The Trick of Treating Cancer in Autoimmune Diseases

Nov 21st, 2019 - ATLANTA — "Immunotherapy operates on this very simple principle: a patient's cancer can be eradicated if we can just instruct the immune system to eradicate it," said Ryan Sullivan, MD, associate director of the melanoma program at Massachusetts General Hospital in Boston. "But for patients with autoimmune disease, it comes with a catch." Immunotherapy helps a patient's immune system locate and...

SPIRIT-H2H results confirm superiority of ixekizumab over adalimumab for PsA
Sharon Worcester

Nov 21st, 2019 - ATLANTA – Ixekizumab (Taltz) provided significantly greater improvement in joint and skin symptoms, compared with adalimumab (Humira), in biologic-naive patients with active psoriatic arthritis (PsA), according to final 52-week safety and efficacy results from the randomized SPIRIT-H2H study. Dr.

COAST-X top-line results: Ixekizumab improves nonradiographic axSpA vs. placebo
Sharon Worcester

Nov 21st, 2019 - ATLANTA – Adding ixekizumab (Taltz) to conventional background medications significantly improved the signs and symptoms of nonradiographic axial spondyloarthritis (axSpA) in the randomized, double-blind, placebo-controlled phase 3 COAST-X trial. Sharon Worcester/MDedge News Dr.

Fewer people are dying from systemic sclerosis at younger ages
Jeff Craven

Nov 21st, 2019 - ATLANTA – Patients with systemic sclerosis aged 44 years and younger in the United States now have mortality comparable to that of the general population in that age group, according to recent results presented at the annual meeting of the American College of Rheumatology. Dr.

Rituximab tops azathioprine for relapsing ANCA-associated vasculitis remission maintenance
M. Alexander Otto

Nov 21st, 2019 - ATLANTA – Rituximab (Rituxan) is superior to azathioprine (Imuran) for preventing ANCA-associated vasculitis relapses in patients with histories of previous relapses, according to a randomized trial of 170 patients presented at the annual meeting of the American College of Rheumatology. Dr.

Atmospheric and Environmental Changes Tied to Organ-Specific Lupus Flares

Nov 19th, 2019 - NEW YORK (Reuters Health) - Changes in atmospheric and environmental factors may contribute to organ-specific disease exacerbation in patients with systemic lupus erythematosus (SLE), according to a new study. The study found "strong associations between atmospheric variables and fine particulate matter concentration over the 10 days prior to a patient visit and organ-specific lupus flares at t...

Few Serious Infections in Babies Exposed to Non-TNF-inhibitor Biologics or Tofacitinib

Nov 18th, 2019 - NEW YORK (Reuters Health) - Children born to mothers with chronic inflammatory diseases who took non-tumor-necrosis-factor inhibitor (TNFi) biologics or tofacitinib while pregnant appear to be at low risk of developing serious infections, a new analysis suggests. "Our findings help to address the important knowledge gap in biologic and small-molecule drug safety in pregnancy and our data are re...

Personal Goals Crucial in Virtual Reality Physical Training

Nov 18th, 2019 - ATLANTA — Virtual reality can help patients with movement issues, but only if it is done correctly and tailored to individual patients, said Robert Ferguson, a neurorehabilitation clinical specialist who focuses on such therapy. Clinicians "are reading the research and they are applying it wrong," he explained. "The evidence suggests that it's not about the virtual reality, it's about how you u...

Biologic DMARDs appear as effective in elderly-onset RA as in young-onset RA
Sharon Worcester

Nov 18th, 2019 - ATLANTA – Elderly-onset and young-onset rheumatoid arthritis patients initiating treatment with biologic disease-modifying antirheumatic drugs (bDMARDs) respond similarly with respect to clinical improvement at 48 weeks and adverse events, data from a large registry in Japan suggest. Sharon Worcester/MDedge News Dr.

Arthritis Risk Underestimated in Children With Down Syndrome

Nov 17th, 2019 - The prevalence of arthritis in children with Down syndrome is at least two times greater than previously reported, findings from a new study suggest, but the diagnosis is often missed or significantly delayed. There are several reasons for this, including a lack of awareness on the part of clinicians and parents that children with Down syndrome can be at high risk for what's known as arthropath...

The 'Silver Lining' of the Opioid Crisis: More Pain Research

Nov 17th, 2019 - Congress has appropriated almost a billion dollars in 2018 and 2019 so that the National Institutes of Health (NIH) can address the opioid epidemic. About half of that money is to address pain management, reported Charles Helmick, MD, who works on the NIH Helping to End Addiction Long-term (HEAL) initiative, which supports research into pain. "Reducing prescribed opioids means addressing arthri...

PREVENT trial shows benefits of secukinumab for nonradiographic axSpA
Jeff Craven

Nov 15th, 2019 - ATLANTA – Patients with nonradiographic axial spondyloarthritis who received secukinumab with or without loading doses showed improvements in physical function, quality of life, inflammation, and other disease signs and symptoms, according to results from a phase 3 study presented at the annual meeting of the American College of Rheumatology. Jeff Craven/MDedge News Dr.

New Guidelines Underway for Gout and Vasculitis

Nov 14th, 2019 - ATLANTA — A first look at new guidelines for the treatment of gout was presented here at the American College of Rheumatology (ACR) 2019 Annual Meeting. A key update is to use a treat-to-target strategy with urate-lowering therapy for all patients with gout. The draft guidelines recommend starting patients on a low-dose urate-lowering medication, then increasing the dose to reach and maintain a...

How Old Outcome Surveys Let Young Patients Down

Nov 14th, 2019 - ATLANTA — Young adults with chronic illnesses are not being asked the right questions on surveys of patient-reported outcome measures, warns an international focus group. Younger adults saw the outcomes on daily functioning as outdated, said Erika Mosor, MSc, from the Center for Medical Statistics, Informatics, and Intelligent Systems at the Medical University of Vienna, who is president-elect ...

Marked increase in psoriasis seen with TNFi use in pediatric inflammatory diseases
M. Alexander Otto

Nov 13th, 2019 - ATLANTA – Tumor necrosis factor inhibitors almost quadrupled the risk of psoriasis in children with inflammatory bowel disease, juvenile idiopathic arthritis, or chronic nonbacterial osteomyelitis in a review of 4,111 patients at the Children’s Hospital of Philadelphia. Dr.

Cost-effectiveness of Duloxetine for Knee OA Patients Whose Pain Can’t Be Controlled by NSAIDs
James Sullivan, Jeffrey Katz 2 and Elena Losina, Brigham and Women's Hospital et. al.

Nov 13th, 2019 - Background/Purpose: Knee OA is a disabling condition affecting over 14 million adults in the US. NSAIDs provide only short-term pain relief, creating the need for additional pain management. Growing evidence indicates that chronic knee OA pain is associated with centralized pain pathways. Based on these considerations, ACR and OARSI recommend or conditionally recommend the use of duloxetine. Th...

Clinical and Functional Outcomes Among Rheumatoid Arthritis Patients Switching Between JAK1-Selective Inhibitor Upadacitinib and Adalimumab Following Insufficient Response
Roy Fleischmann, Mark Genovese, Ricardo Blanco et. al.

Nov 13th, 2019 - Background/Purpose: The goal of RA treatment is to achieve clinical remission or, at minimum, low disease activity (LDA). Modification of initial csDMARD therapy with the addition of a biologic (b) DMARD, such as a tumor necrosis factor inhibitor (TNFi), or Janus Kinase inhibitor (JAKi) may be needed following an inadequate response (IR).1 Switches in mechanism of action have been advocated in ...

Cannabis Use Among Patients in a Large US Rheumatic Disease Registry
Kristin Wipfler, Teresa Simon, Patricia Katz et. al.

Nov 13th, 2019 - Background/Purpose: Legalization of cannabis use is rapidly increasing worldwide, raising the need to evaluate trends and medical implications. A systematic literature review showed inconsistent results on tolerability and safety of cannabis-based medicines for any chronic pain [1]. Additionally, little is known about the use and effectiveness of cannabis in rheumatic diseases [2]. We sought to...

Baseline Clinical and Serological Findings in Pediatric-Onset Discoid Lupus Erythematosus: Analysis of a Multicenter Retrospective Cohort Study
Nnenna Ezeh, Kevin Buhr, Cordellia Nguyen et. al.

Nov 13th, 2019 - Background/Purpose: DLE is a rare, disfiguring disorder in children. Small retrospective studies suggest 20-25% of patients progress to SLE. Progression risk factors are poorly understood, but DLE has been associated with delay in SLE diagnosis and reduced access to care. This multicenter retrospective cohort study aimed to describe baseline characteristics and clinical phenotypes of pediatric ...

Model-based Cost-Effectiveness Analyses Comparing Combinations of Urate Lowering Therapy and Anti-Inflammatory Treatment in Newly Diagnosed Gout Patients
Celine van de Laar, Martijn A.H. Oude Voshaar, Carly Janssen et. al.

Nov 13th, 2019 - Background/Purpose: To assess the cost-effectiveness of various combinations of urate lowering therapy (ULT) and anti-inflammatory treatment in the management of newly diagnosed gout patients, from the Dutch societal perspective.  Methods: The Anakinra versus Treatment as usual in the Treatment of ACute Gout (ATTACG) study was the  primary data source for  this study.  Since only patients with ...