Effectiveness of newer arthritis meds

 Newer oral medications for rheumatoid arthritis (RA) do work quite well in the "real world," despite some doubts that they would, according to a new study.

The study, of 622 adults with RA, found that most were doing well on medications called JAK inhibitors, a relatively new drug class for the arthritic condition. They are taken by mouth, unlike many other RA drugs, which are given by injection or infusion.

Three JAK inhibitors—tofacitinib (Xeljanz), baricitinib (Olumiant) and upadacitinib (Rinvoq)—are approved in the United States. They are specifically for people with RA who do not get relief from, or cannot tolerate, older RA medications.

But while JAK inhibitors have proven effective in clinical trials, there have been questions about whether that would translate to the real world—where they are often given to patients whose RA has stubbornly resisted standard treatment.

The new findings—published Nov. 1 in the journal Rheumatology—may allay the concerns.

Researchers in Japan found that patients on any of four JAK inhibitors approved there generally fared well.

Overall, about one-third saw their RA go into remission within six months, and over 80% reached the goal of "low disease activity," where symptoms are largely under control.

The takeaway is straightforward, according to a U.S. rheumatologist who was not involved in the research.

"This study confirms the efficacy of JAK inhibitor therapies," said Dr. Stanley Cohen, of Rheumatology Associates in Dallas.

It also suggests the different JAK medications have an equal likelihood of working, Cohen said. No trials have compared the drugs head-to-head, he noted, but individual studies of each medication had suggested they are similarly effective.

And "real-world experiences," including the new study, confirm that, Cohen said.

RA is caused by a misguided immune system attack on the body's own joint tissue, leading to pain, swelling and stiffness in the joints. Over time, that systemic inflammation can feed problems in other areas of the body, including the heart, lungs, skin and eyes.

Numerous RA medications can slow the progression of joint damage by targeting parts of the immune response. JAK inhibitors are among them.

However, they are not considered an initial go-to for RA, Cohen said.

He pointed to a 2021 trial that raised safety concerns about JAK inhibitors for some older patients.

That study included RA patients age 50 and up who had at least one risk factor for heart disease or stroke, such as high blood pressure or diabetes. It found that those given the JAK inhibitor tofacitinib had a higher risk of heart attack, stroke and certain cancers, versus patients given a TNF blocker.

TNF blockers are older RA drugs, given by injection or infusion, which include etanercept (Enbrel) and adalimumab (Humira).

Based on those findings, the U.S. Food and Drug Administration added a boxed warning to all JAK inhibitors used for RA. The agency also recommended that doctors only prescribe a JAK inhibitor after patients have tried at least one TNF inhibitor.

For the new study, researchers led by Dr. Shinya Hayashi of Kobe University in Japan analyzed medical records from 622 RA patients treated at seven medical centers. All received any of four JAK inhibitors approved in Japan.

Researchers found that most patients—around 90%—were still taking their medication six months after starting. And most had gotten symptom relief, or even remission.

That's not the end of the story, though. Six months is a short follow-up, the researchers pointed out, and it's not clear how effective JAK inhibitors are long-term.

Besides effectiveness, people with RA have to consider a treatment's safety, too.

Cohen noted that although JAK inhibitors have been tied to some increased risks versus TNF inhibitors, the overall risks still appear "quite low."

In the trial that spurred the FDA warning, 3.4% of tofacitinib patients had a heart attack or stroke over four years, compared with 2.5% of TNF inhibitor users.

Overall, Cohen said, the risks of JAK inhibitors appear similar to those of TNF blockers and other "biologic" drugs that target the underlying immune activity driving RA.

Because they put the brakes on a portion of the immune response, all of those medications can make people more susceptible to certain infections.

Cohen said JAK inhibitors do seem to carry a higher risk of shingles, which is caused by a reactivation of the chickenpox virus (which, after a person is infected, remains dormant in the body).

But that, Cohen noted, can be countered with shingles vaccination.

The study received no outside funding. Some of Hayashi's co-researchers have received funding from drug companies that make JAK inhibitors.

More information: HealthDay has more on rheumatoid arthritis.

Shinya Hayashi et al, Real-world comparative study of the efficacy of Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study, (2023). DOI: 10.1093/rheumatology/kead543

https://medicalxpress.com/news/2023-11-effectiveness-arthritis-meds.html

Von der Leyen hails Kyiv's progress towards EU accession

 Standing next to President Volodymyr Zelenskiy, she said Ukraine had reached many milestones despite the war with Russia, highlighting Kyiv's judicial reforms.

The EU assessment, due on Wednesday, is expected to say how far Ukraine has advanced in fulfilling various economic, legal, and other criteria to clear the way for accession talks in December.

Ukraine, which applied to join the European Union days after Russia's full-scale invasion in February 2022, sees membership as a top priority.

The EU's 27 members are due at a summit in December to decide whether to allow Kyiv to begin accession negotiations, which would require unanimous backing.

https://www.marketscreener.com/news/latest/Von-der-Leyen-hails-Kyiv-s-progress-towards-EU-accession-45243645/

Election Group Slapped With RICO Says It Can Prove Trump Won Georgia In 2020

  by Samantha Flom via The Epoch Times (emphasis ours),

Former Black Voices for Trump leader Harrison Floyd’s legal team intends to prove his innocence of claims he unlawfully participated in an election subversion plot in Fulton County, Georgia, by showing that former President Donald Trump won the state’s 2020 presidential election.

Mr. Floyd was charged on Aug. 14 alongside the 45th president and 17 other co-defendants with violating Georgia’s Racketeer Influenced and Corrupt Organizations (RICO) Act, conspiracy to commit solicitation of false statements and writings, and influencing witnesses.

He was the only defendant to spend time in jail due to the indictment before he was released on bond on Aug. 30.

“Your Honor, this case isn’t about whether you or I think that Donald Trump lost the election. It’s about what Mr. Floyd believed at the time,” noted Chris Kachouroff, one of Mr. Floyd’s defense attorneys, at a Nov. 3 hearing before Judge Scott McAfee.

“It’s also [about] what the false statements are alleged to have been, and indeed, are they really false,” he said.

Opening the Door

The judge ordered the hearing in response to motions to quash three sweeping subpoenas Mr. Floyd’s legal team served to the office of Georgia Secretary of State Brad Raffensperger, the Fulton County Clerk of Courts, and the Fulton County Board of Elections.

Materials the attorneys requested included the ballot images and envelopes for all absentee ballots cast in the 2020 general election, all absentee ballot application forms, reports from the Dominion voting machines used, and all laptops and poll pads used by election workers, along with other documents, files, and drives.

Attorneys also requested all documents and recordings concerning the secretary of state’s post-election investigation into allegations of election fraud.

“The state chose to open this door,” Mr. Kachouroff said. “It is a broad and sweeping complaint. They opened the door wide open for us to walk in and ask for these things.”

The attorney noted that the 98-page indictment repeatedly asserts as fact that President Trump lost the 2020 election in Georgia, and the charges against Mr. Floyd are predicated on that claim. But if Fulton County District Attorney Fani Willis is wrong and President Trump actually won the election, then Mr. Floyd cannot be guilty of soliciting “false statements and writings” that conveyed as much.

The indictment also maintains that Mr. Floyd and the other co-defendants were aware that President Trump lost the election and that their actions constituted an unlawful conspiracy to change the results in his favor.

That assertion, Mr. Kachouroff said, would also be undermined by proof that the former president won or even just proof that the election’s outcome is uncertain. And the subpoenaed materials, he argued, are likely to contain that proof.

“We could make that argument that he’s innocent no matter what happened,” he noted. “And, of course, we would. We’re defense attorneys; that’s what we do.

“But at the end of the day, those are the possible options down the road that could arise. Right now, we believe we’re at Option 1, that President Trump indeed won the election, and we can prove it—with respect to Fulton County.”

Pushback

Mr. Raffensperger’s office, represented by Attorney Jackson Sharmon III, has argued that the broad scope of materials requested by the defense would place an “undue burden” on an entity that is not even a party in the case.

Contesting the subpoena before the judge, Mr. Sharmon said the requested documents contain “little, if anything,” relevant to Mr. Floyd’s defense.

“If the purpose is state of mind, his intent, the documents we would produce—which he didn’t know about, he didn’t have—are not going to have any effect on the determination of his intent at the time he allegedly undertook the acts that are in the indictment.”

Mr. Sharmon also challenged the defense’s argument that proving President Trump won the election would necessarily erase the possibility that Mr. Floyd had criminal intent.

“With all due respect, I don’t think that’s the case,” he said. “That’s not the way intent, in a criminal case, is adjudicated.”

Meanwhile, attorneys for Fulton County said it could take months to produce the requested materials. And in terms of relevance, they pointed to Mr. Kachouroff’s admission that he could argue his client’s innocence even without the requested materials as evidence they weren’t needed.

But for Mr. Kachouroff, the state’s arguments didn’t negate his client’s right to those materials.

“Harrison Floyd is looking at between eight and 33 years. That’s his liberty interest. Courts take liberty interest very seriously so that liberty interest overcomes any burden the state has to be set back by a month or two or three.”

By the end of the hearing, the three subpoenas were reduced to two as it was revealed that the Board of Elections did not possess any of the requested materials, which are held by the Clerk of Courts.

The judge, expressing concern over the potential disclosure of voters’ personally identifiable information, said more information was needed to determine what exactly was being requested, the extent of the state’s burden in producing it, and whether a protective order was needed.

https://www.zerohedge.com/political/election-group-slapped-rico-says-it-can-prove-trump-won-georgia-2020

Over 200K African, Asian migrants crossed US southern border during ballooning crisis

 The crowds of migrants pouring across the U.S. southern border include hundreds of thousands of people from as far away as China, India and Africa, recent federal government statistics show.

Arrests of migrants from countries such as Senegal, Mauritania, China and India entering via Mexico tripled to 214,000 during the fiscal year that ended in September, from 70,000 in the prior fiscal year, according to US Customs and Border Protection data.

In fiscal 2021, there were less than 19,000 migrant “encounters” from Asia and Africa, according to CBP statistics.

Overall, in fiscal 2023, CBP counted nearly 2.48 million encounters at the southern border, up 4% from 2.39 million the previous year.

“The increase in migration from Asia and Africa is remarkable,” said Enrique Lucero, head of the migrant support unit of the Tijuana city government, across from San Diego in an interview with the Wall Street Journal. “These days, we are dealing with 120 nationalities and 60 different languages.” 

It was the second consecutive year “encounters” along the length of the nearly 2,000-mile border with Mexico topped two million, according to CBP statistics. Most of the migrants continue to be from Latin America and the Caribbean.

The new groups, known as “extracontinentals” are posing a challenge to federal authorities because deporting migrants back to Asian and African countries is time-consuming and expensive, according to the outlet.

“That puts a lot of strain on our operations because we just don’t have longstanding ties or agreements in place with many countries in order to facilitate quick removals,” a US government official told the newspaper. “We are actively working on that.”

In Mexico, authorities reported a four-fold increase of migrants from Asia and Africa this year, the Journal reported. Travelers said they use TikTok and Facebook to share information and videos of their routes, while others use the details they find online to launch their own trips.

Chinese migrants typically make their way to the US southern border after flying into Brazil, Ecuador or Nicaragua, which have limited visa requirements for some nationalities.

They then travel by bus or cars to hotels or houses where they are put up by smugglers. Many wear disposable bracelets like those used at resorts, with details naming the groups that coordinated their trip, Mexican authorities told the Journal.

Migrants from India more often fly to Mexico City from Europe, or cross the border through Canada, according to reports.

CBP data shows there were 189,402 encounters at the northern border in the fiscal year that ended in September, a 73 percent leap from the 109,535 the prior year and a nearly sevenfold surge from two years ago.

U.S. and Mexican authorities are also seeing a growing number of Russians arriving as they flee their homes — about 12,500 since the invasion of Ukraine in February 2022, compared with 509 the year before the war.

https://nypost.com/2023/11/04/news/more-than-200k-african-asian-migrants-crossed-us-southern-border-during-ballooning-crisis-data/

TikTok post advertises Corona, Queens, brothel

 A seedy Queens brothel is being brazenly advertised on social media as having “really good, delicious” women.

“We are here with all the ladies,” a woman says in Spanish in the video, posted to TikTok by @zombiesinnyc on Oct. 19.

“Yes. So the public knows what is the good, the really good, delicious,” another woman says in the clip, which provides the brothel’s address in Corona.

The video shows a handful of lingerie-clad women sitting around on couches as men linger nearby and has the words “Inside a W#0r3 house” written over it.

The rooms are dark and neon light shows appear to be projected onto the walls.

About 20 men were seen going in and out of the house between 2 p.m. and 4 p.m. Friday, including one wearing an MTA jacket.

The property is owned by Fresh Meadows Park Phoenix LLC, public records show.

The company lists no registered agents with the state and has a Jericho address.

An owner could not be reached.

A woman’s advocate said brothels stay busy in the city because of a lack of enforcement.

The NYPD and city prosecutors have been dialing back on arresting prostitutes in recent years and promising to focus on sex buyers, but that promise hasn’t materialized overall, said Taina Bien-Aime, executive director of the Coalition Against Trafficking in Women.

4

A video captured scenes from inside the house and was uploaded to TikTok on Oct. 19.

TikTok @zombiesinnyc

“Corona was always a hotspot for prostitution and brothels, primarily women from Central and Latin America who were trafficked from there,” she said. “Now I think it’s just exacerbated because it’s lawless in New York.”

The home is a mile away from the notorious stretch of brothels on Roosevelt Avenue exposed by The Post as the “Market of Sweethearts.”

Mayor Eric Adams has blamed the rise in prostitution in the neighborhood on an increase in female Venezuelan migrants who are struggling to find work in the Big Apple.

4

The home is a mile away from the notorious stretch of brothels on Roosevelt Avenue exposed by The Post as the “Market of Sweethearts.”

J.C. Rice

He said the surge in “illegal” activity is just “one example” of how the nation’s ongoing migrant crisis is destroying the city.

It’s not clear if the migrants he referenced are being sex trafficked or if they’re soliciting of their own free will.

“This is what happens when you create an atmosphere that people can’t provide for themselves — you can’t work, you can’t provide for your job, and have to turn to illegal activities to do so,” Adams told reporters during a Tuesday briefing.

https://nypost.com/2023/11/04/metro/busy-alleged-brothel-in-corona-queens-advertised-on-tiktok/

NYC equity commish linked to group pushing for independent black nation on US land

 The person tasked by the city with bringing “racial equity” to the Big Apple is affiliated with a radical organization that seeks to establish an “independent black nation” on US soil and is demanding reparations.

Linda Tigani, who was appointed chair and executive director of the Commission on Racial Equity last week by Mayor Adams and Speaker Adrienne Adams, worked as an organizer with the New York chapter of the Malcom X Grassroots Movement until 2019.

Among its principles is the pursuit of reparations and to “Free the Land,” or to establish an “independent Black Nation on land in north amerikka” comprising South Carolina, Georgia, Alabama, Mississippi, and Louisiana, according to MXGM’s website.

“We say ‘Free the Land’ because We want independence so that we can ensure our Human Rights are protected and that our land will be a zone and base for all who seek liberation and freedom,” the website reads.

Tigani proudly features the phrase “working to Free the Land” on her X account, which she made private after the Post last week reported on antisemitic messages she spewed on the platform in recent years. These included a slew of posts including the phrase “from the river to the sea,” which is a call for the eradication of the Jewish state of Israel and its citizens.

4

Tigani proudly displayed the incendiary slogan in her X bio.

X @LindaTigani

“It’s alarming to have someone in charge of a racial commission who uses language hinting at erasing any race or throws around racially loaded terms,” Councilman Bob Holden (D-Queens) told The Post.

“The city should remove her immediately to ensure the commission truly represents racial equity.”

Following The Post’s coverage of Tigani’s hateful posts, the Adams administration said it was discussing next steps with Speaker Adams’ office for the new CORE head, who earned $165,363 in fiscal year 2023 in her previous role as acting chief equity and strategy officer for the city Health Department.

4

Tigani worked as organizer with the Malcom X Grassroots Movement’s New York chapter.

X @MXGMNational

“To be clear, Mayor Adams strongly disagrees with the messages in these posts and has repeatedly stated his support for the existence of a Jewish state of Israel,” a spokesperson said last week.

Tigani told The Post she was sorry for not realizing how her X posts had harmed the Jewish community, and that in her new position she would “be sensitive to the concerns of all New Yorkers.”

She also claimed phrase “Free the Land” is in fact “a call to end all forms of violence and harm to one another and to preserve the land we live on.”

4

A spokesperson for Mayor Adams has declared that he strongly disagrees with Linda Tigani’s social media posts.

X @MXGMNational

“To achieve social justice, we must address the impact of climate change,” she added.

The independent Commission on Racial Equity is tasked with seeking out New Yorkers’ input to consider when the city develops its racial equity priorities. 

The mayor and speaker’s offices as well as the Malcom X Grassroots Movement did not respond to requests for comment.

https://nypost.com/2023/11/04/metro/nyc-racial-equity-commission-head-affiliated-with-group-pushing-for-independent-black-nation-on-us-land/

'Dem internal fight over Israel-Hamas war puts party in disarray: President is making it even harder’

Democrats are engulfed in behind-the-scenes battles over Israel’s war against Hamas, as leftist staffers in both the Democratic National Committee and the State Department voice increasingly strident demands for a cease-fire — threatening to tear the party asunder amid President Biden’s re-election effort.

“The president centered his 2020 campaign on a ‘Battle for the Soul of the Nation,’ but it seems as though the administration is currently in a battle for its own soul,” an unnamed DNC official told Axios Saturday.

“I don’t know how you can see supporting the large-scale killing of Palestinian civilians as anything but immoral,” the official said.

“This promises to be a long, grueling campaign, and the president is making it even harder” by supporting Israel, another party leader grumbled.

On Friday, 51 DNC staffers signed on to an open letter demanding that party leaders push Biden to call for an immediate ceasefire in Gaza, the Huffington Post reported.

“As strategic partners to the administration… we feel it is the DNC’s moral obligation to urge President Biden to publicly call for a ceasefire,” the employees, who make up more than 15% of the party’s fundraisers and campaign organizers, wrote.

“I think a lot of us feel it’s increasingly hard to focus on our work,” said one of the signers.

The divide is mainly between young pro-Palestine progressives and older Dems who sympathize with Israel, the staffers said — echoing the internal clashes over the Vietnam War that derailed President Lyndon B. Johnson’s re-election in 1968.

The DNC staffers’ letter came one day after Senate Majority Whip Dick Durbin became the first senator to demand a halt in Israel’s military campaign against the Palestinian terror group.

Biden has not called for an Israeli cease-fire, only for a “pause” in the fighting to “give time to get the prisoners out.”

Meanwhile, a career State Department officer has publicly bashed Biden repeatedly on X, accusing him of being “complicit in genocide.”

“Your rhetoric and approach from day one has resulted in the deaths of thousands,” foreign affairs officer Sylvia Yacoub posted to Biden on Oct. 30, the Washington Free Beacon reported — one of more than a half-dozen social media screeds she has lobbed at her ultimate boss since the Israel-Hamas war began last month.

“There is so much blood on your hands.”

Yacoub, a former Obama Foundation associate and an organizer for Hillary Clinton’s 2016 presidential campaign, has since locked down her account.

https://nypost.com/2023/11/04/news/dems-battle-over-israel-hamas-war-leaving-party-in-disarray/