Outcomes

RheumNow Podcast – Falling or Falling in Love?

Save

Dr. Jack Cush reviews the best journal articles from the past week on RheumNow.com.

Drug Monitoring Ineffective with Infliximab Treatment

Save

The predictive value of therapeutic drug monitoring (TDM) while on biologics is debateable; gastroenterology routinely relies on TDM, while rheumatologists do not. A randomized trial compared TDM to no TDM in patients receiving infliximab for chronic immune-mediated inflammatory diseases (

Childhood Lupus May Hamper Adult Careers

Save

Long-term outcomes of kids with childhood-onset systemic lupus erythematosus (cSLE) are uncommon, but this cSLE cohort analysis suggests that SLE significantly impacts their future education, vocation, and employment as they reach adulthood.

A cohort of 106 cSLE (93% female, 73% White

Results Disappoint for Fecal Transplant in Arthritis

Save

Fecal microbiota transplantation (FMT) showed disappointing results among patients with active psoriatic arthritis, a small randomized trial found.

During 26 weeks of follow-up, the risk of treatment failure was higher among patients receiving FMT compared with those given a sham

Higher Cardiovascular Risks with Systemic Lupus Erythematosus

Save

The Journal of the American College of Cardiology has published the results of a study showing that patients with systemic lupus erythematosus (SLE) have an increased risk of heart failure (HF) and other long-term cardiovascular outcomes. 

Data taken from Danish

Predictors of Methotrexate Toxicity

Save

A metanalysis showed that while adverse events (AEs) are common when methotrexate is used in rheumatoid arthritis or inflammatory arthritis patients, serious AEs ranged from 2.1 to 9.5% and drug discontinuations ranged from 6.7% to 15.5%, mostly due to gastrointestinal events. 

Seven Year Delay in Diagnosing Spondyloarthritis

Save

A large patient cohort study suggests that the mean diagnostic delay (DD) in European axial spondyloarthritis (axSpA) patients is 7.4 years, moreso in women and younger patients.

An online survey of 2,652 patients from 13 countries (European Map of Axial Spondyloarthritis - EMAS)

Tofacitinib in Ankylosing Spondylitis

Save

A phase III trial assessing the efficacy and safety of tofacitinib in adults with with active ankylosing spondylitis (AS) shows that JAK inhibitiion was superior to placebo in a 48 week study.

A total of 269 adult AS patients with a prior an inadequate response or intolerance to ≥2

Psoriatic Pregnancies Pose Risks to the Mother, Not Child

Save

A metanalysis of pregnancy outcomes in women with psoriasis and psoriatic arthritis finds an excess risk of adverse maternal events, but not adverse neonatal events.

This systematic review included 16 studies meeting inclusion criteria. 

Overall they found that pregnant women

Dual IL-17 Targeting is Effective but has More Candidiasis

Save

Bimekizumab (BIM) is a monoclonal antibody that targets both interleukin-17A and interleukin-17F, which as a biologic target has worked well in the management of psoriatic disease. The current issue of the NEJM has two reports wherein BIM was shown to be more effective than secukinumab and

Little Effect with Multimodal Treatment of CMC1 Osteoarthritis

Save

A randomized clinical trial of patients with CMC1 osteoarthritis shows modest benefits when a combination of conservative treatments (education, splinting, hand exercises, 1% diclofenac sodium gel) was used compared to education alone. While there were small to medium benefits with regard to

Golimumab Effective in non-radiographic Axial Spondyloarthritis

Save

The GO-AHEAD study was designed to assess the long-term efficacy and safety of golimumab (GLM) in non-radiographic axial spondyloarthritis (nr-axSpA).  After the 16-week, placebo [PBO]-controlled double-blind phase, 189/198 (95.5%) entered the long-term extension (OLE) for 36 weeks wherein

Lupus Activity Affects Mortality

Save

Each one-unit increase on a disease activity score during the first year after enrollment into a systemic lupus erythematosus (SLE) cohort was associated with a significant increased risk for death and organ damage during subsequent follow-up, researchers reported.

RheumNow Podcast – Coconspirators: RA and Lung Disease

Save

Dr. Jack Cush reviews and discusses more than a dozen news and journal articles from the past week on RheumNow.com.

Diagnostic Delay in Spondyloarthritis

Save

Literature review and metanalysis of many studies suggests that significant delay to diagnosis in axial spondyloarthritis (axSpA) exist, are longer than other rheumatic diseases and have not changed over time.

From a total of 64 studies identified the reported mean delay in diagnosing

Increased Methotrexate Liver Disease in Psoriasis

Save

A Danish cohort study examined the risk of methotrexate related liver disease risk in patients with psoriasis (PsO)and psoriatic arthritis (PsA), and found that compared to rheumatoid arthritis (RA), psoriatic patients had up to a 3 fold higher risk of liver disease. 

In a population-

BSRBR: Demyelinating Disease Following Anti-TNFα Therapy

Save

Analysis of patients receiving anti–tumor necrosis factor α (TNFi) therapy in the British Society for Rheumatology Biologics Register (BSRBR) shows that the risk of demyelination is rare but is marginally incrased by taking TNFi therapy. 

From their large registry (n=13,489) they

Increased Risk of COPD in ACPA+ Pre-RA Patients

Save

The lung and its pathology is uniquely tied to rheumatoid arthritis (RA) and its pathogenesis.  A new study shows that elevation of anti–citrullinated protein antibodies (ACPAs) before diagnosis of RA increases the risk of developing chronic obstructive pulmonary disease (COPD) and/or asthma

New Side Effect From mRNA COVID Vaccines?

Save

Herpes zoster reactivation -- a.k.a. shingles -- following COVID-19 vaccination in six patients with comorbid autoimmune/inflammatory diseases may be a new adverse event associated with the Pfizer/BioNTech mRNA vaccine, suggested a new report.

At two centers in Israel, there have been

Broadalumab Efficacy in Axial Spondyloarthritis

Save

Broadalumab (Siliq), an anti-interleukin-17 receptor A monoclonal antibody, is currently FDA- approved for use in adults with plaque psoriasis; but a recent trial shows it to be effective in patients with axial spondyloarthritis (axSpA).

Autoimmune Risk of Death Up during COVID

Save

A population-based study in the UK shows that patients with rare autoimmune rheumatic diseases (RAIRD) were 44% more likely to die during the 2020 COVID-19 pandemic (March - April) compared to either the general population or their pre-COVID risk.

This cohort study compared hospital

NICE Guidelines on Chronic Pain Management

Save

In the United Kingdom, where it is estimated that chronic pain affects one‑third to one‑half of the population, NICE (National Institute for Health and Care Excellence) has recently released an updated guideline on the management of chronic pain for people aged 16 years and over. This

IL-23 Targeting for Enthesitis in Psoriatic Arthritis

Save

Treatment with guselkumab (Tremfya) was effective in resolving enthesitis among patients with psoriatic arthritis (PsA), a post-hoc analysis of two phase III trials found.

At week 24, 45% of patients receiving subcutaneous guselkumab every 4 weeks and 50% of those given the medication

DMARD Dropouts During COVID-19

Save

A full year from the onset of the SARS-COV-2 pandemic, rheumatologists are still seeing the consequences of COVID, with many patients avoiding usual care, follow-up visits, routine lab testing and with many self-stopping their antirheumatic meds, because it seemed like the right thing to do

Anti-inflammatory Diet Control of Rheumatoid Arthritis

Save

The TOMORROW study assessed the relationship between diet and disease activity in rheumatoid arthritis (RA) patients and has shown that RA patients are more likely to have higher inflammatory diets, but that a change to an anti-inflammatory diet resulted in lower disease activity scores.