Rheumnow Podcast

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”!