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RheumNow Podcast – Vasculitis and Strange Bedfellows (12.14.18)

d Jack Cush, MD

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

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CDC Top 15 Most Common Opioid Overdose Drugs

d Jack Cush, MD

The Dec. 12 issue of the National Vital Statistics Reports from the U.S. Centers for Disease Control and Prevention reports that the most commonly abused drugs causing drug overdose deaths (between 2011-2016) include fentanyl, heroin, oxycodone, and cocaine.

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Psoriatic Arthritis Does Not Add to Pregnancy Problems

d Jack Cush, MD

When psoriatic arthritis (PsA) patients become pregnant, they do not have more infertility or adverse pregnancy outcomes compared to healthy controls.

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No End in Sight for the Shingrix Vaccine Shortage

d Jack Cush, MD

There is a national shortage of a new shingles vaccine, Shingrix, which is a problem for those who want to start the vaccine and those seeking to receive their second and final injection. 

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IL-23 Outduels IL-17 Inhibition in Psoriasis

d Jack Cush, MD

Johnson & Johnson has announced the preliminary results of its phase 3 ECLIPSE study; a head-to-head trial wherein guselkumab (Tremfya; an IL-23 inhibitor) was compared to secukinumab (Cosentyx; an IL-17 inhibitor) in adults with moderate to severe plaque psoriasis.

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CV Risks Similar in Systemic Sclerosis and Rheumatoid Arthritis

d Jack Cush, MD

Interactions between disease-related inflammatory processes and the development of several morbidities have been well-studied in RA, particularly heart disease. This is not the case for the often-lethal SSc (estimated standardized mortality ratio between 2.5 and 4.0).

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With irAEs arthralgias snd arthritis are common, but also can present as tendinitis tenosynovitis, dactylitis, PMR and most are seronegative https://t.co/WRvczdEsh9
Dr. John Cush RheumNow ( View Tweet)
Bing Bingham MD talking on immune related adverse events (MSK and autoimmune). Says these occur in 3-5% of cancer pts treated with Checkpoint inhibitors. Unofficial surveys show nearly 50% of Rheums have seen these referrals. #MARS #ARTHROS https://t.co/yZHMQjpMz8
Dr. John Cush RheumNow ( View Tweet)
Read my take on why TWITTER can be a + force in the field of RHEUM! @RheumNow @psufka RonanTKavanaugh @AWIRGOUP @creakyjoints @ACRheum @EULAR_org Social Media as a Creative/Disruptive Force in Rheumatology (or Why I Now Tweet) https://t.co/hvRyEREFvu

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Leonard Calabrese LCalabreseDO ( View Tweet)

Best Rheums go to the Best Meetings - RHEUMNOW LIVE - the next best Rheum CME meeting - Interactive panels, digital interface, Downloads, Shot Lectures, Big Name Faculty. Special discounted Holiday Registration rates. March 22-24 2019 in Ft Worth, TX https://t.co/5TVg0Frsbf

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Dr. John Cush RheumNow ( View Tweet)

While flu activity is starting to rise in US, CDC issued Updated Influenza Antiviral Medications Summary for Clinicians | CDC. **DON’T USE: Amantadine OR Rimantidine to Tx flu ** ⁦@RheumNow⁩ ⁦@CDCFlu⁩ https://t.co/6W26hBEQvF

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k dao KDAO2011 ( View Tweet)

Comparison of pediatric (214) and adult (5348) GPA pts shows Pediatric GPA to have 30% more hospitalizations and 2-3 fold more leukopenia, neutropenia, hypogamma than adults. No diff in severe infections, major relapse, ESRD. https://t.co/Q1qX80RJDK

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Dr. John Cush RheumNow ( View Tweet)

By turning my back to the EMR, looking 1 on 1 at the patient and letting the patient tell their story, I collect more information, trust and goodness than I would ever from by reading reams of reports and results and "documenting"

Dr. John Cush RheumNow ( View Tweet)

No differences seen in the rates of major adverse CV events (MACE) between RA, axial SpA or PsA pts, suggesting inflammation, rather than a disease, drives CV risk. Data from a Swiss mixed retrospective/prospective cohort study https://t.co/Kn8a8tWId9

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Dr. John Cush RheumNow ( View Tweet)

I find my self thinking or saying, "what were you thinking", "oh no, say it isnt so" or "what?!!?!" when I shoud say "maybe another/better way would be.." or "I think the next time you should try...." and "my other patients find that when you it this way...."

Dr. John Cush RheumNow ( View Tweet)

Too often doctors think their job is to know the answer and fix the problem. All too often, strangely and surprisingly, that isnt what the patient wants or needs. They need someone who cares, doesnt judge behaviors and displays a pulse and personality

Dr. John Cush RheumNow ( View Tweet)

27yoF w/ chronic 4 mos b/l knee effusions (SF WBC=22K, -C/S), MRI synovitis only, Labs normal but with +ANA 1:160, neg Parvo, B27, RF, CCP, RPR, HCV/HBV, ESR and CRP. No resp to NSAIDs or IA steroids. DX?

Dr. John Cush RheumNow ( View Tweet)

28 yr old w/ nail pitting on both hands. Other signs of nail psoriasis are yellow/ pink ("oil-drop") discoloration, onycholysis, subungual hyperkeratosis, nail plate crumbling, splinter hemorrhages. 3 other diseases cause nail pitting -which ones? https://t.co/B38TE1MYW0

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Dr. John Cush RheumNow ( View Tweet)

Statin Safety review from the American Heart Assn says 1 in 4 adults > 40yrs takes a statin; lowering LDL by 55-60%. Statin-induced rhabdomyolysis is <0.1%, and serious hepatotoxicity is ≈0.001%. The risk of statin-induced new diabetes is ≈0.2%/Year https://t.co/1FLZFsvmvZ

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Dr. John Cush RheumNow ( View Tweet)

Acute onset 1st MTP swelling and Pain w/ ultrasound evidence of synovitis on power doppler - the most likely diagnosis is? https://t.co/VGkxLR7aRh

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Dr. John Cush RheumNow ( View Tweet)

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