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Diagnosing Early Lupus from Mimics

d Jack Cush, MD

A multicenter study of early systemic lupus erythematosus (SLE) patients examined manifestations at disease onset and found that certain clinical features can help to distinguish early SLE from other SLE‐mimicking conditions. 

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High CV Risk in Lupus

d RheumNow

Patients with systemic lupus erythematosus (SLE) remain at risk for accelerated atherosclerosis, and important questions have yet to be answered, British investigators reported.

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Trazodone High Risk of Falls and Fractures

d Jack Cush, MD

The CMAJ (Canadian Medical Association Journal) has reported that trazadone use in the elderly may be associated with a risk of falls and major fractures. 

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Musculoskeletal/Rheumatic diseases (arthralgias, myalgias, arthritis, PMR, myositis, Sjogrens, SLE) are uncommon side effects of immune checkpoint inhibitors, so-called irAE (immune related adverse events). Good review here. https://t.co/R52SW0HUjv

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Dr. John Cush RheumNow ( View Tweet)

Despite many excellent therapies, most patients with gout are not adequately managed, and patients and providers have many misconceptions about gout. Great review by Ted Fields, MD https://t.co/Njpo1225XP

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Dr. John Cush RheumNow ( View Tweet)

Bisphosphonate safety review - risk of Atypical Femoral Fracture is 1/1000 and risk of osteonecrosis of the jaw is 1/10,000. One-third of IV zolendronic acid pts will have arthralgia/myalgias or flu like sxs. https://t.co/80xBkZlKgn

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Dr. John Cush RheumNow ( View Tweet)

TB Testing 2 - Note: <10% of pts initially PPD/IGRA neg may be positive later (either they were anergic or have a new TB infx). I Recommend repeat TB testing 3 mos after starting or changing from 1st to 2nd biologic - Repeat testing indicated if newly EXPOSED or when Risk Changes

Dr. John Cush RheumNow ( View Tweet)

TB Testing - Do PPD or IGRA before TNFi or biologic - If negative, start therapy - If Positive, Eval for active TB (Sxs, CXR, C/S); if neg --> LTBI Rx BEFORE biologic - If "Indeterminate", repeat or change test. If same or neg--> start biologic - Do not do annual TST or IGRA

Dr. John Cush RheumNow ( View Tweet)

Metanalysis shows DMARDs (6 studies) and biologics (5 studies) offer NO clinically significant benefit compared with placebo in Osteoarthritis. https://t.co/fNGVzuNQNo

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Dr. John Cush RheumNow ( View Tweet)

Vasculopathy (inflammatory, occlusive, necrotizing) distguishes juvenile dermatomyositis from adult myositis - also w/ high risk of severe extra-muscular dz (GI, Lung, cardiac, skin). Good review article here https://t.co/yH8xwKl6S8

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Dr. John Cush RheumNow ( View Tweet)

Could routine use of hydroxychloroquine reduce the rate of serious infections in immunosuppressed patients? A modest to moderate risk reduction noted in two large SLE cohort studies. https://t.co/pssLrteRRq

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Dr. John Cush RheumNow ( View Tweet)

2018 NRMP report shows Rheumatology as one of the most competitive fellowships with 313 applicants for 221 positions - 147 filled by US grads and 69 by FMGs. https://t.co/xRmMyA2yCy

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Dr. John Cush RheumNow ( View Tweet)

Clinical Trials Benchmark for Biosimilar Development is one of several educational videos available in the "Therapeutic Update: Biosimilars in Rheumatology" video series, sponsored by Sandoz, Inc. and now available on RheumNow. https://t.co/1vmnEJqOSi

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Dr. John Cush RheumNow ( View Tweet)

J Rheum (Ward et al) reports that the minimal clinically important improvement (MCII) of RAPID-3 was –3.8. https://t.co/UxCOeMl52g

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Dr. John Cush RheumNow ( View Tweet)

The "Type" of person you are often is displayed with how you manage authority

Dr. John Cush RheumNow ( View Tweet)

CORRECTION: mm! Guidelines on CT pulm nodules-no F/U needed for solid nodules <6mm in low risk pts (age,smoking, morphology); but larger (6-8mm), suspicious nodules should have 6 & 12 mos F/U images. Some 8cm or more nodules require more freq assessments https://t.co/Nl6zV3VQg1

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Dr. John Cush RheumNow ( View Tweet)

“This is not your responsibility but it is your problem.” — Cheryl Strayed I believe the converse is more important to what we need to teach our patients - "This is not just your problem, this is now your responsibility"

Dr. John Cush RheumNow ( View Tweet)

Safety and Immunogenicity is one of nine educational videos available in the "Therapeutic Update: Biosimilars in Rheumatology" video series, sponsored by Sandoz, Inc. and now available on RheumNow. https://t.co/1vmnEJqOSi

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Dr. John Cush RheumNow ( View Tweet)

FDA Approves Gamifant (emapalumab-lzsg) for Primary Hemophagocytic Lymphohistiocytosis https://t.co/YALlc0XdKh

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Dr. John Cush RheumNow ( View Tweet)

Are you a US rheumatologist interested in what the midterm election results mean for us? 100 members of the next Congress are NEW and we need to meet them! Please invest in #RheumPAC NOW. Help advance arthritis research, reform step therapy & other causes! https://t.co/pcRkh6eLfJ

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Angus Worthing MD AngusWorthing ( View Tweet)

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