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Best of 2019 - War on RA - Part 3: Useless Drugs

d Jack Cush, MD

We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.

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Best of 2019 - Are Non-TNF Biologics Superior to TNF inhibitors?

d Jack Cush, MD

Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis.

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Best of 2019 - Methotrexate and the Risk of Lung Disease

d Jack Cush, MD

Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.

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Im starting a War on RA. I need you go get mad. Read it here https://t.co/oIekFqSZVN or watch it here https://t.co/4mBzQBSys0

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Dr. John Cush RheumNow ( View Tweet)

FDA has approved Otezla 30 mg bid for adults with oral ulcers associated with Behcet's Disease; based on the results showing apremilast lowers the number and pain of oral ulcers in a 12-week placebo-controlled Phase 3 study. https://t.co/kN7PdOY0MF

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Dr. John Cush RheumNow ( View Tweet)

Review of 541,744 total knee replacement (TKR) in Australia (1999-2017) finds lower revision rates in RA vs. OA, but increased risk of infection in RA (esp. males) https://t.co/XA1jLoOEBo

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Dr. John Cush RheumNow ( View Tweet)

I would never allow my patient to self medicate or regulate their Prednisone or MTX, immunosuppresives or biologics. It's what they don't know that will hurt them.

Dr. John Cush RheumNow ( View Tweet)

Doctors know medicines. But when a doctor treats him/herself the adage is that he/she has a fool for a patient. Remind your patients of this next time they try to test themselves with out the input if an expert

Dr. John Cush RheumNow ( View Tweet)

Is the Serious infection (SIE) risk different between TCZ and TNFi? Not when used after failing 1 TNFi; But for biologic initiators, SIE risk was higher in TCZ compared to TNFi or ABA (based on claims data from 16074 TCZ matched to 33109 TNFi initiators https://t.co/ZHVWF9fIHF

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Dr. John Cush RheumNow ( View Tweet)

Kaiser Permanente study of 1,956 adult #SLE patients shows that only 58% of lupus pts were ≥80% adherent to hydroxychloroquine. Only age and increasing visits were predictive. Not predictive were the rheumatologist, center or socioeconomic factors. https://t.co/m0oN1OC9bn

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Dr. John Cush RheumNow ( View Tweet)

Since fasting is so hot right now, here is a hot off the press @NEJM review of it => Effects of Intermittent Fasting on Health, Aging, and Disease | NEJM https://t.co/Ijc0NSFa9s

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Philip Robinson philipcrobinson ( View Tweet)

Should we keep our patients with #gout on colchicine indefinitely (if no contraindications/intolerances) for their higher risk of MI/CVD? https://t.co/4bQds3u1oL

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Tuhina Neogi, MD, PhD Tuhina_Neogi ( View Tweet)

The ACR and EULAR have developed the first-ever international set of classification criteria for IgG4-RD, which was established and tested using a data-driven approach and multicriterion decision analysis – details: https://t.co/rI8dRM8kmO https://t.co/sTJ360Ouxb

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American College of Rheumatology ACRheum ( View Tweet)
Congrats & welcome new rheum fellows! Another competitive year, with rheum match rate (71.3%) behind GI (62.8%) but similar to CARDS (72.8%) & HONC (77.4%) Thankfully better than last year (65.1%) but still a lot of (well deserved!) excitement for the field! https://t.co/QDD5VCD8Rv
Mike Putman EBRheum ( View Tweet)
Patients and insurance companies in the United States pay higher prices for medications, imaging tests, basic health visits and common operations. https://t.co/oQrCSOE58j

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NYT Health NYTHealth ( View Tweet)

#DidYouKnow Sir #WilliamOsler died ☠️ of what he called “the old man’s friend” (#pneumonia)? Learn more about the “father of #InternalMedicine” during the 💯th anniversary of his death https://t.co/0O61Qctouq. #IMProud @mcgillu @UniofOxford @JohnsHopkins @Penn @RoySocMed https://t.co/1ZS79pZrhx

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ACP ACPinternists ( View Tweet)
The #Rheumatologist: Ellen M. Gravallese, MD, Begins ACR Presidency → https://t.co/ZO6ilPG0lk

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American College of Rheumatology ACRheum ( View Tweet)

Exciting work by colleagues in US, led by NIH. https://t.co/bGB75bOGFB. immunodominant peptides of topo 1, fibrillarin, and centromere protein A are homologous to viral protein sequences from the Mimiviridae and Phycodnaviridae families, suggesting molecular mimicry.@NIH_NIAMS

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Dr. Dinesh Khanna sclerodermaUM ( View Tweet)

Antiphospholipid syndrome incidence is 5 per 100k/Yr; lesser known complications include Libman Sachs valve dz, livedo reticularis, racemosa, skin ulcers/necrosis, GN, thrombotic microangiopathy, AVN, non-traumatic fractures https://t.co/rWlWZ39Lhd

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Dr. John Cush RheumNow ( View Tweet)

The Best Rheums go to the Best Meetings - RHEUMNOW LIVE - March 13-14-15 2020 Great Venue =Fort Worth. Short Lectures, interactive sessions, Q&A panels, TED (like) Talks, digital, streaming and much more. You dont want to miss this meeting! https://t.co/69Y3QyU3Wc

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Dr. John Cush RheumNow ( View Tweet)

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