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
