What Are the Therapeutic Alternatives When a Janus Kinase Inhibitor Fails to Work? SAN DIEGO—Treatment alternatives after Janus kinase (JAK) inhibitor failure in real-life conditions were analyzed and presented at ACR Convergence 2023 by Pablo Francisco Muñoz Martínez, a rheumatologist at the Hospital Universitario y Politécnico La Fe, Sagunto, Spain.1 JAK inhibitors are newer, targeted…
Study Probes Corticosteroid Dependence in Polymyalgia Rheumatica
Background/Purpose Polymyalgia rheumatica (PMR) treatment is primarily based on long-term corticosteroids, which results in significant toxicities. Studies have shown that patients with PMR are exposed to years of corticosteroid treatment.1,2 In a single academic center cohort, we found that 76% of patients remained on steroids at the end of two years.3 In a second cohort…
How Prevalent Is Subclinical Giant Cell Arteritis in Polymyalgia Rheumatica?
Background/Purpose It has been reported that 20–50% of patients with polymyalgia rheumatica (PMR) have subclinical giant cell arteritis (GCA). The natural history of ultrasound-defined subclinical GCA in PMR is not known. Methods Twenty-five newly diagnosed PMR patients who met a clinical diagnosis for PMR, verified by two rheumatologists, were examined by ultrasound. All six branches…
Study: Patients with PMR Experience Fatigue, Sleep Disturbance & Mood Disorders
Background/Purpose Polymyalgia rheumatica (PMR) is typified by pain and stiffness of the shoulder and hip girdles. Previous qualitative studies have highlighted the importance to patients of additional symptoms, including fatigue and sleep disturbance. These features of PMR are less recognized by clinicians and have not yet been quantified in the literature. Further, the adequacy of…
Long-Term Voclosporin Treatment Looks Promising for Lupus Nephritis Patients
AURORA 2, a double-blind, phase 3 study, evaluated the long-term safety, tolerability and efficacy of voclosporin compared to placebo in patients with lupus nephritis receiving an additional two years of treatment following completion of the one-year AURORA 1 study. Patients enrolled in AURORA 2 continued to receive the same treatment randomly assigned in AURORA 1, in combination with mycophenolate mofetil and low-dose glucocorticoids. Saxena et al. propose that the rapid renal response achieved with voclosporin treatment has long-term benefits, supported by stable kidney function over the three-year treatment period.
Pharmacokinetic Modeling & Efficacy Extrapolation: FDA Takes New Approaches to Drug Approvals
An array of new and expanded indications of therapeutics for rheumatic disease last year relied on pharmacokinetic modeling for intravenous dosing and efficacy extrapolation for pediatric populations.
Pregnancy Outcomes in Patients Treated with TNF Inhibitors
A study found the continuation of tumor necrosis factor inhibitor (TNFi) treatment in patients with chronic rheumatic inflammatory diseases after pregnancy diagnosis was not associated with worse outcomes than those who discontinued treatment with TNFi’s.
Insight into the FDA Approval of Ustekinumab Biosimilar
In late October, the FDA approved the first biosimilar to ustekinumab to treat patients with psoriasis, psoriatic arthritis and other conditions. Ustekinumab-auub is expected to be available in the U.S. by 2025.
Clinical Year in Review: 2023
SAN DIEGO—At ACR Convergence 2023, Philip Seo, MD, MHS, presented an overview of clinical updates in rheumatology from the past year.
Risks of Severe HCQ Non-Adherence
Lower HCQ Serum Levels Associated with SLE Flare, Damage & Mortality Background & Objectives: Nguyen et al. set out to assess the consequences of severe non-adherence to hydroxychloroquine (HCQ) by measuring hydroxychloroquine serum levels, risks of systemic lupus erythematosus (SLE) flares, damage and mortality over five years of follow-up. Methods: The Systemic Lupus Erythematosus International…
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