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Cardiovascular Disease Increased in Hospitalized Lupus Patients

d Jack Cush, MD

Systemic lupus erythematosus (SLE) patients who are hospitalized have an increased prevalence of atherosclerotic cardiovascular disease (ASCVD) and its individual phenotypes of coronary artery disease (CAD), peripheral artery disease (PAD), and cerebrovascular disease. 

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Rituximab Safety Concerns when Used in anti-TNF Refractory RA

d Jack Cush, MD

The SUNSTONE study evaluated the long‐term safety of rituximab in rheumatoid arthritis (RA) previously exposed to ≥1 anti–tumor necrosis factor inhibitors (TNFi) and showed a stable, but high, rate of serious infections, opportunistic infections and an overall higher mortality rate.

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Rituximab Superior to Cyclosporine for Membranous Nephropathy

d Jack Cush, MD

The NEJM has reported that rituximab (RTX) and cyclosporine (CYA) was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months. 

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RheumNow Podcast – Boiling Hot MAS (7.12.19)

d Jack Cush, MD

Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.

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NIH Conference Review of Chronic Fatigue Syndrome

d Jack Cush, MD

The current issue of JAMA reviews recent advances on chronic fatigue syndrome, also known as myalgic encephalomyelitis/(ME/CFS), based on a 2-day conference held at the NIH in an April 2019.

The NIH 2-day conference reviewed recent progress and new research in several areas described below.

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CRP Utility in COPD Exacerbations

d Jack Cush, MD

NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.

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EHR-Related Adverse Events Usually Involve Medications

d Jack Cush, MD

Concerns about the unintended risks inherent in electronic health records (EHR) by analysis of EHR–related harms identified from large database of malpractice suits and claims; they found that EHR related adverse events exist, and may be associated with an severe harms and uncommonly, death.

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Its been 30-40 years since the "House of God" by Samuel Shem changed your medical thinking, if not humor. Check out Dr. Len Calabrese's recollections and call to join his summer book club and add some commentary!! https://t.co/L8wiGpWk42

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A review of 376 FDA advisory panels between 2008-15, finds that 22% of FDA’s final actions were discordant with an advisory panels recommendations (moreso w/ safety panels). Of these, 3/4 lead to more restrictive actions and 1/4 less restrictive decisions https://t.co/AK7KbwN2l5

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Analysis of 149 OA and 203 RA pts from Rush Univ Rheum Clinic showed the same disease burden (by RAPID3) betw OA & A at initial visits, but after 6 mos. RAPID3 was more improved in RA patients than OA patients (P < 0.001). https://t.co/fNQ2ncJScI

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Analysis #osteoarthritis clinical trials placebo response ratio (PRR) as the placebo to treatment effect size ratio. PRR was best for walking time/distance (0.30, 95% CI 0.16 to 0.43) and worst for PRO pain (0.44, 95% CI 0.23 to 0.65) https://t.co/4VorQdSIV2

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RheumNow Podcast is up! Discussing MAS, CBD, CCP in PsA, Cost savings w/ LLDAS, lupus pregnancy and no go on NGF. View here>> https://t.co/zUclX3ISIs or listen on iTunes or SoundCloud>> https://t.co/DVw7Trrh5r

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ER study from 2015-17 shows that among 456 #gout patients, 28.3%) received opioid at discharge; 80% of these were new. Average dose was 38mg morphine equivalent for a median of 8 days - more likely w/ polyarticular gout, hx diabetes & hx prior opioids https://t.co/xf2jD1i4hg

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Upadacitinib versus Placebo or Adalimumab in Patients with Rheumatoid Arthritis and an Inadequate Response to Methotrexate:- Arthritis & Rheumatology - second Jak to beat the gold standard!

Peter Nash drpnash ( View Tweet)

Do biologics work in relapsing polychondritis? French cohort of 41 pts use 105 biologics (TNFi=60; TCZ 17; anakinra 15; RTX 7; ABA6). While 63% resp in 1st 6 mos (on pred!), a complete response rate was 19.0%. Steroid sparing variable, high infx rates. https://t.co/Ff9KULlKVD

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Swedish registry comparison of 541 PsA 40944 non-PsA pregnancies between 1997-2014, shows PsA pregnancies had increased risks for preterm birth (adj OR 1.63) and caesarean deliveries (OR 1.47), but no increased risks for pre-eclampsia, stillbirth https://t.co/L5GcNVbjgQ

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Analysis of 14 studies &3291 Psoriatic arthritis patients shows the overall frequency of anti-CCP antibodies=9.8%. In PsA, CCP+ was associated with increased risks of polyarthritis (OR 4.4), bone erosion (2.8), and dactylitis (1.98), but not of enthesitis. https://t.co/hM11ZaskfV

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Study of 182 hospitalized adult-onset Still's disease patients shows predictive factors for developing macrophage activation syndrome to include: 1. Splenomegaly (OR 5.745), 2. pericarditis (OR 6.5), and 3. ferritin >2000 (OR 4.7). https://t.co/oNsaCL6O92

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Increased time spent in lupus low dz activity state (LLDAS) reduces healthcare costs. Among 212 SLE pts analyzed; increased cost assoc w/ damage & steroid use, but spending ≥50% of time in LLDAS resulted in a 26% reduction in direct medical cost https://t.co/Kfd064kZFX

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Study of 28 states and 10.268 lupus Medicaid patients showed that only 15% were adherent to Plaquenil treatment. Adherence was lower in blacks living in certain zip codes but not in zip codes prevalents for Hispanic, white, education, poverty level. https://t.co/ytFXaOGKB2

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Dr. John Cush RheumNow ( View Tweet)

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