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Great and Not So Great (9.30.2022)

Sep 30, 2022

This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.

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Efficacy and Safety of JAK Inhibitors in Psoriatic Disease

Sep 28, 2022

There is a growing body of evidence demonstrating efficacy and safety of JAK inhibitors in patients with moderate-to-severe psoriasis and psoriatic arthritis, according to a systematic review in BMC Rheumatology.

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VTE Risk from Swedish Rheumatology Quality Register - VTE Prevalnce/1000PY TNFi 5.15; JAKi 11.33; Gen Pop 3.3. VTE adj HR JAKi vs TNFi =1.73 (1.24, 2.42); PE HR 3.21 (2.11, 4.88) and DVT HR 0.83 (0.47,1.45)
STAR-RA study - real world claims data shows tofacitinib doesnt increase malignancy risk. Study of 83,295 pts (10,504 TOFA). Risk of malignancy w/ TOFA not increased (HR 1.01) w/ RWE or RCT-duplicate cohort (HR 1.1; 95% CI 0.85, 1.62)
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CD19 CAR T Cell Therapy in SLE (9.16.2022)

Sep 16, 2022

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review

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The 2022 ACR abstracts are published and posted for you. Let the Learning begin!
TYK2 Inhibitor FDA Approved for Psoriasis BMS made a mega bet on deucravacitinib, an in-house experimental TYK2 drug, in the leadup to the big Celgene buyout, keeping it while auctioning off Celgene’s top-selling Otezla to Amgen for $13.4 billion

First In Class, TYK2 Inhibitor FDA Approved for Psoriasis

Sep 12, 2022

Deucravacitinib (Sotyktu), a first-in-class, oral, selective, allosteric tyrosine kinase 2 (TYK2) inhibitor, is the only approved TYK2 inhibitor worldwide and the first innovation in oral treatment for moderate-to-severe plaque psoriasis in nearly 10 years.

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FDA has approvef deucravacitinib (Sotyktu), an oral TYK2 inhibitor, for use in adults with Moderate-to-Severe Plaque Psoriasis. Approval was based on pivotal Phase 3 POETYK PSO clinical trials demonstrated superior efficacy over PBO & apremilast
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Does Fibromyalgia Need B12? (9.9.2022)

Sep 09, 2022

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from

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JAKi inhibit Vaccine responses some - study of 113 RA fully vaccinated pts assess 6wks post 2nd jab - 51 on JAKi and 62 not on JAKi. Pts not on JAK 77.4% had humoral response; 29% less (54.9%) in thos on JAK inhibitors; even more if on MTX + JAKi
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.

STING/IFN Activation Promotes ANCA-Associated Vasculitis Progression

Aug 29, 2022

Research presented in the Journal of Experimental Medicine shows that ANCA-associated vasculitis (AAV) may be propagated by pathogenic mechanisms triggering cGAS/STING/IRF3-dependent IFN-I release.

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Review of VTE risk with JAK inhibitors - Tofacitinib: 10mg or 5 mg bid - PE rates 0.5 & 0.3/100PY; higher w/ risk factors, VTE 0.35/100PY - Baricitinib: IR of DVT/PE was 0.5/100PY - Filgotinib: 200mg VTEs 0.2/100PY Most VTE occured in LT extension of RCT
NICE has approved upadacitinib (Rinvoq) for availability in England & Wales for use in adults w/ active ankylosing spondylitis not controlled with conventional therapy, only after TNF inhibitors are tried or not suitable
JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness
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Managing JDM with Calcinosis

Aug 19, 2022

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

  1. CDC report of fungal infx in US 2019 - coccidioidomycosis (20,061), histoplasmosis (1,124) & blastomycosis (240

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Rheums! Do you have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
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Hit Parade Review (8.12.2022)

Aug 12, 2022

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on

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JAK Inhibitors in Difficult Still’s Disease A small retrospective study suggests that patients with difficult to treat AOSD or sJIA may respond well to JAKi agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.

More Bad Safety News for Xeljanz

Aug 08, 2022

Another analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in rheumatoid arthritis are higher than with tumor necrosis factor (TNF) inhibitors.

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Upadacitinib in non-radiographic Axial Spondyloarthritis The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of nr-AxSpA, extending the efficacy of UPA beyond classic ankylosing spondylitis.

JAK Inhibitors in Difficult Still’s Disease

Aug 05, 2022

A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.

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The Great Unknowns (8.5.2022)

Aug 05, 2022

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

  1. 521 clinically suspect arthralgia (CSA) pts were

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Oral surveillance - tofacitinib vs TNFi in high risk pts: more infections, serious infection (SIEs) & non-serious infx with Tofa vs TNFi. SIE risk 17%-48% higher; SIE higher w/ high dose Tofa, esp in pts aged≥65. Usual risk factors - age, pred, comorbid.