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  • 2024.year.review
    2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list (in no particular order) of 2024 developments and desires that may change rheumatologic practices.
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Your patients with RA deserve the opportunity to achieve disease control.     Listen as Dr. Christina Charles-Schoeman and Dr. Manish Jain discuss their approach to disease control after TNFi failure. Sponsored by AbbVie Medical Affairs + Health Impact. https://t.co/vrKGALuKdG https://t.co/lNxFtJUT5E
Dr. John Cush @RheumNow (  View Tweet)
A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
Dr. John Cush @RheumNow (  View Tweet)

Glucorticoid Toxicity Index

Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids (GC).

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Long-Term Use of NSAIDs Linked to Lower Dementia Risk https://t.co/nlo2BodhLG https://t.co/TiE34zyvts
Dr. John Cush @RheumNow (  View Tweet)
Are Combination Biologics Safe? Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution. https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA
Dr. John Cush @RheumNow (  View Tweet)
A Case of IgA Vasculitis Presenting as Duodenal Perforation Presentation by Dr. Audrey Liu, at the Rheumatology Winter Clinical Symposia - Feb 2025 https://t.co/kZWgy1S0Wh https://t.co/9mJAzVRVpl
Dr. John Cush @RheumNow (  View Tweet)
Hydroxychloro-King (3.7.2025) Dr. Jack Cush reviews the news, journal reports and regulatory actions from the past week on RheumNow. https://t.co/83ZAyrrgg3 https://t.co/63cIdP559y
Dr. John Cush @RheumNow (  View Tweet)
Late Breaking abstract from 2025 Amer. Acad. Dermatology (AAD) on the Phase 3 ICONIC-LEAD study showed J&J's oral IL-23 inhibitor (icotrokinra) was superior to deucravacitinib in skin clearance (65% vs 8%) & PASI90 (50% v 4%) at Wk 15 in 684 moderate-to-severe plaque PsO pts… https://t.co/GYK604kJ9u https://t.co/Ao1BpL1Qxt
Dr. John Cush @RheumNow (  View Tweet)

Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients

Annals of Internal Medicine has published a  Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk by 45%, but increased the risk for major adverse cardiac events (MACE) by 36%. 
 
Cardiac concerns are heightened
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Increased Mortality In Arthritis Patients with COPD

EurekAlert!

People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study. The study is published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal.

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The European Commission (EC) has approved Celltrion’s Avtozma (CT-P47), a biosimilar referencing Roche’s RoActemra (tocilizumab). https://t.co/ukMDwtgUhw https://t.co/htDVWKbu3n
Dr. John Cush @RheumNow (  View Tweet)
Congratulations to Dr. Mehmet Hocaoglu (University of Pittsburgh) on being awarded a 2024 Rheumatoid Arthritis Research Program grant to investigate the unique and shared risk factors between patients with preclinical rheumatoid arthritis and patients with RA.… https://t.co/eF4yb3Hxsj https://t.co/MLNWKFiCiU
Dr. John Cush @RheumNow (  View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/3Y2cOzt3TQ https://t.co/6f8yiwMqAa
Dr. John Cush @RheumNow (  View Tweet)
Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush @RheumNow (  View Tweet)
DANBIO registry study - 21 982 Rx Starts, 96 475 PYs & 1423 cancers identified. Overall cancer risk w/in tocilizumab/sarilumab, abatacept or rituximab were not signif increased (HRs ranged from 0.7 to 1.1) compared with TNFi & with bDMARD-naïve real world RA pts… https://t.co/fPLFlWoQsw https://t.co/4KlGnjfNKm
Dr. John Cush @RheumNow (  View Tweet)
Global burden of #OA among postmenopausal women continues to escalate. From1990 to 2021, was > 1.3-fold increases in OA incidence, prevalence, DALYs. Knee OA has heaviest burden; hip OA least. Higher BMI signif influences the burden of OA https://t.co/L6qd7ISFF8 https://t.co/1SkNJWxm54
Dr. John Cush @RheumNow (  View Tweet)
BMS announced new data from Phase 3 POETYK PsA-2 trial - Sotyktu (deucravacitinib)vs apremilast vs PBO in PsA w/ higher ACR20 vs PBO at Week 16 (54% vs 39%). AEs led to discontinuation in 1.3% (PBO), 2.2% (Deuc) and 10.5% (apremilast). https://t.co/NAa2JigkZN https://t.co/mvaQXfjShd
Dr. John Cush @RheumNow (  View Tweet)

Are Combination Biologics Safe?

Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
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Polypharmacy (>=5Rx) studied in 81 RA & 30 SLE pts. Polypharmacy incr at 2 yrs ~44% to ~73%. Med adherence >85%. Polypharmacy NOT assoc w/ Dz activity in SLE, but in RA did correlate w/ better DAS28CRP score at one year https://t.co/Jw05DIrBym https://t.co/pLIoDvPj8i
Dr. John Cush @RheumNow (  View Tweet)
Metanalysis of 376 studies, 347 468 pts w/ chronic pain (mean 51yrs; 70%F) finds ~40% had clinically significant depression and anxiety (more common in Women, younger people, pts w nociplastic pain). Depression common in FM (54%) & OA/RA (~28%). https://t.co/s1tcgC3y7k https://t.co/NCxkOA82jD
Dr. John Cush @RheumNow (  View Tweet)
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