All News
Is MTX Safe in the Elderly? (12.1.2023)
Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.
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Next generation JAK-inhibition strategies
It has been just over a decade since the approval of tofacitinib (JAK1/JAK3-inhibitor) by the US FDA for the treatment of rheumatoid arthritis. Since then, baricitinib (JAK1/JAK2-i), filgotinib and upadacitinib (both selectively targeting JAK1) also have been licensed for the treatment of rheumatoid arthritis. As there are many more JAK-inhibitors evaluated in clinical trials currently, how do you stand out?
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MTX Toxicity in Older CKD Patients
You know this; you've taught this; but here's a good study documenting a higher risk of methotrexate toxicity when used in the setting of older patients with chronic kidney disease.
Yesterday's JAMA published a higher 90-day risk of serious adverse events in older adults with CKD taking low-dose methotrexate, compared to hydroxychloroquine.
Here’s what will change my practice in Rheumatoid Arthritis
Here's what I learned at ACR23 that will change the way I practice in rheumatoid arthritis.
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Withdraw DMARDS after remission?
The possibility of withdrawing DMARDs after patients achieve remission has been in our minds for a while. Yet when our patients ask whether it is a good idea to taper or stop their DMARD when they are doing well, most of us don’t have a black or white answer for them.
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Race to the top: how high will treatment response rates in RA reach?
We have become accustomed to the 60/40/20% rule for the outcome of ACR 20/50/70 respectively for biologics and targeted synthetic DMARDs.
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Plotting Future ACR Convergence Meetings (11.24.2023)
In this week's podcast, Dr. Jack Cush reviews the ACR Convergence 2023 meeting and proposes how to best learn at your next large medical meeting.
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Reconsidering Steroids
There is not a single one of us in rheumatology who hasn’t prescribed steroids, but we really need to reconsider how much and how often we use them.
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TNFi and RA-ILD – The Pendulum Swings Again
TNF inhibitors revolutionised the treatment of rheumatoid arthritis. While highly effective for the joint manifestations of the disease, a note of caution was sounded regarding the potential for worsening of ILD with these agents. Within this framework, a study by England et al presented at ACR23 was highly relevant.
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IgG4 disease- the WInS withdrawal study results
IgG4-related disease describes a group of fibroinflammatory diseases whose features may include autoimmune pancreatitis, swelling of or within an organ system, salivary gland disease, swollen lymph nodes, skin manifestations, and symptoms consistent with allergies or asthma. While remission induction treatment with glucocorticoids has proven effective, the high relapse tendency is an ongoing challenge for clinicians.
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Early aggressive treatment in SLE: are we there yet?
Early treatment with DMARDs has revolutionised the outcomes of patients with rheumatic arthritis. However, this concept has not been fully extrapolated to other autoimmune rheumatic diseases such as systemic lupus erythematosus.
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Do We Stop or Continue Treatment?
Remission had been a dream, an elusive concept. But then, with the introduction of biologics, conventional synthetic and targeted synthetic DMARDS, patients are able to live longer and with a better quality of life. While these therapeutics have been helpful, they are expensive and carry potential side effects. The big question looms: Do we stop or continue treatment?
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Rheumatology Roundup - ACR 2023
Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.
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