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CV Risk Management in Rheumatic Disease Patients

Jack Cush, MD

The European League against Rheumatism (EULAR) has developed recommendations for cardiovascular risk (CVR) management in rheumatic disease patients based on literature review and expert consensus.

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Hand OA and Heroes in Rheumatology (2.11.2022)

Jack Cush, MD

Interesting reports this week about dementia, who gets hand OA and a great list of women Heroes and Pillars of Rheumatology. Tune in as Dr. Jack Cush reviews the news and journal articles from this past week in RheumNow.com.

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Vitamin D and the Risk of Autoimmune Diseases

Jack Cush, MD

The results of the VITAL study (presented at ACR 2021) are now published by BMJ, showing that vitamin D and omega 3 fatty acids reduce the overall risk of autoimmune disease (AID) in a population based intervention trial.

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An Ounce of Prevention (2.4.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  He discusses the GI side effects of IL-17 inhibitors, downstream revenues from rheumatology care and dietary prevention of gout. 

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virus,COVID,Vaccine, booster

MMWR: Booster Vaccine Efficacy in Immunosuppressed Patients

CDC/MMWR

For adults aged ≥18 years who received 2 doses of an mRNA COVID-19 vaccine, a third dose increased vaccine effectiveness (prevention of hospitalization) among adults without (82% to 97%) and with immunocompromising conditions (69% to 88%), with near similar efficacy.

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Challenges in Lupus: -Mortality greatest in 1st yr -Dx Delays 6.4 yrs -Long-term complications increased 50 fold -Steroids worsen long-term outcomes -Health care costs increased 3 to 5 years prior to Dx -Mean delay in drug starts after Dx =177 days https://t.co/QUbsIQtcRa https://t.co/zAMUp99ecg

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Olumiant (baricitinib) studies in Lupus halted by Lilly due to mixed results in phase 3 trials. While the BRAVE-1 study showed 4-mg BARI meeting primary endpoint at 52 weeks; the Brave-II failed to do same & failed key secondary endpoints https://t.co/XBmo15UCYl

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Lupus international cohort study of 1460 HCQ pts showed that SLE flares were increased with dose reduction (aHRs 1.20;CI 1.04 to 1.38) and HCQ discontinuation (aHR 1.56; 1.31 to 1.86), higher with low educational levels after HCQ D/C https://t.co/fO4fBtrFYo

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Round up of last week's QD Clinics: -Steroid Weaning -Diagnosing Neuropsychiatric Lupus - Not the Same Ol’ Lecture - Your Next Follow-up Visit is When? QD Clinic is sponsored by RheumNow Live https://t.co/9U1wcbIMs4 https://t.co/HjyyGtbe4r

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Among 10,205 admissions for psychosis, 19% were tested for ANA, 15% of those were ≥1:160; BUT ONLY 4 patients met 2019 ACR/EULAR criteria for SLE, & 2 met criteria for Neuropsychiatric SLE - NPSLE prevalence of 1.5% ANA+ psychosis pts https://t.co/r2sTSVKC66

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Women Heroes in Rheum: - Barbara Ansell - JIA - Nanna Svartz - SSZ - Gertrude Elion - Nobel Prize for allopurinol, AZA - Tsai-Fan Yu - gout Rx - Mary Betty Stevens - lupus & vasculitis - Marian Ropes - 1st F ARA president - Fionula Brennan - TNFi & more https://t.co/a9tKUyWBBu https://t.co/UsHDpzJ8ma

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A prospective study of 124 pediatric SLE pts from UK - estimated Incidence 0.36/100 000. In 1st year 71% on systemic steroids, 98.2% on immunosuppressives, 20.4% accruing damage (mostly neuropsychiatric); most needing multiple speciality team care https://t.co/wdh52pn1Fd

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Psychosis is rare in SLE; Retrospective cohort review finds 18/709 SLE or 2.5% developed lupus psychosis. Psychosis remitted in 12/18 w/ a combo of antipsyschotic (in 38.9%) and immunosuppressive (steroid 72%, CTX 56%, RTX 17%, etc) https://t.co/AnCPaPS8QE

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The next generation of lupus therapies (esp in lupus nephritis) - belimumab, voclosporin , anifrolumab, obinutuzumab. Better trial designs, better organ endpoints, but yet these trials/results are limited by the high dose steroids in play.... https://t.co/48D9rI9EEH

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van Vollenhoven et al strategies onT2T in SLE 1) Choose a Target; treat, monitor, adjust 2) LLDAS & DORIS remission are good targets 3) T2T trials needed w/ current Rx & new biologics & sm molecules 4) LLDAS & DORIS as outcomes in clinical trials https://t.co/aTq398iaSD https://t.co/yWlp4vY7kh

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ASK CUSH ANYTHING! Have a Rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/LAC6XrYEyN https://t.co/POGHk7Ibq2

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Lupus metanalysis of 41 studies, 17,270 pts shows that REMISSION was maintaned for 1 year in 42–88% of pts, and 5 yrs in 21–70%. Remission assoc w/ older age @dx, lower Dz activity, NO major organ involve. REM had less damage, better QOL https://t.co/1zPcITcYMo

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Register for RheumNow Live, March 19-20, 2022. You can attend RheumNow Live in person in Irving, Texas - or, the comfort of your own home or office. You can also receive CME credit! https://t.co/c7oLLCllM8 https://t.co/EGCGFilnVv

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Why Are Physicians Silent About Outrageous Drug Prices? https://t.co/hLrUFCiKwm https://t.co/ZgRoW9Duo6

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COVAX Registry: Safety of COVID-19 Vaccines in Rheum Patients  https://t.co/MrywKZKcIV https://t.co/QgajVPdesg

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