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Anti-CD40 Therapy in Sjögren's Disease
Sjögren's disease is a chronic autoimmune condition without a clear effective therapy - DMARD or biologic. The TWINSS study has demonstrated the safety and efficacy of iscalimab, a monoclonal antibody against CD40, in a phase 2 randomized clinical trial of active Sjögren's disease (SD).
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More Noninflammatory Pain in Difficult to Treat RA
A Canadian cohort of difficult-to-treat rheumatoid arthritis (D2T RA) patients shows significantly more non-inflammatory pain in D2T RA compared to patients responding to b/tsDMARDs.
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The Burden of Rheumatoid Arthritis (2018–2020)
A recent study that quantified the economic and humanistic burden of rheumatoid arthritis (RA) in the USA showed significantly higher health care expenditures, particularly medication costs, and suboptimal quality of life in RA.
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Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease
A matched cohort study from the Veterans Health Administration shows that rheumatoid arthritis patients have a >50% increased risk of lung cancer, and a 3-fold higher risk of lung cancer in RA-interstitial lung disease (ILD).
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Depends on Where You’re Looking (8.9.2024)
https://t.co/GDAN37DJSx https://t.co/jVoumC00r5
Dr. John Cush RheumNow ( View Tweet)
Mass General Brigham Study 172 RA-ILD pts w/ 6.5 yrs F/U (age 62 yrs): noted (4%) lung transplants & 44 (26%) ILD-related deaths. FVC rapidly declining pts (14%) had aOR 19x lung transplant & aOR 2.8 ILD-related death. Slow decline in 54%, no decline 32% https://t.co/fKDnJIu9a7 https://t.co/ondzN4WZ1F
Dr. John Cush RheumNow ( View Tweet)
Favorable results from Vasculitis Pregnancy Registry; enrolled 147 women, 149 pregnancies; data on 78 pregs. 36% had active vasculitis during Preg, 14 hospitalized (4 w/ vasculitis. 74% Rx vasculitis meds during preg & 97% live births, 21% preterm https://t.co/rq2Y4ij0OW https://t.co/wmmFPvlOGY
Dr. John Cush RheumNow ( View Tweet)
EMR study looked at NIDDM & 4 indicators of #Obesity (waist circumference, waist/hip ratio, BMI, & visceral fat area -- 600 gout pts vs 9,935 controls shows all obesity measures signif incr odds of #Gout (OR 1.775, 1.691, 1.858, & 1.578, respectively) https://t.co/JJn5txgxiN https://t.co/tgnWWl9COe
Dr. John Cush RheumNow ( View Tweet)
Breast CA (BC) & TNFi - study of 2 cohorts (Optum commercial * SEER/Medicare) found that 17% & 16% of BC pts received TNFi. 1 yr overall survival was no different +/- TNFi (HR= 0.77 & 0.84); but BC survival better on TNFi (HR 0.28; 0.08–0.98) vs csDMARDs. https://t.co/cGqT80rGTR https://t.co/n7i5VNFkVT
Dr. John Cush RheumNow ( View Tweet)
Oral microbiota study (w/ 16S rRNA sequencing) of 72 severe psoriasis vs 16 controls. PsA pts had incr in Aggregatibacter & decr Prevotella. PsO pts had incr in Capnocytandophaga, Campylobacter & Acetobacter, but decr Bacteroides & Muribaculaceae https://t.co/ol947Afupt https://t.co/OknMRtJ4oT
Dr. John Cush RheumNow ( View Tweet)
Prescription Painkiller Misuse in Chronic Pain Patients
A new scientific review has found that nearly 1 in 10 patients experiences opioid dependence or opioid use disorder and nearly 1 in 3 shows symptoms of dependence and opioid use disorder.
https://t.co/DnUe1l51bS https://t.co/G4RPg8eqqe
Dr. John Cush RheumNow ( View Tweet)
Review of Inflammatory vs non-inflammatory pain in RA
- Pain may be more than inflammation
- Residual plain is a problem
- Consider damage vs FM
- Central vs. Neuogenic pain https://t.co/JUgc5IsgMq https://t.co/CRekJsAP04
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Dr. John Cush RheumNow ( View Tweet)
Lit review of ILD in anti-synthetase syndrome finds no conclusive evidence of effective treatment. 10 studies, 514 pts (68% female); Hi Res CT positive in 87% w/ 49% having NSIP pattern. 48% Jo-1+, 28% Ro52+. Low improvements w/ RTX (12%), CYC (17%). https://t.co/B7R0xQrUyw https://t.co/2hMzO8hyiV
Dr. John Cush RheumNow ( View Tweet)
Retrospective study from Univ of Tokyo on 194 Behcets dz (BD) pts, found 25% who developed intestinal BD (meanF/U 12 yrs). Use of #PPI significantly incr risk of intestinal BD (adj HR 2.48; vs non-PPI), w/ a confirmed duration/dose-dependent relationship. https://t.co/qFeS8svMLj https://t.co/KT8OBrY96S
Dr. John Cush RheumNow ( View Tweet)
Immune pathology of bursitis in rheumatic conditions - role of inflammation, degeneration, & mechanical stress. Cells and cytokines involved. Tenditis and tenosynovitis often coexist w/ bursitis https://t.co/fXf1LBTS4e https://t.co/LxmsIXhZaU
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Dr. John Cush RheumNow ( View Tweet)
Anti-Ku + myositis: an acquired inflammatory protein-aggregate myopathy. 92% female, median age 56yrs w/ very hi CK levels, 31% have overlap w/ scleroderma (half of these have ILD). Path shows by myofiber necrosis, MHC-class I/II+, endomysial inflammation https://t.co/7HDUEPmbdi https://t.co/vnSjOph31G
Dr. John Cush RheumNow ( View Tweet)
Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/5chrS3sW8i https://t.co/twSv4Zs9r3
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Dr. John Cush RheumNow ( View Tweet)
JAMA: Trends in the Ranking of Leading Causes of Death—US, 2019-2023 https://t.co/RgGrYe0tbE https://t.co/SdMmadOD3S
Dr. John Cush RheumNow ( View Tweet)
3+ million persons died in USA in 2023. Overall age-adjusted death rate in 2023 was 6.1% lower than 2022. Overall death rate highest among non-Hispanic Blacks or African Americans. The number of COVID-19 deaths was 68.9% lower than in 2022 https://t.co/Oqgxcs4yUz https://t.co/lDn1PuEQ5Z
Dr. John Cush RheumNow ( View Tweet)
Finding Spondylitis Among Psoriasis, Uveitis and Colitis Patients
Maksymowych and colleagues have shown that screening patients with either psoriasis, iritis, or colitis may yield a surprising percentage meeting ASAS criterial for axSpA.
https://t.co/lVCdGnMVaT https://t.co/jFILeHrQXj
Dr. John Cush RheumNow ( View Tweet)