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Secukinumab Better than Adalimumab - Maybe?

d Jack Cush, MD

The EXCEED study was a head-to-head trial of secukinumab (SEC) versus adalimumab (ADA) as first-line monotherapy in psoriatic arthritis (PsA) patients; this 52 week trial showed that while SEC failed to achieve clinical superiority over ADA, SEC treated patients demonstrated higher

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RheumNow Podcast – The Beat Goes On (5.8.20)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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COVID-19 and Thrombotic Complications

d Jack Cush, MD

Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection.

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A new feature of COVID-19; "Covid toes" manifest as multifocal, asymmetric, erythema, ecchymoses, ischemic changes that blister or appear vasculitic. The toes, heel and soles can be affected. Healing in 12-20 days. https://t.co/Isqn9ebnQj

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Dr. John Cush RheumNow ( View Tweet)

Subanalyses of Mobility and Monarch studies show that #RA patients with highest tertiles of IL-6 (and CRP) had more disease activity, more Xray damage and better responses (less Xray change) to Sarilumab (vs Adalimumab or MTX). https://t.co/5mTePETFAQ

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Dr. John Cush RheumNow ( View Tweet)

1194 participants in Osteoarthritis Initiative shows 10 yr risk of incident Xray Knee OA was not increased by long term sitting, low-moderate physical activity (adjOR 0.69; 0.48-1.01) or strenuous phys activity (aOR 0.75; 0.53-1.07) https://t.co/7pCOwLpscr

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Dr. John Cush RheumNow ( View Tweet)

"There's a rule in acting called "Don't play the result." If you have a character who's going to end up in a certain place, don't play that until you get there. Play each scene and each beat as it comes. And that's what you do in life: You don't play the result." -Michael J. Fox

Dr. John Cush RheumNow ( View Tweet)

Why are more MEN (severely?) affected in COVID-19? Men have higher levels of circulating ACE2 (unrelated to ACEi or ARB HTN meds) based on a Biobank study of 1485 men, 537 women. ACE2 is found in lungs, heart, kidneys, vessels & testes https://t.co/CWXevTNYWm

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Dr. John Cush RheumNow ( View Tweet)

Anakinra studied in COVID(+) ARDS (nonICU) pts w/ high CRP L or ferritin; 29 high dose Anakinra vs 17 controls. At day 21, more survival with anakinra 90% vs. Controls 56% (p=0·009). Anakinra also more improved CRP+resp function (72 vs 50%) https://t.co/wxjlQG44Oc

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - The Beat Goes On.... anakinra, nr-AxSpA, Smoking & GPA, PSS guidelines, IFNa, COVID and IL-6, HCQ,QTc, and Thromboses https://t.co/BsaALcHclv

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Dr. John Cush RheumNow ( View Tweet)

European Medicines Agency (EMA), FDA and Health Canada have all issued warnings about the use of hydroxychloroquine & chloroquine in coronavirus, stating they should only be used in drug studies or hospitalized pts. https://t.co/HT39sT31Rq

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Dr. John Cush RheumNow ( View Tweet)

American Hospital Association (AHA), in a new report, projected a loss of $202.6 billion from COVID-19 expenses and lost revenue for US hospitals and health systems from Mar 1 to Jun 30—about $50 billion in losses each month. https://t.co/pidOduwnDb

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Dr. John Cush RheumNow ( View Tweet)

Anakinra works in CPPD. Metanalysis of biologics use finds 74 pts Rx with anakinra for refractory dz (85%) or w/ contraindications (23%). Anakinra resp seen in 81% of acute and 43% of chronic CPPD pts. Few adverse events reported (4.1%) https://t.co/PwJO4ta6i7

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Dr. John Cush RheumNow ( View Tweet)

COVID-19 Does alot of Damage via thrombotic complications - a role for complement or autoantibody mediated thrombotic microangiopathy? #COVID19 https://t.co/33R8WxE5C0

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Dr. John Cush RheumNow ( View Tweet)

Grand Rounds tomorrow at Rutgers - Im Lecturing on “Disease Modifying and Biologic Use for COVID-19 & the Cytokine Storm Syndrome” https://t.co/FYsr77a68Z Meeting ID: 934 0443 3549

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Dr. John Cush RheumNow ( View Tweet)

Random thought about virtual clinics. Beginning to think that phone just as good as a stop gap as video. Less performative, more relaxed, and less tiring. Rheumatology is mainly (mainly) about history esp for those patients you know well.

Ronan Kavanagh RonanTKavanagh ( View Tweet)

“Middle-high level of RF-IgM could lead to false-positive reactivity of SARS-CoV-2 IgM “ As more people want SARS-CoV2 antibody testing, I am afraid this will give people a false sense of security ⁦@RheumNow⁩ ⁦@ACRheum⁩ NCBI - NLM - NIH https://t.co/vkjWRJQV27

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k dao KDAO2011 ( View Tweet)

Check out a great Grand Rounds by Dr. Len Calabrese @LCalabreseDO on "IL-6 in Health & Disease" - great 30 min lecture and great Q&A session - Bravo Lenny! https://t.co/eWTKotQya3

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Dr. John Cush RheumNow ( View Tweet)

Case report of a stable GPA patient treated with pred and Rituxan on 3/5, developed COVID Sxs next day, progressed to high fever, resp failue, mech ventilaion, Rx with antivirals, HCQ; extubated day 20, negative PCR x2 and discharged day 29. https://t.co/SSSKRbYK2R

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Dr. John Cush RheumNow ( View Tweet)

Italian study of 1193 Psoriasis pts, there were 17 biologic (TNF, UST, IL17 IL23) treated COVID cases. When compared to 19 local nonPSO/Nonbiologic pts. PsO had more Sxs (OR 3.4), more hospitalizations (OR 3.6), but no difference in ICU admission or death https://t.co/6LR857Ksdk

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Dr. John Cush RheumNow ( View Tweet)

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