Rheumnow Podcast

Individualized PsA Treatment With an IL-23i or a JAKi In Part 2 of our series on managing the complexities of PsA, Saakshi Khattri, MD, and Lindsay Tom, PA-C, discuss their experience individualizing treatment for real patients with multidomain PsA and the IL-23i and JAKi data that informed their decisions. Sponsored by AbbVie Medical Affairs + Health Impact. https://rheumnow.com/therapeutic-update/individualized-psa-treatment-il-23i-and-jaki
After posting, if you could log into spodity studio, and turn off transcripts, comments, and chapters, that would be great. If you don't have time to do this, let me know and I can log in and do it after you post. I'm not sure how quickly those features populate after you post to podbean.

Every day, every month, rheumatology publishes news and reports on JAK inhibitors, IL-17s, IL-23s, lupus, myositis, and scleroderma – all which could change how you practice dermatology. I'm Jack Cush from RheumNow, and This is Derm on RheumNow.

This month’s podcast will Scratch the surface and find new drugs for dermographism, Hidradenitis, SLE, DLE & PsA. Probiotics loseout to placebo in PsA and Obesity sinks psoriasis biologics.
This month:
- The FDA is reviewing Sun Pharma’s tildrakizumab (Ilumya), an IL-23 inhibitor, for use in active psoriatic arthritis, with an October 29, 2026, action (PDUFA) date. Decisions to be based on PsA INSPIRE-1 and INSPIRE-2 Phase 3 Studies https://t.co/iDWhub0k91
- FDA has approved the IL-23 inhibitor tildrakizumab (Ilumya) use in adults with active psoriatic arthritis (PsA), expanding the interleukin indications beyond moderate-to-severe plaque psoriasis. (Based on INSPIRE-1/2; 800 adults, 52-week RCTs) https://buff.ly/xz2D3mc
- FDA has approved rembrutinib (Rhapsido - BTK inhibitor from Novartis) as 1st Rx for adults with dermographism not controlled by H1 antihistamines (expanding its use beyond chronic spontaneous urticaria) https://buff.ly/xNfuSlh
- Novartis announced that the European Commission has approved secukinumab (Cosentyx) for use in adults w/ polymyalgia rheumatica, not responding to GCs. SEC is 1st IL-17A inhibitor approved in Europe for PMR https://t.co/ASTwbSrGr2
- Merck MSD announced positive results w/ tulisokibart (anti-TL1A) in MK-7240-012, Phase 2b DBRPCT in mod-severe hidradenitis suppurativa. Wk 16 HiSCR50 responses were 72% (hi dose), 64% (mid dose), 52% (low dose) vs 35% PBO. https://t.co/cvBH0fvCnI https://t.co/jo7JaXMItZ
- Biogen announced the 52-week OL results of AMETHYST Phase 2/3 RCT of litifilimab in 93 #CLE pts. Betw wk 24 & 52, pts improved w/ clear skin (27.2%; CLA IGA 0-1) & 29% CLASI-70 (dz activity) https://t.co/61zxVhUwuj
- EADV abstract showed daxdilimab (anti-ILT7; on plasmacytoid dendritic cells) was effective in mod-severe discoid lupus. Ph II RCT 72 refract. DLE RCT; DAX vs PBO - ↓ CLASI-A vs placebo @24 wks. wk 4 50%+ CLASI-A ~62% vs 24% https://t.co/gJ4drxErGD
- Italian retrospective study of 562 plaque psoriasis Rx w/ biologics - 34% were obese. Primary Rx failure signif. more w/ obesity (17% vs 6%; HR 2.75). A 5 kg/m2 BMI incr assoc w/ 37% higher risk. Lower risk of failure w/ IL-17i (HR 0.49) & IL-23i (HR 0.47). Obesity not assoc w/ secondary failures or safety D/Cs https://t.co/fUik6pBcnq
- Tx persistence & response in PsA is a problem - influenced by demographics & Dz severity. 815 PsA pts in e Brit Society Rheumatology PsA Registe. @12 mos - 24% MDA, 24% ACR50. Median F/U 31 mos, only 65% still on index Rx. D/C higher w/ apremilast & w/ poorer baseline activity & PROs https://buff.ly/ZTZueX8
- Single center study of Probiotics in #PsA showed no benefit. 66 moderately active PsA pts (PASDAS 3.2+) on stable Tx: Rx probiotic vs PBO x 12 wks. 56 pts analyzed, PASDAS 3 responders: 43% probiotic vs 65% PBO (P 0.167), w/ no change in gut permeability markers or stool https://t.co/g6icpjuQOU
- 92 early (~2 yrs) systemic sclerosis pts were treated with #MTX; 79% diffuse SSc. At 3 mos, 34% of dcSSc 25% reduction in mRSS - increasing to 62% 24 mos (29% at 24 mos ITT w/ non-responder imputation). GC did not improve skin. Dz progression seen w/ 75% of MTX monoTx D/C https://t.co/WvqyI8GKjT
- Metanalysis of IVIG in scleroderma (11 studies, 363 pts) showed IVIG to be safe; signif improvement in skin by mRSS (SMD −0.59; p 0.0019) & GI Dz (SMD −0.73; p 0.0012; I2 = 0%). W/ inflam myopathy signif reduction in CK (SMD −0.53; p 0.001) https://t.co/h53FrACCgA https://t.co/qavoD3Vren
- High TB & LTBI burden in Latin America. Review of PANLAR registry 590 IMID pts (54% GC, 44% bDMARDs (TNFi), 29% JAKi, 27% csDMARD). Only 430 (73%) had TB screening- 59 (14%) Dx w/ LTBI. @12 mos, 99 repeat TB screening - 5 new LTBI cases Dx. Only 2 (0.34%) had active TB. (CDC https://t.co/wnPdEueb4N

Dr. Cush reviews the news and journal reports from this past week on RheumNow. This week on the podcast – hopeful guidelines for PMR, certainty about good & bad beverages in gout; Mixed results in Sjogrens, non Lupus drugs saves Lupus lives and big hips sinks ships in Psoriatic arthritis.

Listen to leading rheumatology and dermatology experts for an engaging discussion on the evolving landscape of Cutaneous Lupus Erythematosus (CLE) and Systemic Lupus Erythematosus (SLE).

Drawing on recent RheumNow survey findings, our expert panel explores real-world challenges in lupus assessment and management, clinical decision-making, disease activity evaluation, current treatment strategies, and emerging therapeutic approaches. Gain valuable perspectives on advances in lupus care, persistent unmet needs, and opportunities to improve patient outcomes.

Expert Panelists:

Victoria P. Werth, MD

Joseph F. Merola, MD

Maria Dall'Era, MD

Moderator: Jack Cush, MD

Sponsored by Biogen.

Dr. Jack Cush reviews the journal articles and regulatory announcements from this past week on RheumNow, including: two crystals in one joint; twice the cryptococcus risk in JAKs?; Myositis and Scleroderma; and a Sjögren’s patient with early damage has a greater than 2-fold risk of lymphoma. Double trouble week on the RheumNow podcast.

Dr. Jack Cush reviews this weeks news from RheumNow.com -- including placebo trumps controversial therapies, the dynamics of disease activity, fuze the big toe, and patients don’t appreciate being told “its all in your head”!

On this weeks podcast Dr. Jack Cush reviews the news - Steroids are easy to start and hard to stop; hold the MTX but not the biologic or JAK, weighing in on avacopan, and age old messages for old age patients.

Dr. Saakshi Khattri hosts dermatologist Dr. Ahmad Amin and gastroenterologist Dr. Joshua Steinberg to discuss multidisciplinary care in PsA and other immune-mediated inflammatory diseases. Learn how signals in the skin and gut may prompt the need for collaboration across specialties to support better patient outcomes that extend beyond the joints. Sponsored by AbbVie Medical Affairs + Health Impact. https://rheumnow.com/therapeutic-update/psa-beyond-joints-rheum-derm-and-gastro-perspectives

Dr, Jack Cush reviews the news and journal articles from the past week on RheumNow.com

Dr. Lourdes Perez-Chada Sleep and Obesity: The Role of Sleep in Weight Management: https://youtu.be/3gcJtb5gjI4
Dr. Alexis Ogdie & Dr. Anastassia Amaro Physician Perspective: Talking to Patients Regarding Obesity: https://youtu.be/6-EVOTiUKio

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

In this webinar, experts discuss the rapidly evolving landscape of obesity treatment, from lifestyle interventions and bariatric surgery to the latest incretin-based therapies and emerging approaches to precision management. Faculty will share practical guidance on selecting appropriate treatments, optimizing GLP-1/GIP therapy, navigating safety, cost and compounding concerns, and providing comprehensive care that considers issues such as sarcopenia and bone health. Speakers: Dr. Juliana Simonetti Dr. Grace Wright Dr. Jack Cush (moderator) Dr. Philip Mease

Dr. Jack Cush 'Introducing Weightloss': https://youtu.be/-CDsmyaCVJQ
Dr. Derin Karacabeyli 'Building A Multidisciplinary Program for Obesity and Arthritis Management': https://youtu.be/42Ac1xmXn4k

Dr Juliana Simonetti 7 Dr. Philip Mease 'What Are the Four Pillars of Obesity Management?': https://youtu.be/TwhlkRtsjtA

Dr. Richard Conway Bariatric Surgery 'Curing' Arthritis?: https://youtu.be/W2-0RkyGqcc
Dr. David Liew Managing Muscle and Fat Loss with GLP-1s: https://youtu.be/fLCDLuJGyPA
Daric Mueller (PA-C) GLP-1s and History of Thyroid Cancer?:https://youtu.be/H_UlthPGN6Y
Dr. Bella Mehta How Weight Loss Changes the Course of Knee Osteoarthritis: https://youtu.be/Jg0hflvIMEo

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