID-19 and studies have show that HCQ has failed when given as post-exposure prophylaxis to health care workers (HCWs).  A new randomized controlled trial has shown that HCQ failed

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