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Update on Pregnancy Management in RA

d Jack Cush, MD

Two recent reports offer good news to rheumatoid arthritis (RA) women who are planning to become pregnant. 

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No Difference in Oral or IV Antibiotics for Bone & Joint Infections

d Jack Cush, MD

Research from the NEJM shows that oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first six weeks for complex orthopedic infections.

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Low IBD Risk with Secukinumab

d RheumNow

The interleukin-23 (IL-23)/IL-17 axis plays an important role in inflammation and infection. Some of these chronic immune-mediated inflammatory disorders include PsO, PsA, AS, and IBD. Patients with PsO, PsA, and AS have up to a four-fold risk of developing IBD versus the general population.

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Ixekizumab and Complete Resolution of Enthesitis and Dactylitis

d Jack Cush, MD

IL-17 inhibitors have proven to be effective in psoriatic arthritis. Analyses of ixekizumab-treated PsA patients with enthesitis or dactylitis shows this approach to yield significant improvements in enthesitis and dactylitis.

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Vertebroplasty and Kyphoplasty Shown to Be Ineffective

d Jack Cush, MD

There are approximately 750,000 new vertebral compression fractures each year in the United States, with resultant acute and chronic back pain in over one‐third of patients with vertebral fractures (VF).  Both percutaneous vertebroplasty or balloon kyphoplasty have been advocated as useful m

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Multidisciplinary Recommendations for Rheumatoid Foot Problems

d Jack Cush, MD

Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems.

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MMWR reports SCURVY outbreak in the Sudanese; NOTE this also occurs where you live, especially in young people with Horrible, monotonous diets. Sxs include arthralgias, lethargy, fatigue, gingival pain/bleeding, hyperkeratotic skin changes, chest pain https://t.co/v41LdnheOu

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RCT of Vitamin D in 379 elderly UK adults aged ≥70 y (48% women) give either 12,000 IU, 24,000 IU, or 48,000 IU. There was no ΔBMD, but parathyroid hormone decreased in all 3 groups (significantly betw 48,000 and 12,000-IU groups (P < 0.01). https://t.co/2ZxJ3kcYqx

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The rheumatoid arthritis drug Xeljanz saw revenues jump 33% for the year, with total revenues coming in at $1.8 billion in 2018 https://t.co/E7KHJSgkjF

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Dr Uma Mahadevan and colleagues have published guidelines for managing pregnancy in IBD patients. Rec coordinated care w/ maternal-fetal medicine subspecialist, GI doc, preconception planning, more on treatement https://t.co/A5zsHYd9hm

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Survey Q for Rheumatologists - a new arthritis drug is FDA approved - how long do you wait to prescribe it?

Dr. John Cush RheumNow ( View Tweet)

17.2% of 576 autoimmune pts had Mechanic hands: 50% MCTD; 35% DM; 15% PSS; 15% of UCTD; 14% Sjogren’s; NO SLE pts. 81% Mechanic+ had abnl capillaroscopy. DM w/ Mechanics had more Raynauds, Jo-1+ & abnl capillaroscopy https://t.co/igdTHUYmSj

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UK pts w/ hemochromatosis homozygous for HFE p.C282Y finds men 40-70 w/ incr risk of Hemochr Dx, (OR 411), liver Dz (4.3), RA (2.23), OA (2.01) & DM (1.53). Heterozygotes w/ hemochromatosis was more common but morbidity was modest. https://t.co/8NyRRJGqTl

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Using data mining and machine learning of medical/facility claims the estimated prevalence of myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS) in the U.S. is 1.7 million to 3.38 million - with 35-40% of patients being MEN. https://t.co/mXy7sQEPgb

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Congratulations to Dr. Sasha Bernatsky for receiving the Arthritis Alliance of Canada Award https://t.co/vgiKcTXuNK

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QD Clinic - The Tophi Guy | Gout case management from https://t.co/2dcFVgu8z6 https://t.co/Nj3PbgVuFK

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Comparison of 187 RA and 157 without inflammatory joint dz, shows a significant association between periodontitis and RA (adjusted OR = 20.57). Periodontitis severity was significantly associated with RA disease activity (p < 0.001) https://t.co/Bmv2LKRnYz

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2014-2015 study of 750K from Southern Sweden shows 24% of OA patients used opioids (2 fold higher than those without knee or hip OA).

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QD Clinic - RA patients on Biologic with Recurrent UTI. Lessons from the clinic and J Cush, MD https://t.co/OaFY6GCT80 via @YouTube

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101 kids w/ Takayasus finds 3% mortality in Yr 1, 50% morbidity in 5 yrs. Median onset was 14 yrs, 76%F. Sxs include HTN (70%), BP discrep(55%), bruits (52%), pulse deficits (38%). Artery Inv: Renal (62%), aorta (43%), subclavian (44%), carotid (43%). https://t.co/nXdjLviRyk

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