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Smoking Cessation Lowers RA Disease Activity and CV Risks

d Jack Cush, MD

A multinational cross-sectional cohort study suggests that smoking cessation in rheumatoid arthritis (RA) patients is associated with lower disease activity measures, improved lipid profiles and lower rates of cardiovascular (CV) events.

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Spondyloarthritis Affects Pregnancy Outcomes

d Jack Cush, MD

A Danish registy has shown that the the prevalence of Spondyloarthritis (SpA) diagnosed prior to delivery has increased 5 fold in the last two decades and that SpA is associated with an increased risk of adverse pregnancy outcomes (APO).

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Apremilast Reduces Oral Ulcers in Behcet's Syndrome

d RheumNow

A multinational trial finds a statistically significant number of patients with Behçet's syndrome showed a greater reduction in the number of oral ulcers with apremilast compared with placebo.

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Propensity Score–Matched Cohort claims study compared 11,248 matched pairs RA pts starting either abatacept or TNF inhibitor. ABA had a signficiantly lower risk of hospitalized infx compared to infliximab (HR 0.63), but equal SIE risk vs ETN or ADA. https://t.co/brid5dAdIh

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Dr. John Cush RheumNow ( View Tweet)

Palmoplantar pustulosis has very low prevalence rates (<0.1%), qualifying as an orphan disease, Registry data from US, Denmark, Germany identified 1,435, 751 and German PPP patients, respectively; 14-61% also have Psoriasis, with higher risk of PsA https://t.co/S6r4GtG3bF

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Dr. John Cush RheumNow ( View Tweet)

Ultrasound study of 980 #gout pts finds Bone erosions were seen in 44%, with 78.4% of these found in the first metatarsophalangeal (MTP) joint. Independent predictors include age, duration of gout, tophi, US synovitis and and joint effusion. https://t.co/LxjgfM29Xd

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Dr. John Cush RheumNow ( View Tweet)

Of 1757 systemic sclerosis patients in the EUSTAR study, 25% had diffuse SSc and 9% had current or previous digital gangrene, 16% had digital ulcers (DUs), not CV risk factors. https://t.co/31ypT1V1zO

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Dr. John Cush RheumNow ( View Tweet)

Meta-analysis of 30 studies shows that ACPA-positive RA patients are marginally more likely to achieve EULAR and ACR20 responses with abatacept (RR 1.18; 95% CI 1.03, 1.35), but not with TNFα-i (RR 0.97; 0.86, 1.10) (compared to ACPA-negative) https://t.co/V5CviFVSGt

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Dr. John Cush RheumNow ( View Tweet)

ACR/ARP 2019 attendees get “sneak preview” of updated gout clinical practice guideline → https://t.co/VRyfj75nVu #ACR19

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American College of Rheumatology ACRheum ( View Tweet)

Metanalysis shows that although MTX may blunt some vaccine responses (eg Pneumococcal), the use of MTX, TNF inhibitors and other biologics should not deter vaccination as most vaccine responses are preserved despite therapy. https://t.co/KINrQMIQkt

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Dr. John Cush RheumNow ( View Tweet)

Study of two dietary patterns and the risk of SLE from the Nurses' Health Study (NHS, 1984–2014) and Nurses' Health Study II (NHSII, 1991–2015) shows no association between incident lupus and (healthier) prudent or (less healthy) Western diet. https://t.co/tvX2HqzWxF

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Dr. John Cush RheumNow ( View Tweet)

Spinal/SI MRI in the gen. population finds a high frequency of inflammatory and fatty MRI lesions suggestive of axSpA. MRI done in 793 volunteers < 45 yrs (49% males, 8.4% B27+). SI tJ Bone marrow edema in 17%, Vertebra BME 27% & fatty lesions in 81% https://t.co/XOzyWCyLyC

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Dr. John Cush RheumNow ( View Tweet)

Norways HUNT study shows NO fracture risk with PPI use in 15,017 women and 13,241 men aged 50–85 years. PPIs were not associated with an increased risk of fracture age-adjusted HR 0.82 (0.67–1.01) for women; 1.05 (0.72–1.52) for men. https://t.co/XIAdvxGTrz

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Dr. John Cush RheumNow ( View Tweet)

In the latest edition of @jrheum, our thoughts on why PMR should no longer be considered a syndrome of shoulder and pelvic girdle pain and stiffness, but rather a chronic inflammatory disease of musculotendinous structures. https://t.co/xtcZEqduhx @drdavidliew @earlyARA https://t.co/J2gqXi3PPw

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Claire Owen drceowen ( View Tweet)
If you needed more info that smoking isn’t great for #rheumatoid => Smoking cessation is associated with lower disease activity and predicts cardiovascular risk reduction in rheumatoid arthritis patients https://t.co/kg5ns6W65l

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Philip Robinson philipcrobinson ( View Tweet)

ESPOIR cohort with 172 early seronegative #RA patients finds that early csDMARD use (within 3 mos of Sx) was more likely to predict better outcomes that other prognostic risk (clinical lab or imaging) factors https://t.co/76J93mZ2NH

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Dr. John Cush RheumNow ( View Tweet)

Case-control study of 821 #RA cases & comorbidities between 2009 - 2018 shows some occur after RA- epilepsy (OR 2.13), sleep apnea (1.49), pulm fibrosis (4.63); others predispose to RA, IBD (3.82), T1DM (3.07), VTE (1.80) https://t.co/OV1FsAtMH6

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis shows that although MTX may blunt some vaccine responses (eg Pneumococcal), the use of MTX, TNF inhibitors and other biologics should not deter vaccination as most vaccine responses are preserved despite therapy. https://t.co/KINrQMIQkt

Links:

Dr. John Cush RheumNow ( View Tweet)

We are all going to get sick, the what and why is often unknown . This may be the hardest thing you'll ever do through. How you go through it will define you and deliver you..

Dr. John Cush RheumNow ( View Tweet)

(the Fonz says) Tenacity and gratitude are 2 words to live by. - Henry Winkler

Dr. John Cush RheumNow ( View Tweet)

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