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ASBMR Recommendations on Secondary Fracture Prevention

d Jack Cush, MD

The American Society for Bone and Mineral Research has developed multistakeholder consensus clinical recommendations for the prevention of secondary fractures for those aged 65 years and older after an initial hip or vertebral fracture.

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Increasingly Women are Choosing Subspecialty Careers

d Jack Cush, MD

JAMA Internal Medicine has an analysis of the growing trend of more women enrolling in medical schools in the last few decades, such that more than half of US Med school matriculants in 2017 were women.  Also in 2017, 42% of residents in internal medicine were women.  The reported analy

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Ixekizumab vs. Adalimumab in Psoriatic Arthritis

d Jack Cush, MD

The Annals of Rheumatic Disease reports a psoriatic arthritis study where in ixekizumab was non-inferior to adalimumab for achievement of ACR50 responses but was superior to adalimumab for achievement of PASI100 by week 24.

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Anakinra Use in Hospitalized Gout Patients

d Jack Cush, MD

While the efficacy and safety of interleukin 1 (IL-1) inhibitors (e.g., anakinra) in the acute management of gout and pseudogout has been repeatedly shown, the cost efficacy of such biologic therapy has rendered it impractical for most. A new retrospective study has shown that IL-1 inhibitors may be effective and appropriate for some medically complex, hospitalized patients with acute gout or calcium pyrophosphate crystal arthritis.

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Similar Outcomes for Hip Arthroplasty or Hemiarthroplasty in Hip Fracture

d Jack Cush, MD

The NEJM reports on a randomized comparison of hemiarthroplasty and total hip arthroplasty in displaced femoral neck fractures and shows no difference in function and quality of life over 24 months.

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Ustekinumab Efficacy in Ulcerative Colitis

d Jack Cush, MD

The NEJM reports the results of a one year trial wherein ustekinumab (UST) was shown to be effective at inducing and maintaining remission in patients with moderate-to-severe ulcerative colitis. Ustekinumab, currently approved for use in psoriasis, psoriatic arthritis and Crohn's disease, is a monoclonal antibody against the p40 subunit of interleukin-12 and interleukin-23.

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FDA Approves Rituximab for Children with GPA

d Jack Cush, MD

The U.S. Food and Drug Administration has approved Rituxan (rituximab) for the treatment of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in children 2 years of age and older in combination with glucocorticoids.

This is the first approved treatment for children with vasculitis.

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MotherToBaby Pregnancy Study in 528 RA pts has shown oral steroid use yields a dose dependent risk of pre-term birth. PTB was increased high dose (RR: 4.77) and medium dose (aRR: 1.81) OCS in the 1st 139 gestational days; DMARDs/biologics were not https://t.co/cuggovK8eL

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Dr. John Cush RheumNow ( View Tweet)

Analysis of retail pharmacies and drug costs show that, compared to large chain pharmacies, big box was 48% cheaper, followed by grocery-based (18% cheaper), next small chain (51% higher), and independent pharmacies (61% higher) https://t.co/jlQnNboiAR

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Approximately 20–30% of IBD patients will develop spondyloarthritis. Using a survey tool on 244 IBD pts they found 21% with sufficient criteria to suspect SpA - Other risk factors included being female, Crohn's, prior DMARD or biologic drug use. https://t.co/9Ail7syLmB

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Dr. John Cush RheumNow ( View Tweet)

One of my favorite things about writing "health humanities" pieces for journals are the gracious, thoughtful, insightful notes I get from fellow docs. This one arrived in my inbox this AM. Humbling in its perfection. In response to this article: https://t.co/9uPvPDOPAI https://t.co/85usMOPqlb

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Adam Cifu adamcifu ( View Tweet)
Felt the need to update my 10 commandments. Fortunately, on twitter, commandments are not written in stone. https://t.co/Rt9YDW8lFh
Adam Cifu adamcifu ( View Tweet)
"Physicians don’t hate technology – they have smartphones, fitness trackers and tablets just like everyone else – what they hate is bad technology." Truth. #fightburnout https://t.co/qTG0jZFtDL

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Gabe Charbonneau, MD gabrieldane ( View Tweet)

Survey for Rheumatologists - You would use an MRI in an RA to assess what?

Dr. John Cush RheumNow ( View Tweet)

Kaiser study of 1956 SLE patients shows only 58% of were adherent (≥ 80%) to hydroxychloroquine; not predicted by the Rheum, hospital or socioeconomics. Risk factors for nonadherence included age, being white, # of Rheum visits/yr. https://t.co/qRdJRGvRAr

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Dr. John Cush RheumNow ( View Tweet)

Retrospective claims study shows that higher ACPA and RF titers were independently associated with 60-78% increased mortality in established RA; the association persisted in when Rx with DMARDs, but not with biologics. https://t.co/hHJx4alNIQ

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Dr. John Cush RheumNow ( View Tweet)

Study of 101 RA pts w/ baseline Cardiac CT; after median of 83 mos, 48% had progression of plaque; predicted by older age, inflammation & prednisone (p<0.05). Coronary Art. Calcium progressors were older, obese, HTN w/ more inflammation https://t.co/hJRhfja0yk

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Dr. John Cush RheumNow ( View Tweet)

Tofacitinib therapy is being studied (not yet approved) in several dermatologic conditions - psoriasis, alopecia areata/universalis, vitiligo, atopic dermatitis and dermatomyositis. https://t.co/Ez3u95Eh7K

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Dr. John Cush RheumNow ( View Tweet)

A&R reviews the inflammasome in autoimmune diseases. Pattern recognition recpt induce inflammasome activation, pro-caspase-1 converts to caspase-1 convertin pro-IL-1β and pro-IL-18 active IL-1β and IL-18; seen in RA, SLE, gout, Sjogrens https://t.co/JGadiEWQWf

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Dr. John Cush RheumNow ( View Tweet)

CDC advises against vaping with marijuana, noting that up to 77% of 805 cases and 12 deaths from lung disease tied to vaping with THC https://t.co/dtDvMJ1dlA

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Dr. John Cush RheumNow ( View Tweet)

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