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Phase 3 baricitinib trials (2890 pts) there were 215 prior/occult HBV infection (HbcAb+) and 8 (3.7%) had a positive HBV DNA+ (≥29 IU/mL). Four met the definition of reactivation and 3 required antiviral therapy = check HBV serologies with JAK inhib use https://t.co/9xGIu5hzNh

Dr. John Cush @RheumNow (  View Tweet)

May 28, 2020
TNR Grand Rounds on "Cytokine Storm Syndromes" features a lecture and Q&A with Dr. Randy Cron - watch it here>> https://t.co/1CZ1YOY5W3 or listen on iTunes>> https://t.co/FHJv01AAbC or SoundCloud Podcast>> https://t.co/G0EuWMGTdW https://t.co/z57pBUhAKn
Dr. John Cush @RheumNow (  View Tweet)
May 28, 2020
UPI quotes Dr. Tony Fauci stating (about hydroxychloroquine) "The scientific data is really quite evident now about the lack of efficacy". Yesterday France and other countries have banned the use of HCQ to treat COVID. https://t.co/G0EuWMGTdW

Dr. John Cush @RheumNow (  View Tweet)

May 28, 2020
Great NY Times article on 30+ years of an adversarial friendship between Dr. Tony Fauci and AIDS activist Larry Kramer (who recently passed away). Keen that adversaries can still be on the same side, pushing for change differently https://t.co/lnfk6fXfF2

Dr. John Cush @RheumNow (  View Tweet)

May 28, 2020
BTK inhib (fenbrutinib-FEN) effective in #RA. In a 12 wk RCT, 480 MTX-IR pts Rx either PBO, adalimumab or FEN (50 mg or 150 mg/d). ACR50 resp was PBO 15%; ADA 36%; FEN 50mg 18%, 150 qd 28%, 200 mg bid 35%. FEM NO effx on myeloid & B cell biomarkers. https://t.co/JIb4FtiOQG

Dr. John Cush @RheumNow (  View Tweet)

May 28, 2020
NEJM reports no difference between 5d and 10d course of Remdesivir in severe Covid-19 not requiring mechanical ventilation; but this trial did not include a placebo control https://t.co/mxAR2qQzPa

Dr. John Cush @RheumNow (  View Tweet)

May 28, 2020

TNR Grand Rounds - Cytokine Storm Syndromes

May 27, 2020

This week's Tuesday Nite Rheumatology featured Dr Randy Cron from the University of Alabama - Birmingham as he spoke and took questions on the immunology, immunopathogenesis and treatment of Cytokine Storm Syndrome, especially as they relate to COVID-19 and rheumatic disease patients. The

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Boston and Wuhan Report Rheum COVID Patients at Risk for Respiratory Failure

May 27, 2020

Two current reports from Boston and Wuhan describe cohorts of COVID-19 (+) rheumatic disease patients who generally do well but appear to have a higher risk of pulmonary involvement.

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CORRONA registry compared Triple DMARD (MSH) to TNF/MTX Rx; MSH is infrequently used; Triple DMARD pts were older, longer Dz duration, less Dz activity, more CA & comorbidities. Comparatively MSH had more Discontinuations & less likely to get to LDAS https://t.co/WSHgzrfcIn

Dr. John Cush @RheumNow (  View Tweet)

May 27, 2020
Case-control study of risk factors for [rheumatic use] hydroxychloroquine retinopathy: cumulative dose, duration of intake, creatinine clearance and geographical origin sign^ in multivariate analysis, what is driving the geo finding? genetics? https://t.co/2NGaZiqpsc @RheumJnl

Dr Philip Robinson @philipcrobinson (  View Tweet)

May 27, 2020
NEW RESEARCH: Repeat ANA testing after a negative result has low utility and results in high cost https://t.co/Zfc2vqRue1 #LancetRheumatology https://t.co/N9iHfdNYix
The Lancet Rheumatology @TheLancetRheum (  View Tweet)
May 27, 2020
Proud of this amazing collaboration with @zach_wallace_md: 52 rheumatic cases vs. 104 non-rheumatic comparators, all infected with COVID-19. Rheum cases had 3-fold risk of mechanical ventilation @BrighamResearch @MGHMedicine https://t.co/nBXe78i4JU

Jeff Sparks @jeffsparks (  View Tweet)

May 27, 2020
Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash. AAV w/ skin Sxs have more systemic dz (GN, alveolar hemorrhage) https://t.co/zL7a38aDIt

Dr. John Cush @RheumNow (  View Tweet)

May 27, 2020
Studies have shown a higher risk of gout w/ obstructive Sleep Apnea;a recent study shows higher risk (OR 1.86) disappears (OR 1.05) after adjusting for BMI, CHF, DM, diuretics, and renal dz. Gout associates with comorbidities, including obesity and OSA https://t.co/39Wen3uydM

Dr. John Cush @RheumNow (  View Tweet)

May 27, 2020

Hydroxychloroquine Improves Survival in Lupus

May 26, 2020

Hydroxychloroquine (HCQ) has dominated the news in recent weeks, because of poor outcomes reported when used in COVID patients. Yet, a recent report reaffirms what rheumatologists have known for years - that HCQ use is associated with better outcomes in systemic lupus erythematosus, including

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Be sure to catch tonights 8pm EST Grand Rounds - Cytokine Storm Syndrome given by Dr. Randy Cron (UAB) part of the Tues Nite Rheumatology seriies. Go here to register (this is for rheums) https://t.co/RtugDyTBRX

Dr. John Cush @RheumNow (  View Tweet)

May 26, 2020
Metanalysis of 15 studies & 552,019 pts with RA shows the risk of diabetes to be significantly reduced in RA patients on HCQ (HR 0.61), methotrexate (HR 0.81), TNFi (HR 0.63), but increased with glucocorticoids (HR 1.46 < 10 mg; HR 2.25 for > 10 mg) https://t.co/gULTBtSvYU

Dr. John Cush @RheumNow (  View Tweet)

May 26, 2020
10 FALSE reasons for not wearing a mask - https://t.co/psGrN4iYMs Please wear a mask out of concern and care for others !!

Dr. John Cush @RheumNow (  View Tweet)

May 26, 2020
Well Being Trust (WBT) reports that there are 151,964 deaths from alcohol, drugs, and suicide last year. In less than 3 mos, COVID-19 will kill over 100,000 Americans. WBT estimates that COVID could cause between 27,000-68,000 deaths of despair. https://t.co/yIf1yrzkbr

Dr. John Cush @RheumNow (  View Tweet)

May 26, 2020
Gilead announced phase 2/3 trial results of their JAK1 inhibitor, filgotinib, showing 200 mg qd (not 100 mg qd) dose was effective in ulcerative colitis (SELECTION study) with higher remission rates at weeks 10 (vs PBO); at wk 28 both 100mg and 200mg were superior to PBO

Dr. John Cush @RheumNow (  View Tweet)

May 26, 2020
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