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Gout | More than Flares

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NEW EULAR POSTER: Real-world effectiveness of an IL-23i vs TNFi or IL-17i in PsA. 🔍Learn how these treatment choices impacted joint outcomes in biologic-naive patients. Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/PBR7VMkTBR https://t.co/jpHDRT0b9i
Dr. John Cush @RheumNow (  View Tweet)
Future therapies (in development) for gout - the goal is durable crystal depletion. Created by: Dr. Aravind Palraj @rheumat_aravind for RheumNow. https://t.co/rzP8usVZnT https://t.co/ZDuVWqT2TA
Dr. John Cush @RheumNow (  View Tweet)
Psoriasis = Myocardial Dysfunction (unrelated to Cardiometabolic Risk Factors) 1010 PsO pts vs controls w/o skin dz, assessed clinically & by ECHO. PSO pts (even w/ controlled dz) had signif more myocardial dysfunction (17% vs 6%). Higher BMI & DM independently assoc w/ https://t.co/MjcRmgyCWX
Dr. John Cush @RheumNow (  View Tweet)

The Wider Implications of Dactylitis

Dactylitis, AKA the "sausage digit", is a hallmark of psoriatic arthritis (PsA), but as Possemato and colleagues point out, it is fundamentally a clinical sign, and not a diagnosis. This review article discusses the wider implications of dactylitis in rheumatology and medicine underscores the diagnostic and prognostic significance of this manifestation.

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When Gout Flares, So Does the Cardiovascular System

We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares. I would add that a flare is more than a joint problem. It is a transient, systemic inflammatory event and we should consider it as such.

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STOP-HZ trial - 30 #RA pts going on tofacitinib given Shingrix (RZV) on day 1 & wk 8 & started Tofa on d1 or wk8. @wk 12 VZV responses incr in both (2.66 & 2.91 fold incr). @wk 4, d1 Tofa had fewer ≥1.5-fold VZV vs wk8 (44.8% vs 80%); BUT can you wait 8wks to start JAKi? https://t.co/tH0zPgBbHQ
Dr. John Cush @RheumNow (  View Tweet)
Calcium Pyrophosphate Deposition Dz new terminology from 2026 G-CAN consensus. Preferred: - acute CPP crystal arthritis - Chronic CPP crystal arthritis - Chronic CPP crystal arthritis - OA w/ CPP - Chondrocalcinosis (xray) * Pseudogout is obsolete https://t.co/L95N2ObHr3 https://t.co/ST7RkJa8BR
Dr. John Cush @RheumNow (  View Tweet)
Worldwide, gout is projected to increase 70%, from 55 million to over 95 million by 2050. For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/z04zzEXe0X
Dr. John Cush @RheumNow (  View Tweet)
An AI model trained from routine electronic health record data of 3.7 million individuals predicted cancer 1 year before clinical onset, no less promoted accuracy in detection, staging, treatment response, and prognosis https://t.co/ORrpJ2vIcR https://t.co/ymJWRAYOSw
Eric Topol @EricTopol (  View Tweet)
UTSW observational study of labs (n 14,199) changes w/ MTX use in 2,439 pts (13% RA, 11% PsO/PsA, 15% inflam arthritis) - found no difference in labs q3 vs q6 mos. No signif correlation betw monitoring intervals & changes in ALT, AST,WBC, HCT, MCV, PLT, FIB-4. Small https://t.co/gKwA7juexG
Dr. John Cush @RheumNow (  View Tweet)
RHEUMS! FINAL GOUT SURVEY ON NEW THERAPIES>> Which biologic is FDA-approved for gout? Answer here>> https://t.co/MWSnCZEDdR

Dr. John Cush @RheumNow (  View Tweet)

Fibrosis-4 (FIB-4) Index for Liver Fibrosis is calculated from age, AST, ALT, Plts. Study of 174 RA, PsA, PsO pts on MTX find 11% w/ fibrosis (by elastography). FIB-4 AUC for fibrosis =0.68 (weak). Fibrosis was signif assoc w/ FIB-4 >1.62, DM, obesity, advanced steatosis https://t.co/GYrhs2U1s3
Dr. John Cush @RheumNow (  View Tweet)
The Hidden Cost of Gout For many people, gout is viewed as an episodic disease: a painful flare, a short course of treatment, and then life returns to normal. However, as rheumatologists, we know that recurrent attacks can lead to joint damage and tophi if left untreated. https://t.co/BfZFBZ8YrU
Dr. John Cush @RheumNow (  View Tweet)
Primary biliary cholangitis is a chronic cholestatic disease characterized by autoimmune-mediated destruction of bile ducts, leading to fibrosis, cirrhosis, & liver failure. Ursodeoxycholic acid is 1st line Rx. New Rx include elafibranor & seladelpar (activates peroxisome https://t.co/tKloXvJYek
Dr. John Cush @RheumNow (  View Tweet)
UK primary care database (2000–21) gout study of new colchicine initiators (n 31,478) vs noninitiators (mean 60 yrs, BMI 30), follow-up of 4.5 yrs. Colchicine use had a signif. 12% lower risk of Joint Arthroplasty (HR 0.88); 23% lower TJA in knee/hip OA (HR 0.77) https://t.co/bT07lUYBB2
Dr. John Cush @RheumNow (  View Tweet)
GI dz & malnutrition in scleroderma (SSc) is common, assessed by BMI. Among 450 SSc (F/U 5.3 yrs), lower BMI were significantly assoc w/ pseudoobstruction, smaller oral aperture, higher Medsger vascular severity scores. Defines those at risk https://t.co/JY9YFOWE5C https://t.co/xFZ0rCXjQv
Dr. John Cush @RheumNow (  View Tweet)
Persistence of education and monitoring is crucial to optimal gout management Optimal gout care is dependent on having a well-informed health care provider who recognizes and follows the ACR gout management recommendations. It is important that the misconceptions and myths held https://t.co/XYSwvuihjJ
Dr. John Cush @RheumNow (  View Tweet)
Expert Perspective on Calcium Pyrophosphate Deposition Disease A current perspective article by Dr. Sara Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments. https://t.co/zxJ9aQweNl
Dr. John Cush @RheumNow (  View Tweet)
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