Rheumatology
RCT: Zasocitinib Achieves Significant Psoriasis Improvement in Moderate to Severe Plaque Psoriasis
6 Sep, 2024 | 22:48h | UTCStudy Design and Population: This phase 2b, double-blind, placebo-controlled trial evaluated the efficacy, safety, and tolerability of zasocitinib, a selective tyrosine kinase 2 (TYK2) inhibitor, in patients with moderate to severe plaque psoriasis. Conducted across 55 centers in the US and Canada, the study enrolled 287 patients aged 18 to 70 years with a Psoriasis Area and Severity Index (PASI) score ≥12, and ≥10% of body surface area affected. Patients were randomized to receive zasocitinib at doses of 2 mg, 5 mg, 15 mg, or 30 mg, or a placebo, over 12 weeks.
Main Findings: At week 12, significant improvements in PASI were observed across all doses of zasocitinib. The primary endpoint of PASI 75 was achieved in 18%, 44%, 68%, and 67% of patients in the 2 mg, 5 mg, 15 mg, and 30 mg zasocitinib groups, respectively, compared to 6% in the placebo group. Higher PASI 90 and PASI 100 responses were also observed, particularly in the 15 mg and 30 mg groups. Adverse events were mild to moderate and occurred in 53% to 62% of patients receiving zasocitinib, compared to 44% for placebo.
Implications for Practice: Zasocitinib shows promise as an effective and well-tolerated oral treatment for moderate to severe plaque psoriasis. Its efficacy in achieving skin clearance (PASI 75 and above) at higher doses suggests potential for broader clinical use, with phase 3 trials warranted for further validation.
Retrospective Cohort Study: Rheumatoid Arthritis Linked to Over 50% Increased Lung Cancer Risk, with a Three-Fold Risk in RA-Associated Interstitial Lung Disease – Arthritis Rheumatol
18 Aug, 2024 | 18:58h | UTCStudy Design and Population: This retrospective matched cohort study examined the risk of lung cancer in 72,795 patients with rheumatoid arthritis (RA) and 757 patients with RA-associated interstitial lung disease (RA-ILD) from the Veterans Health Administration database, compared with 633,937 non-RA controls. The study spanned from 2000 to 2019, with patients matched on age, gender, and enrollment year.
Main Findings: The study found that RA was associated with a 58% increase in lung cancer risk (adjusted hazard ratio [aHR] 1.58). The risk was significantly higher in RA-ILD patients, with a more than three-fold increase (aHR 3.25) compared to non-RA controls. Even among never smokers, RA patients showed a 65% increased lung cancer risk, indicating that factors beyond smoking contribute to the elevated risk.
Implications for Practice: The study underscores the significant increase in lung cancer risk among patients with RA, particularly those with RA-ILD. While this elevated risk is notable, further research is necessary to determine the most effective strategies for monitoring and managing this risk. Clinicians should be aware of these findings and consider them when evaluating the overall health and risk factors of patients with RA, especially those with additional pulmonary complications like ILD. Enhanced awareness and individualized risk assessments may help in early detection and management of lung cancer in this high-risk population.
Cohort Study: Efficacy of first-line color doppler ultrasound in diagnosing giant cell arteritis – Ann Intern Med
25 May, 2024 | 19:39h | UTCThis prospective multicenter study aimed to evaluate the efficacy of using color Doppler ultrasound of the temporal arteries as the first-line diagnostic tool for Giant Cell Arteritis (GCA) in 165 elderly patients with high clinical suspicion of the disease. The study followed participants over two years, comparing ultrasound results with temporal artery biopsy (TAB) and physician-based clinical diagnosis including other imaging tests. Key findings indicate that ultrasound confirmed GCA in 44% of cases, which was higher compared to TAB (17%) and clinical expertise (21%). The study showed that using ultrasound first can avoid the need for further invasive tests like TAB in patients with positive ultrasound results. The limitations of the study include its small sample size, unblinded test results, and the absence of a universally accepted objective diagnostic standard. However, it highlights the potential of ultrasound in the early and non-invasive diagnosis of GCA, potentially reducing the risk of severe complications by expediting treatment initiation.
Reference (link to abstract – $ for full-text):
Cohort Study | Mortality risk in anti-MDA5 dermatomyositis linked to rapid ILD progression and anti-Ro52 antibody levels
11 Aug, 2023 | 15:21h | UTC
Commentary on Twitter
High mortality risk predictors in patients with anti-MDA5 dermatomyositis include:
– rapidly progressive interstitial lung disease
– anti-Ro52 antibody
– age > 57 years
(based on study of 126 MDA-5+ DM pts)https://t.co/JLGIgALUip pic.twitter.com/boTTzrixk9— Dr. John Cush (@RheumNow) August 5, 2023
Cohort Study | Vegetarian diet linked to elevated hip fracture risk; BMI plays a partial role
9 Aug, 2023 | 15:16h | UTC
Systematic review informing the 2022 EULAR recommendations for the management of ANCA-associated vasculitis
7 Aug, 2023 | 14:47h | UTCGuideline: EULAR recommendations for the management of ANCA-associated vasculitis
Pathogenesis of systemic lupus erythematosus: risks, mechanisms and therapeutic targets
7 Aug, 2023 | 14:45h | UTC
Review | Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management
4 Aug, 2023 | 11:49h | UTC
RCT | Risankizumab outperforms apremilast in moderate plaque psoriasis treatment
3 Aug, 2023 | 13:21h | UTCCommentary: Risankizumab Shown to be Superior to Apremilast in Treating Adults with Moderate Psoriasis – HCP Live
2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease
2 Aug, 2023 | 14:02h | UTCCommentary: 2023 ACR/EULAR Criteria for Calcium Pyrophosphate Deposition Disease – RheumNow
RCT | Baricitinib demonstrates efficacy in treatment-resistant juvenile idiopathic arthritis
2 Aug, 2023 | 13:45h | UTCBaricitinib in juvenile idiopathic arthritis: an international, phase 3, randomised, double-blind, placebo-controlled, withdrawal, efficacy, and safety trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter
NEW in @TheLancet—Baricitinib was efficacious with an acceptable safety profile in patients with #juvenile idiopathic #arthritis in a phase 3 withdrawal trialhttps://t.co/vZyXUwBiDZ #JIA
Plus linked Comment: https://t.co/VWofLvL427 pic.twitter.com/MGVoUz4xIv
— The Lancet Rheumatology (@TheLancetRheum) July 10, 2023
Novel therapeutics for management of lupus nephritis: what is next?
1 Aug, 2023 | 14:22h | UTCNovel Therapeutics for Management of Lupus Nephritis: What Is Next? – Kidney Medicine
Review | First-line immunosuppression in neuromuscular diseases
1 Aug, 2023 | 14:09h | UTCFirst-line immunosuppression in neuromuscular diseases – Practical Neurology
Cohort Study | More data suggests SGLT-2 inhibitors could reduce gout flares
26 Jul, 2023 | 13:24h | UTCComparative Effectiveness of Sodium–Glucose Cotransporter-2 Inhibitors for Recurrent Gout Flares and Gout-Primary Emergency Department Visits and Hospitalizations: A General Population Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries:
SGLT-2 inhibitors reduced gout flares in patients with diabetes, gout – ACP Internist
SGLT2i Use Linked to Reduced Risk for Flare in Adults With Gout, T2D – HealthDay
SGLT2 inhibitors linked with fewer gout flares in diabetes – MDedge
Cohort Study | The role of antiphospholipid syndrome and specific antibodies in predicting SLE pregnancy complications
25 Jul, 2023 | 13:44h | UTCPregnancy outcomes in 1869 pregnancies in a large cohort from the Spanish Society of Rheumatology Lupus Register (RELESSER) – Seminars in Arthritis and Rheumatism (link to abstract – $ for full-text)
Commentary: SLE and Pregnancy Outcomes – RheumNow
M-A | Comparison of systemic treatments for chronic plaque psoriasis – Anti-IL17 stands out
25 Jul, 2023 | 13:27h | UTC
Review | Hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA): two sides of the same coin
7 Jul, 2023 | 16:01h | UTCHES and EGPA: Two Sides of the Same Coin – Mayo Clinic Proceedings
RCT | Opioids not more effective than placebo for acute low back and neck pain
5 Jul, 2023 | 01:15h | UTCOpioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial – The Lancet (link to abstract – $ for full-text)
News Releases:
Opioids no more effective than placebo for acute back and neck pain – University of Sidney
Opioid pain relievers do not reduce acute lower back and neck pain, study suggests – The Lancet
Commentary from the authors: Opioids don’t relieve acute low back or neck pain – and can result in worse pain, new study finds – The Conversation
Consensus Statement | Evaluation and management of deficiency of adenosine deaminase 2
30 Jun, 2023 | 14:53h | UTCInvited Commentary: Finding a Quorum in Deficiency of Adenosine Deaminase 2 Management – JAMA Network Open
Podcast | Wisely ordering autoantibodies
28 Jun, 2023 | 13:09h | UTC#399 Wisely Ordering Autoantibodies – ACP IM2023 – The Curbsiders
EULAR points to consider for the definition of clinical and imaging features suspicious for progression from psoriasis to psoriatic arthritis
27 Jun, 2023 | 13:37h | UTC
Commentary on Twitter
Have you checked the latest recommendations? @eular_org points to consider for the definition of clinical and imaging features suspicious for progression from PsO to PsA
▶️ 3 stages relevant to PsA prevention
▶️ 5 OP and 10 points to consider? https://t.co/Kr9akTjNC6 pic.twitter.com/cHsg0ZTlb6
— ARD & RMD Open (@ARD_BMJ) June 21, 2023
RCT | Rituximab and MMF combo improves lung function vs. MMF in interstitial lung disease with NSIP pattern, but may increase infection risk
21 Jun, 2023 | 13:16h | UTCRituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial – European Respiratory Journal (link to abstract – $ for full-text)
Commentary on Twitter
ERJ: Rituximab plus MMF is associated with benefits in lung function and progression-free survival compared with MMF plus placebo after 24 weeks of treatment. The safety profile of rituximab plus MMF was similar to that of MMF plus placebo. https://t.co/Mv0IuzLljz pic.twitter.com/1igrt6uDK4
— ERS publications (@ERSpublications) June 11, 2023
M-A | Biosimilar and reference biologics in rheumatoid arthritis show equivalent results
15 Jun, 2023 | 14:47h | UTCCommentary: Adalimumab, Etanercept, Infliximab Biosimilars Show Clinically Equivalence to Biologics in RA – HCP Live
Review | The cervical spine in tension type headache
13 Jun, 2023 | 13:58h | UTCThe cervical spine in tension type headache – Musculoskeletal Science and Practice
Commentary on Twitter
The cervical spine in tension type headache
???https://t.co/EFcxBlDO34 pic.twitter.com/y7SyA3T7qt
— Physio Meets Science (@PhysioMeScience) June 1, 2023
Cohort Study | Prognostic model for predicting methotrexate toxicity in immune mediated inflammatory diseases
12 Jun, 2023 | 13:26h | UTCNews Release: New study reveals way to predict side-effect risk from common immune suppressant medication – University of Nottingham
Commentary: Prognostic model stratifies risk for methotrexate toxicity – ACP Internist