Show Notes
This week I hope to debunk one of rheumatology's "paradoxes." We love to talk about these and subject our fellows to memorizing them for the boards. We often use them to guide clinical practice, but I suspect that many "paradoxes" are actually the result of shoddy epidemiology. Todays' paper from JAMA dermatology covers one that I have heard frequently, which is that steroids cause psoriasis flares. I hope you enjoy! Follow me @ebrheum and check out my newsletter where I cover more of these (links on ebrheum.com)
More from The Evidence Based Rheumatology Podcast
A new therapy for SLE! This one is a CD40-CD40L blocker, which has some nice new-things to inhibit. The study itself was a qualified success and the podcast got a bit more rant-y than it should have been, but hopefully you get a kick out of it. Paper: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00691-4/fulltext
Another day, another B cell drug. This one adds an interesting option for IgG4-RD, offering a "maybe less efficacious maybe less toxic" pathway. I could see folks being excited for this, especially in a disease where non-scary-manifestations are relatively common. Also, check out boardsbank.com! Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2601337
Big trial this week in the NEJM investigating the IL17 inhibitor secukinumab in PMR. Well worth a read, I would bet on FDA approval in the near future. Some interesting tidbits and of course a weird safety thing we now have to grapple with. Be sure to go to boardsbank.com! Free rheumatology board review, >1000 questions! Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2602567
Really interesting study this week comparing the IL17 inhibitor ixekizumab WITH the GLP1 inhibitor tirzepatide to ixekizumab alone. Raises some interesting questions about what worked here and whether or not it matters how it worked.
Great trial this week looking at brepocitinib in dermatomyositis. Looks like a winner, expect it will be approved. Where it fits in our approach to IIM is an open question, but nice to have another option. Study: https://www.nejm.org/doi/10.1056/NEJMoa2503531 JC Companion: https://autoimmunedevreport.substack.com/