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Senate Drills Drug Makers Over Price

d Jack Cush, MD

Reuters reported that today, the US Senate Finance Committee met to question the executives from seven US pharmaceutical companies on the rising price drugs in America. 

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Does Smoking Cessation Reduce RA Risk?

d RheumNow

Individuals who quit smoking and maintained their nonsmoking status over a long duration of time had a decreased risk of developing seropositive rheumatoid arthritis (RA), an analysis of two large prospective cohorts found. 

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Canadian Vaccination Guidelines for the Immunosuppressed

d Jack Cush, MD

A multidisciplinary Canadian task force has developed guidelines for vaccination in patients receiving immunosuppressive therapies, based on the evidence that immunosuppressive use in immune-mediated disease may be  associated with an elevated risk of infections. 

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FDA Slaps a Boxed Warning on Febuxostat for CV Risk

d Jack Cush, MD

The U.S. Food and Drug Administration (FDA) has reviewed data from the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial and concluded there is an increased risk of death with Uloric (febuxostat) compared with allopurinol, and has added this as a boxed warning to the drug’s product label.

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The Risk of Tuberculosis with TNF Inhibitors

d Jack Cush, MD

A study from Turkey shows that among 2117 patients treated with a TNF inhibitor (TNFi) the risk of developing TB was 6 fold higher in those treated with a TNFi compared to non-users.

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Nurses Health Study had 1528 incident #RA cases. Current smoking increased risk of seropositive (not Seronegative) RA (HR 1.47). Smoking cessation >10, >20, >30 yrs ago assoc w/ decreasing risk of seropos. RA, but risk still remains > 30 yrs (HR 1.30) https://t.co/1CsIcXtJ1I

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Dr. John Cush RheumNow ( View Tweet)

Prospective cohort study of 93 Systemic sclerosis patients with ILD; 2/3 had diffuse SSc. Half had PH diagnosis w/in 7 yrs of SSc onset, 83% Rx with ILD therapy, 83% Rx for PH. Survival rate for SSc-ILD and PH at 3 years after PH diagnosis was 91%. https://t.co/ZmOmWutwxq

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Dr. John Cush RheumNow ( View Tweet)

8.9% of systemic sclerosis pts were ANCA+, denoting a subset with increased risk of ILD (44.8% vs 21.8%, p < 0.001) and pulmonary embolism (8.6% vs 3.0%) in SSc. ANCA should be tested in SSc, as it identifies individuals with worse prognosis https://t.co/WhlEpxFdIG

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Dr. John Cush RheumNow ( View Tweet)

QD Clinic - New Changes to Gout Guidelines. Lessons from the clinic - a noncompliant gout patient needs to restart his gout drugs, what to do with febuxostat? https://t.co/XwaUewBjWS via @YouTube

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Dr. John Cush RheumNow ( View Tweet)

ERRATA: "How to Handle Latex Allergies and Biologics" - has been corrected to show that the Cimzia PFS DOES contain 7% of a plastic derived from natural rubber latex. Latex- sensitive patients should be advised to handle the needle shield with caution. https://t.co/ThLns4C5Jt

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Dr. John Cush RheumNow ( View Tweet)

Among 548 pts referred to academic pain center & treated for back pain, 42% met fibromyalgia criteria. FM+ pts were more likely to be younger, unemployed, w/ greater pain severity, more neuropathic pain, depression, anxiety & lower physical function https://t.co/gse5CDnJ13

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Dr. John Cush RheumNow ( View Tweet)

Taiwanese insurance claims data study shows that Sjogrens syndrome patients (n=13398) have increased risk of osteonecrosis of jaw compared to 54K controls (0.08%vs0.03%, p=0.017) & also bisphosphonate ONJ (adjusted HR=7.9, p<0.001). https://t.co/qQSV16muNN

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Dr. John Cush RheumNow ( View Tweet)

JAMA reports from 2005-2015 PCP density in USA decreased from 46.6 to 41.4 per 100 000, with greater losses in rural areas. Every 10 PCP increase per 100K was assoc w/ added 51 day survival; every 10 specialists per 100k correlated with 19d incr survival https://t.co/81TRwFzOnH

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Dr. John Cush RheumNow ( View Tweet)

The Johns Hopkins Myositis Center is proud to announce the launch of the Peter Frampton Myositis Research Fund. https://t.co/SAVf1AEdqO Join @peterframpton and our Myositis Center team as we work to improve the lives of those impacted by #myositis https://t.co/BjOOaHYuJq

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Johns Hopkins Rheumatology jhrheumatology ( View Tweet)
QD Clinic Week 6 Podcast - case based lessons from the real world. Discusion of Pregnancy Rules, Optimizing MTX, Changing DMARDs, Stopping Anakinra in Still's, NP decisions. Listen on iTUNES or Here https://t.co/61KO2jKxJp

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is up! Discussions of Death rates, Jt. Surgeries, Lupus microbiome & activity, JIA outcomes, Tofacitinib Warnings, 25 Yr Hip replacements. Watch here https://t.co/tYS6WDV3in or Listen to the Podcast on iTunes or soundcloud https://t.co/NkXngajhUB

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Dr. John Cush RheumNow ( View Tweet)

For SLE and other pts with photosensitive skin dz: FDA updated regulations for sunscreens—ONLY zinc oxide and titanium dioxide are Generally Recognized As Safe and Effective (GRASE); combo sunscreen-insect repellents are a big NO! https://t.co/KuaJcT6g1s @RheumNow

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k dao KDAO2011 ( View Tweet)

FDAhas added a boxed warning to the label for gout drug febuxostat (Uloric) based on results of a large postmarketing safety study and AAC panel Recs. FDA concluded that there is an increased risk for death with febuxostat compared allopurinol https://t.co/v1ANA3lI0g

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Dr. John Cush RheumNow ( View Tweet)

QD Clinic - Rules for Pregnancy | RheumNow - Share this video A patient on a biologic wants to get pregnant... https://t.co/DhdFLFAR0O

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Dr. John Cush RheumNow ( View Tweet)

A genuine way to engender trust at each visit, is to inquire about something important to the patients life. More impactful, is when you spend time answering, suggesting, guiding them on important health matters not theirs (like sick husband in hospital, death in family, etc)

Dr. John Cush RheumNow ( View Tweet)

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