JAK1: Number one in the family; number one in inflammation?
AbstractSeveral cytokines involved in inflammatory pathologies signal via the Janus kinase-signal transducer and activator of transcription pathway. Four JAKs are known: JAK1, JAK2, JAK3 and TYK2. The specific activation of JAKs and STATs determines the biological effects of each cytokine. JAK1 is involved in the signalling of ‘γc’ receptor cytokines (IL-2, IL-4, IL-7, IL-9, IL-15 and IL-21), pro-inflammatory cytokines including IL-6, as well as IFN. The critical position of JAK1 downstream of these cytokines suggests that JAK1-selective inhibitors are comparable to non-selective ones, without the unwanted consequenc ...
Source: Rheumatology - May 5, 2021 Category: Rheumatology Source Type: research
The safety of JAK-1 inhibitors
AbstractAs efficacy and safety data emerge, differences between JAK inhibitor subclasses are appearing. JAK1 selective drugs, upadacitinib and filgotinib, have broadly come with the same overarching safety recommendations as other immunosuppressive drugs for RA: caution is needed regarding infection risk; monitoring for laboratory abnormalities, including lipids and muscle enzymes, is indicated. A distinguishing feature of JAK inhibitors is a risk for zoster reactivation. Numerically, overall rates of serious infection are similar among JAK inhibitor classes. There are currently no signals for diverticular perforation. VTE...
Source: Rheumatology - May 5, 2021 Category: Rheumatology Source Type: research
Clinical use of Jak 1 inhibitors for rheumatoid arthritis
This article will review the clinical significance of evidence on: (i) Jak 1 selectivity; (ii) efficacy from the SELECT and FINCH clinical trial programmes including patient intolerant or inadequately responding to MTX (MTX-IR) and other csDMARDs patients who are bDMARD-IR) and those using monotherapy when MTX is not tolerated or contraindicated and those treated when methotrexate naive; and (iii) safety from the clinical trial programmes of these two agents will be discussed. (Source: Rheumatology)
Source: Rheumatology - May 5, 2021 Category: Rheumatology Source Type: research
A systematic review and meta-analysis of the incidence rate of Takayasu arteritis
ConclusionsTAK is an extremely rare disease. It affects women more commonly than men. There is considerable variation in the incidence rate between populations. We suggest that future research should focus on discrete populations in order to better identify genetic and environmental risk factors. (Source: Rheumatology)
Source: Rheumatology - May 4, 2021 Category: Rheumatology Source Type: research
A patient with acute-onset hemorrhagic necroses and bullae of the legs
A 30-year-old woman presented with sudden onset of large irregular shaped confluent hemorrhagic necroses, ecchymoses and bullae affecting both legs (Fig. 1A). Physical examination was otherwise unremarkable apart from a malar rash. Laboratory evaluation disclosed a high C-reactive protein level, thrombocytopenia, prolonged thrombin time and International Normalized Ratio, normal fibrinogen, elevated D-dimer levels and hypocomplementemia. Four years earlier, SLE had been diagnosed in the presence of malar rash, autoimmune hemolytic anaemia, hypocomplementemia and high-titer antinuclear and anti-dsDNA antibodies [1]. Antipho...
Source: Rheumatology - May 3, 2021 Category: Rheumatology Source Type: research
Efficacy of subcutaneous tocilizumab in a patient with severe gout refractory to anakinra
Dear Editor, Gout is a urate-related disease characterized by joint inflammation and severe pain. Without prompt treatment, it can lead to joint sequelae and severe systemic repercussions. Deposits can be dissolved with urate-lowering therapies such as allopurinol, febuxostat and lesinurad. During the initial months, prophylaxis for attacks (such as colchicine, NSAIDs and CSs) should be added. Nevertheless, some patients continue to develop flares, despite this regimen. In such cases, inflammation can be fought by blocking IL-1 with anakinra [1]. However, not all patients respond equally, and some may be refractory or anak...
Source: Rheumatology - May 2, 2021 Category: Rheumatology Source Type: research
Comprehensive microRNA and transcriptomic profiling of rheumatoid arthritis monocytes: role of microRNA-146b in pro-inflammatory progression
ConclusionsOverall, in this study we have identified a new miRNA-146b candidate that is predicted to negatively regulate the anti-inflammatory RARA transcript, whereas circulating miRNA-146b level can be used as a biomarker predicting pro-inflammatory RA progression and disease activity. (Source: Rheumatology)
Source: Rheumatology - May 2, 2021 Category: Rheumatology Source Type: research
UNC13D mutation in a patient with juvenile polymyositis with recurrent macrophage activation syndrome
National Natural Science Foundation of China10.13039/50110000180981701627 (Source: Rheumatology)
Source: Rheumatology - April 30, 2021 Category: Rheumatology Source Type: research
VEXAS syndrome in a woman
Rheumatology key messageAs well as men, women with VEXAS-compatible features should be screened for mutations ofUBA1. (Source: Rheumatology)
Source: Rheumatology - April 30, 2021 Category: Rheumatology Source Type: research
Successful treatment of penile Mondor ’s disease with infliximab in a patient with Behçet’s disease
Dear Editor, Superficial penile thrombophlebitis or penile Mondor ’s disease is a rare condition that can be seen due to aetiologies including diseases with vascular damage other than Behçet’s disease (BD). We herein present a patient with BD who was admitted to our clinic with penile Mondor’s disease and treated successfully with infliximab and anticoagula tion.Rheumatology key messagePenile Mondor ’s disease can be presented as a rare vascular complication of Behçet’s disease.A 37-year-old male was referred to our clinic from the department of urology due to painful penile erection. He denied recent vigorous ...
Source: Rheumatology - April 28, 2021 Category: Rheumatology Source Type: research
P077 Upskilling rheumatology therapists in work rehabilitation: an evaluation of the Workwell training programme
Conclusion The 2-day VR course, plus 2 days self-study, led to significant improvements in knowledge and confidence in delivering VR amongst attending OTs. Work is a key component of OT. This training course could help expand work services in Rheumatology to keep patients working.Disclosure A. Hammond: None.S. Woodbridge: None.R. O'Brien: None.A. Ching: None.J. Parker: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P076 Adherence to COVID-19 risk stratification during the peak of pandemic: a District General Hospital experience
Conclusion Although uptake of postal communication was high in this study, it was difficult to establish how rapidly the guidance was delivered. We realise the need to employ better ways of communicating with the patients. Innovative ways such as text messaging and social media have an important role in the delivery of a rapid mass communication during the pandemic. It was reassuring to note that only a very small number of patients had COVID-19 among the patients who followed the government advice to either shield or isolate. But, it would be interesting to see whether the incidence of COVID-19 cases rise since rheumato...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P075 Evaluation of the impact of the COVID-19 pandemic on patients with rheumatic diseases in the UK: results from the REUMAVID study
Conclusion The REUMAVID study has allowed us to measure and quantify the experience of British patients with rheumatic disease during an unprecedented public health crisis. A reduction in healthcare access, concern about treatment, changes in daily life habits and worsening of well-being and mental health w ere reported during the first wave. Patient organisations were the main source of COVID-19-related information. Further data will be gathered during the second wave.Disclosure M. Garrido-Cumbrera: None.V. Navarro-Comp án: Honoraria; Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB.D. Webb: Grants/research supp...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P052 Leflunomide and severe COVID-19 outcome: a cautionary observation from the COVID-19 Scottish Registry of Autoimmune Rheumatic Diseases (SCAR-19)
Conclusion Preliminary data from this Scotland-wide registry has identified only a small number of leflunomide treated ARD patients infected with COVID-19. However, it is concerning that all cases experienced a serious outcome. Given the relatively infrequent prescription of this drug, combining similar nat ional registry data is necessary to ensure this observation is not spurious. If confirmed, leflunomide washout procedures should be encouraged among such patients when they first present with COVID-19.Disclosure M. Karabayas: None.J. Brock: None.G. Fordyce: None.N. Basu: None. (Source: Rheumatology)
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
P051 Symptoms of COVID-19 and anxiety levels in adult patients receiving b-and ts-DMARDS using an online reporting system
Conclusion During the first peak of SARS-CoV-2, the number of patients reporting COVID-19 symptoms appeared high and was associated with high levels of anxiety. As only a small number have been swab-tested, this may suggest that larger numbers of untested individuals have had COVID-19 with mild symptoms. Fe atures of inflammatory rheumatic illnesses may mimic COVID-19 symptoms and create diagnostic difficulty (joint pain and fatigue) whilst anxiety may lead to over-reporting of symptoms in the absence of infection. The key symptoms of fever, cough and SOB were less common and may be most reliable.Disclosure M. Lwin: No...
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research
