Rheumnow Podcast

The Derm on RheumNow podcast is a review of recent citations and content curated for dermatologists – addressing Psoriasis, PsA, CLE, calcinosis, CTD skin disorders. dermatology drugs, biologics, and JAK inhibitors.

Features Dr. Jack Cush, Editor at RheumNow.com.

Show Notes:

FDA Grants Priority Review to Zasocitinib for Plaque Psoriasis. Regulatory decision expected 1st quarter 2027. Supported by phase 3 RCTs, 3000 pts -- LATITUDE PsO 3001 and 3002 clinical trials. https://t.co/o7oqxSXHSw

Systematic review of 290 psoriasis pregnancies 211 live births (73%) finds biologic exposure (UST 241, 42 TNFi) during PREG assoc w/ favorable maternal/fetal outcomes. Only 24 cont either CZP or ADA throughout PREG. Rates of miscarriage, LBW, congenital anomalies, comparable w/ https://t.co/H5GLrvxwPv

SELECT-PsA 2 subanalysis of 195 active PsA not responding to TNFi shows switching to upadacitinib 15 (vs PBO) was superior @wk 24 - ACR20 (58% vs 22%), ACR50 (38% vs 9.5%), ACR70 (22% vs 0%), MDA (24% vs 3%) & maintained thru wk 152. Switching MOAs makes sense! https://t.co/YEkZuQ95Mu

Do biologic Rx lower risk of PsA? Metanalysis (15 studies, 124,138 psoriasis pts, 778K PYrs F/U), showed Biologic use assoc w/ lower risk of PsA (HR 0.54); best for IL-17i (0.65) & IL-12/23 or IL-23i (0.46) vs TNFi. IL-23i superior to IL-17i (HR 0.67) https://buff.ly/N4froBW

OL study of tofacitinib in 20 juvenile DM pts w/ calcinosis cutis (11 boys; age 10.4 yrs; CC x 31 mos). Calcinosis assessed by CT scan showed decr Agatston score from 6,349 to 4,007. No SAE. https://t.co/UDLLwce3mp

Metanalysis of Metabolic syndrome (MetS) in #SLE (65 articles, 11K pts). MetS prevalence 27% (higher in males (36 vs 27%). HCQ assoc w/ signif less MetS (OR 0.66), but more w/ CTX (1.39), AZA (1.25), MMF (1.13), but not steroids or MTX. MetS pts were older, obese, w/ high Chol & LDL https://buff.ly/VQNvSI9

TriNetX retrospective EHR study showed VTE in #RA not incr by taking JAKi. Pts undergoing THA/TKA Rx w/ JAKi (n 284) vs TNFi (n 288). VTE- 17 JAKi (6%) vs 11 TNFi (3.8%)- nonsignif incr (RR 1.57) https://t.co/OM5ipieQtr

In 2022, Overweight & obesity affect 65.8% of Swiss PsA pts (vs gen pop.= 43%) and has increased since 2007. Obesity was assoc w/ elevated CRP (56% vs 37%), Inc Pt global assess (3.2 vs 2.8), & MD global (2.5 vs 2.1) & lower EQ-5D-3L(0.7 vs 0.8). https://t.co/xPoy4dgvlD

Study of 119 Rheum pts on GLP-1 Rx (65% T2DM, 35% obesity; mean BMI 35). @ 12 mos wt loss −7.7 kg & 56% improved 1 BMI category. Signif decr in A1c, FBS, lipids, LDL, TG, ESR & CRP. GLP-1RAs useful cardiometabolic benefits https://t.co/fdNtvGu8Vb~

Estimated 7 million Americans (~1/3 US GLP1 Rxs) get GLP-1 drugs from online compounding source- but these are not FDA approved. They maybe cheaper, but dosing/quality is suspect. FDA needs to close the 503B loophole to outlaw these copycat Rxs https://buff.ly/xezDWaJ

Data presented at 2027 ASMBS meeting showed betw 2020-2024, wt loss surgeries dropped 23%, from 230,000 in 2022 to 177,000 in 2024. Less than 1% of eligible pts are now having weight-loss surgery https://t.co/UnYIIBDdnz

Together PsA 52 wk data (n 271): ACR50 plus 10% wt loss - 39.2% w/ Taltz & Zepbound vs 1.7% w/ Taltz alone. Together PsO trial results (n 274): PASI100 plus 10% wt loss - 30.6% w/ Taltz & Zepbound vs 4.4% w/ Taltz alone. https://t.co/27TBZyL8l1

FDA Approves Brepocitinib to Treat Dermatomyositis

Necrotizing arteritis is rare w/ IgA Vasculitis (IgAV). Review compared 30 IgAV-NA to 257 adult IgAV & 196 PAN pts. Overall IgAV-NA is a severe IgAV phenotype with life-threatening complications & should prompt vascular imaging and intensified immunosuppression. IgAV-NA had more more GI bleeds, perforation, surgical abdomen, neuropathy, pancreatitis, livedo, more multi-organ involvement and mortality https://t.co/XdPbGX770D

In the final webinar in this series, we move beyond the medication to explore what comprehensive obesity care can look like in rheumatology practice. Experts will discuss practical approaches to patient conversations, lifestyle support and referrals, overcoming weight bias and barriers to care, and building a sustainable care model that leverages the broader healthcare team, technology, and current clinical guidelines.
Speakers: Dr. Alvin Wells Dr. Alexis Ogdie Stacie Ireland, NP Dr. Guada Respicio Dr. Jack Cush

Dr. Catherine Bakewell 'Pharmacologic Treatment of Obesity': https://youtu.be/K8o0ZnqySZA
Dr. Larissa McGarrity 'Psychology of Health Behavior Change in Obesity': https://youtu.be/v-rGrpjqh24
Dr. Elena Philippou 'Nutrition, Weight Management and Rheumatic Disease': https://youtu.be/2EOpgsS-EfA

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

Daric Mueller (PA-C) RA, IBD and Frank's Sign: https://youtu.be/guRvytT9NW4
Dr. Bella Mehta Weight Loss Changed the Course of Rheumatoid Arthritis: https://youtu.be/hD-BydV8HYE
Dr. Eric Dein Treat to Target Obesity: https://youtu.be/zoohn5XfES4