Shingles Risk with JAK Inhibitors and Other Biologics
Jul 29, 2021
Recent News
Read ArticleRegistry data suggests an increased risk of herpes zoster (HZ, shingles) in rheumatoid arthritis (RA) patients taking JAK inhibitors (JAKi) but also with other biologic DMARDs, compared to csDMARDs.
RA patients from the German RABBIT register were prospectively enrolled (2007 - 2020) and safety events were ascertained, including HZ events.
No Cancer Risk with TNF Inhibitors in Rheumatoid Arthritis
Jul 29, 2021
The ARTIS Study Group has published their analysis of (non-skin) cancer risk in rheumatoid arthritis, claiming the overall safety of biologic DMARDs and targeted synthetic DMARDs (tsDMARDs).
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Health personnel (HCP) @ long-term care facilities (LTCFs) are at high risk for COVID-19. March 2021, 57% of LTCF HCPs were vaccinated. COVID-19 vax was highest in MDs (75.1%); lowest nurses (56.7%) & aides (45.6%). https://t.co/VjHutcrh26
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Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
The FDA has authorized baricitinib ALONE as treatment for COVID-19 hospitalized adults and pediatric patients requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO) https://t.co/WMc78GmOLU
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Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
What predicts ILD progression in Systemic Sclerosis? Study of 138 SSc pts; 72% had ILD, 35% FVC decline (F/U 2.9y). Only Scl-70 A positivity predicted FVC decline at 5yrs. HRCT Esophageal dilation had nonsignificant DLCO decline, but not FVC https://t.co/fE0JCsZ44O
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Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
ICYMI:
EULAR guidelines rec starting prednisone dose in #PMR to be between 12.5-25mg/d. A cross sectional study of 138 pts (63M, 75F, age 73.4 yes) saw the mean starting dose to be 19.2±7.7 mg. https://t.co/Yf3yqRRMCK
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Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
ICYMI
While myeloperoxidase (MPO) Abs are seen in idiopathic pulmonary fibrosis (IPF), only 7–23% develop vasculitis. Study of 58 pts w/ IPF & MPO Abs - UIP most frequent ILD pattern, 13 had rheumatic dz; MPO Abs did not change survival of UIP/IPF pts https://t.co/RXXIPUBMBT https://t.co/sJpbzIbBJt
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Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
Big news! You can download/listen to the RheumNow podcast in more places than ever! Find us on Apple and Google podcasts, the PodBean app, Spotify, Pandora, TuneIn+Alexa, iHeart Radio, PlayerFM, Listen Notes, Stitcher, Overcast, Pocket Cast, Castro, Castbox, and Soundcloud! https://t.co/1WSUh06jjN
Dr. John Cush @RheumNow ( View Tweet)
Jul 29, 2021
Combo Methotrexate and Leflunomide Safety in RA
Jul 28, 2021
Methotrexate and leflunomide (LEF) are the most widely prescribed DMARDs worldwide; yet biologic DMARDs are the newest and best selling agents for rheumatoid arthritis worldwide. A recent study of combination therapy with MTX and LEF underscores the efficacy and safety of this approach and puts it in perspective against biologic DMARDs in RA.
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Cardiovascular Prevention Lacking in Rheumatoid Arthritis
Jul 28, 2021
An increased cardiovascular disease (CVD) risk in rheumatoid arthritis is well known and feared but an RA cohort study suggests that preventive medication use in RA patients lags behind that seen in diabetes mellitus (DM).
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Persistence of Sxs & Labs long after COVID. German study of 96 postCOVID pts followed 12 mos only 22% were Sx-free; Most had fatigue (53%), dyspnea (37%), concentration (40%), CNS (32%) & sleeping problems (26%), +ANA ≥1:160 in 44% https://t.co/L2ZzniDT18
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Dr. John Cush @RheumNow ( View Tweet)
Jul 28, 2021
204 pts w/ dermatomyositis/polymyositis Rx w/ IV early pulse steroids(IVMP) or IVIG. IVMP & IVMP+IVIG was assoc w/ 56-58% incr odds of complete response. Pulse IVMP+IVIG incr risk of steroid D/C. Early IVMP/IVIG=no impact on mortality https://t.co/yRFJgos8Qq
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Dr. John Cush @RheumNow ( View Tweet)
Jul 28, 2021
Bariatric surgery result in less pain med use. UK THIN database study of 588,494 pts: the 694 w/vbariatric surgery had a 23% increased odds of no analgesic use for ≥12 mos (HR=1.23) & all-cause mortality was also lower (HR=0.46) than controls https://t.co/b90AOE7lfg
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Dr. John Cush @RheumNow ( View Tweet)
Jul 28, 2021
CDC Reverses Stance on Masks
Jul 27, 2021
Today the Centers for Disease Control and Prevention (CDC) said that masks should be used by those vaccinated against the coronavirus in public indoor spaces in parts of the country where the virus is surging.
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US News & World Report Ranks Best Rheumatology Hospitals
Jul 27, 2021
Medscape has published the annual U.S. News and World Reports ranking of Rheumatology Hospitals, again honoring Johns Hopkins Hospital with the top spot, with runner up status going to the Cleveland Clinic, Hospital for Special Surgery, Mayo Clinic and Brigham and Women's Hospital.
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Claims data analysis of US Adult Medicaid patients shows and association between PTSD and increased risk of #SLE. 10K SLE compared to >100K controls. Prevalence of PTSD was significantly higher in SLE (10.74 vs 7.83 per 1000 (adj OR 2.0) https://t.co/p9F5iYENAu
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Dr. John Cush @RheumNow ( View Tweet)
Jul 27, 2021
CMAJ: nice full read review of biologic use during pregnancy.
1) autoimmune/arthritis pts may use biologics during pregnancy
2) mom/infant should avoid live vax 1st 6–12 mos
3) Minimal biologic transfer in breast milk
4) no risk of congenital anomalies
https://t.co/mlZTrDjXSi
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Dr. John Cush @RheumNow ( View Tweet)
Jul 27, 2021
Top 10 things you should know about THE EYE in your rheumatology practice @CRASCRRheum
#uveitisclinic
#uveitisrheumatologyclinic
#kensingtoneyeinstitute https://t.co/SqRKOYa2N0
Vanessa Ocampo - MD @DrDDRheum ( View Tweet)
Jul 27, 2021
Another report of JAK inhibitor working in GVHD - Successful treatmente of joint & fascial involvement in GVHD with baricitinib. https://t.co/TQlPLCD2T7 https://t.co/474GpFKBo2
Dr. John Cush @RheumNow ( View Tweet)
Jul 27, 2021
New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate
The ACR has issued new guidelines on the treatment of RA, addressing questions about initial treatment with methotrexate and minimizing reliance on glucocorticoids.
https://t.co/J9wmcZr17D https://t.co/Tf3G9sFgm9
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Dr. John Cush @RheumNow ( View Tweet)
Jul 27, 2021
Former Rheumatologist Settles Civil Fraud Claims for $2 Million for alleged False Claims Act violations. Charges were based on claims for improper medical treatments and false billing to a federal program. https://t.co/HZwrwDrkVk
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Dr. John Cush @RheumNow ( View Tweet)
Jul 26, 2021
From the blog
Rebuttals
Mar 15, 2021
Since the COVID vaccine rollout, more people have been eligible to receive the vaccine. However, not everyone chooses to get one. I have heard many reasons (aka excuses) from my patients who are vaccine hesitant.
Most come from people who are highly intelligent, and claimed that they will receive the vaccine but not yet. While I am not trying to force people to get vaccinated, I wanted to hear their side of the story and also ask that they hear mine.
Recent Podcasts
- RheumNow Podcast – World Going to Pot (7.23.2021)Jul 27, 2021
RheumNow Podcast – World Going to Pot (7.23.2021)Jul 23, 2021- RheumNow Podcast – What Not to Do (7.16.2021)Jul 16, 2021
- RheumNow Podcast – As Good As I Ever Was (7.2.2021)Jul 02, 2021
- RheumNow Podcast – Modern Treatment of RA Pregnancy (6.25.2021)Jun 25, 2021
Therapeutic Update
Upadacitinib’s Long Term Efficacy and Safety
Sponsored by AbbVie Medical Affairs
Jun 01, 2021
Explore upadacitinib’s long-term efficacy through 3 years in the SELECT-COMPARE trial and dig into data
for the integrated safety analysis across 6 phase 3 studies with up to ~4.5 years of exposure.
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