The Evidence Based Rheumatology Podcast

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.    Paper: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.70134 Newsletter: http://autoimmunedevreport.com/  

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/  

Good RCT this week, investigating the CD20 B cell inhibitor obinutuzumab for SLE. Sign up for my newsletter if you would like to have a read-along companion piece!    Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2516150 Landing Page: https://ebrheum.com/ Substack: https://autoimmunedevreport.substack.com/

Quick podcast this week about a nifty head to head study that I had previously missed. Worth reading if - like me - you're still trying to figure out how the heck to manage osteoporosis.  Paper: https://pubmed.ncbi.nlm.nih.gov/28755782/

Today I cover the recent publication of the RESET-RA study, which evaluated vagal nerve stimulation to treat rheumatoid arthritis. Have a listen in full, but let me be clear upfront: I do not think this works and will not be referring any patients to receive it. This will forever be my pivotal example of the effect of unblinding, but would love to hear if you think different!    Paper: https://www...

Surprisingly (unbelievably?) impressive RCT evaluating the Blys/APRIL inhibitor "telitacicept" for patients with SLE (mixed SLE and SLE-LN). Very curious to see where the FDA goes with this one.    Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2414719

Ever wonder how often you really need to check "monitoring" labs? If so then this is the podcast for you! Bryant England mentioned this during his excellent Year in Review session at ACR Convergence 2025. I've been meaning to cover it and finally got around to doing so. Have a listen and share with friends!   Paper: https://pubmed.ncbi.nlm.nih.gov/40854212/

Covering a very interesting study this week, which investiaged the PDE4B inhibitor nerandomilast for patients with progressive pulmonary fibrosis (specifically including 325 patients with autoimmune ILD). Would have been yet another ho hum trial if not for the big reveal... have a listen to find out! Article: https://www.nejm.org/doi/full/10.1056/NEJMoa2503643  

Another episode looking into safety this week! Tackling that pesky issue of TNFs and CHF. Be sure to subscribe to my newsletter and check out the papers below!    Newsletter: https://sprw.io/stt-ee87b4 ATTACH: https://pubmed.ncbi.nlm.nih.gov/12796126/ RENEWAL: https://www.ahajournals.org/doi/10.1161/01.cir.0000124490.27666.b2 Observational Studies: https://pubmed.ncbi.nlm.nih.gov/23155221/  

Covering an interesting but ultimately disappointing post hoc study of multiple upadacitinib trials in RA. Initially some hope for clarity in the "Do JAKs cause all the badness?" questions, but ultimately landing me about where I have been since ORAL-SURVEILLANCE was published Paper: https://www.sciencedirect.com/science/article/pii/S0003496724423091  

Interesting read this week - I cover a nifty little paper that presented data about adrenal insufficiency after stopping prednisolone, published in JAMA Open in March 2025.     Open Access Journal Here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831668

Interesting NEJM trial this week comparing methotrexate to prednisone for pulmonary sarcoidosis. Paper available here: https://www.nejm.org/doi/full/10.1056/NEJMoa2501443 

Podcast this week about the recently published SELECT-GCA study, which evaluated the use of the janus kinase inhibitor upadacitinib (Rinvoq) for patients with new and relapsing GCA. Successful trial and an interesting topic. Paper itself here: https://www.nejm.org/doi/full/10.1056/NEJMoa2413449

This week I cover another of my newsletters, though I mostly use it as a skeleton to riff on a common (and challenging) issue for rheumatology consultants; diagnosing HLH. Check out the guidelines themselves here and have a listen to the podcast!    https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00273-4/fulltext

Another day, another b cell podcast. Seems to be all the rage! This week I discuss the recently published NEJM trial of the anti CD20 agent obinutuzumab in lupus nephritis. Worth a read and listen, paper can be found here: https://www.nejm.org/doi/full/10.1056/NEJMoa2410965

What do you do when observational data and RCTs conflict? This week I'm covering the "real world PEXIVAS" study that was done by the French Vasculitis Study Group. Great read, interesting issues, have a listen and be sure to share with friends! 

One of my rare case-report podcasts, a topic that I typically avoid. The craze about CAR-T has also made me a little crazy, though, so I wanted to share what I think may be the ultimate destination for "more B cell depletion than rituximab" strategies.    Article: https://www.nejm.org/doi/full/10.1056/NEJMc2407150

Podcast this week about overdiagnosis! Currently one of my favorite topics and something that I think will be an emerging issue in our field. We recently published a Viewpoint in Lancet Rheumatology ( https://pubmed.ncbi.nlm.nih.gov/39341221/ ) addressing this issue. I'm going to read from it and after that will be giving a few final (spicy) thoughts on the topic. Hope you find it worthwhile! s

New RCT in a new disease with a new drug! But is it as shiny as one would hope? Interesting discussion today about what a trial means, how it will affect practice, and how we could do better as a field. Happy holidays everyone! 

Reading one of my recent newsletters this week, this one about PMR tapers. Be sure to subscribe at ebrheum.com if you want access to the visuals and upcoming editions!   

Quick rundown of an important rheumatology RCT this week, discussing the IL-5 inhibitor benralizumab for the treatment of relapsing/refractory EGPA.    MANDARA Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2311155

Important methodology podcast this week, covering a lot of ground with expert epidemiologist Rishi Desai. Really enjoyed our conversation and glad to be publishing today!  **House Keeping Note: we actually recorded this ~15 months ago but I somehow lost the audio... which somehow re-appeared! #technology  STAR-RA: https://pubmed.ncbi.nlm.nih.gov/35027405/  

Exciting podcast this week about the upcoming / impending use of CAR-T in rheumatology. Highly recommend rheumatologists learn about this now; it's going to be a big thing for many years to come. In a future episode I will lay out my case for skepticism, but for now I think a good run down of the first big published series will be enough!    NEJM CAR-T Case Series: https://www.nejm.org/doi/full/10...