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RheumNow Podcast – Delays in Diagnosis (3.8.19)

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d Jack Cush, MD

Mar 08, 2019

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

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Multiple Delays in Referral of New RA Patients

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d Jack Cush, MD

Mar 07, 2019

A UK study of early onset arthritis or new rheumatoid arthritis patients shows multiple sources of delayed referral to the first rheumatology consultation.

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Congenital Heart Block: Dangers Ahead

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d RheumNow

Mar 07, 2019

Children of autoantibody-positive mothers who were born with congenital heart block were at high risk for developing later cardiovascular and autoimmune disorders, as were their siblings, Swedish researchers reported.

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Biologic Agents have Equal Efficacy in Enthesitis and Dactylitis

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d Jack Cush, MD

Mar 06, 2019

A systematic review has shown that TNF inhibitors (TNFi) are equaled in efficacy by other biologic agents (ustekinumab, secukinumab, and ixekizumab) in psoriatic arthritis (PsA) patients with in dactylitis and enthesitis.

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CORRONA Registry - Chronic opioid use doubled 2002-2015, rising from 7.4% to 16.9%. Strongest predictors included severe pain (HR 2.53), antidepressant use (HR 1.79), high Dz activity (HR 1.55) & high disability (HR 1.45). https://t.co/vPBqvWIy19

Links:

https://buff.ly/2SXcyYo

Dr. John Cush RheumNow ( View Tweet)

Mar 11, 2019

Full Read Review Inclusion Body myositis: IBM) is slowly progressive & commonly misdiagnosed as arthritis or polymyositis. IBM is assoc w/ CV complications and other autoimmune dz. Look for unique features such as finger flexor and knee extensor weakness. https://t.co/WteGovZBFL

Links:

https://buff.ly/2Hj6Sqz

Dr. John Cush RheumNow ( View Tweet)

Mar 11, 2019

Free online access to RheumNow Live - 16 hrs of Innovative lectures and Q&A Panels beginning friday afternoon 3/22, ending Sunday 3/24. Register for FREE at https://t.co/wIgS5rq4UE or come to https://t.co/4UQlqwujiR

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Dr. John Cush RheumNow ( View Tweet)

Mar 11, 2019

PODCast of the last weeks QD Clinics can be found on iTUnes and here >> https://t.co/6SJHvbA2ho

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https://buff.ly/2VQnl8Q

Dr. John Cush RheumNow ( View Tweet)

Mar 11, 2019

A 10-year study of more than half a million Danish children found no evidence that vaccines increased the risk of autism. The study comes at a time when anti-vaccine suspicion is on the rise again. https://t.co/ZhZaW1kUQl

Links:

https://nyti.ms/2TEtHKU

NYT Health NYTHealth ( View Tweet)

Mar 10, 2019

Complacency - not knowing whether you’re in a groove or rut - Lisa Bodell

Dr. John Cush RheumNow ( View Tweet)

Mar 10, 2019

“Innovation is the pirate ship that sails into the yacht club”. - Lisa Bodell

Dr. John Cush RheumNow ( View Tweet)

Mar 10, 2019

Shoulder replacement surgery - low risk of revision in older women (2.7%), highest (23%) in men 55-59 yrs; Revision highest in the 1st 5 yrs. SAE risk <90d was <4.8%; highest in men >85 yrs (21%). Pulm embolism risk Rel Risk = 61fold in women 50-64. https://t.co/NVSzfgZvwS

Links:

https://buff.ly/2U15dIK

Dr. John Cush RheumNow ( View Tweet)

Mar 08, 2019

Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil. Data from 84 papers, 611 male exposures, 5986 pregnancies https://t.co/yfIYoMqaRs

Links:

https://buff.ly/2SLifsw

Dr. John Cush RheumNow ( View Tweet)

Mar 08, 2019

Study of 6529 Afib pts on warfarin, 37.5% were also on aspirin. Adding aspirin to warfarin yielded significantly more bleeding (26 vs 20%), major bleeding (5.7 vs 3.3%), ER visits (13.3 vs 9.8%) but similar thrombosis rates (2.3 vs 2.7%) at 1 yr. https://t.co/m5XDBEN6jh

Links:

https://buff.ly/2TAQmHZ

Dr. John Cush RheumNow ( View Tweet)

Mar 08, 2019

Claims analysis from Natl Taiwan Health Database, compared 262 JIA pts w/ controls & showed JIA pts have 30 fold higher risk of an adult autoimmune dz- Hazard Ratio=129.5 for RA; aHR-10.1 SLE, 49.62 AS & 8.2 PsA. Highest risk (46x) for JIA onset 11-15 yrs https://t.co/oL3stNLYvc

Links:

https://buff.ly/2SKBgvd

Dr. John Cush RheumNow ( View Tweet)

Mar 07, 2019

Risk of pancreatitis with azathioprine in adults estimated to be 3-7%, but unknown in kids. 3374 pairs of pediatric IBD pts compared pts on AZA vs not. AZA use was associated with a 5.82 events/100PY risk of pancreatitis (AZA 49·1 vs NOT 8·4 events/100PY) https://t.co/arap2ShTPN

Links:

https://buff.ly/2HkIlAm

Dr. John Cush RheumNow ( View Tweet)

Mar 07, 2019

Rule of thumb on VTE risks: Normal population 0-.4/100PYs; RA patients are increased at 0.3-0.7/100 PY. If a new RA drug were to cause VTE (venous thromboembolic events; DVT/PE) it would have to have a rate consistently higher than 0.5 and probably higher than 0.7/100PY

Dr. John Cush RheumNow ( View Tweet)

Mar 07, 2019

The PARA study shows among 249 pregnancies (2002-2008), breastfeading was less in RA - at 4-6, 12 & 26 wks postpartum 43%, 26% and 9% of the RA breastfed (vs 63%, 46% & 41% in controls). Many patients D/C breastfeeding so they could start medication. https://t.co/ONf1jgFJYL

Links:

https://buff.ly/2IUIFYW

Dr. John Cush RheumNow ( View Tweet)

Mar 07, 2019

A study of 2,369 patients with fibromyalgia showed the mean time from initial complaint to diagnosis was 6.42 years. Comorbidity, younger patient, and older physician age were associated with longer time to diagnosis. https://t.co/mHGIR7C4PW

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https://buff.ly/2SNnurL

Dr. John Cush RheumNow ( View Tweet)

Mar 07, 2019

QD Clinic - Five Leflunomide Pearls | from RheumNow https://t.co/A4dwd0eTQ9

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https://buff.ly/2tUI0ww

Dr. John Cush RheumNow ( View Tweet)

Mar 06, 2019

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