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The RheumNow Podcast – Heartbreak of Methotrexate (11.16.18)

d Jack Cush, MD

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

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Growing Tick Population Comes with Health Concerns

d Jack Cush, MD

CNN has published a recent government report from the Tick-Borne Disease Working Group that suggests the US tick population is growing and may bring with it an increase in tick-related illnesses. 

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Pilot Data on Rituximab in Henoch-Schonlein Purpura

d Jack Cush, MD

Management of Henoch-Schonlein purpura (HSP) can be challenging as supportive care and avoidance of corticosteroids are often insufficient options. A new series of case reports and literature review of steroid refractory HSP suggests that rituximab may be effective in reducing hospital admissions, overall steroid use, and is capable of inducing remission.

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Scleroderma Expert Treatment Preferences

d Jack Cush, MD

Frustration may be the word that best characterizes many scleroderma management plans - owing to a lack of trials, lack of agreement and lack of clear guidance on management.

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Chikungunya Virus Vaccine Developed

d Jack Cush, MD

Lancet reports on a new vaccine for Chikungunya fever (MV-CHIK) demonstraing excellent safety, tolerability and good immunogenicity, independent of pre-existing immunity against the vector. MV-CHIK is a promising vaccine for the prevention of chikungunya fever.

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Subclinical Heart Inflammation Seen in RA

d RheumNow

Subclinical myocardial inflammation is common among patients with rheumatoid arthritis (RA) and is associated with articular disease activity, researchers reported.

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Pre-Diabetes Associated Risk for Arthritis, Obesity and Physical Inactivity

d Jack Cush, MD

The current MMWR reports that arthritis is seen in nearly one-third of adults with prediabetes and that more than half of such patients are obese and not engaged in regular physical activity.

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I just woke. Ok if I get there around 835?

Dr. John Cush RheumNow ( View Tweet)

44 WF w/ RA is on max dose MTX + ETN for 7 mos. but still has 5 swollen joints, CDAI =13 & nl ESR/CRP. What do you do next?

Dr. John Cush RheumNow ( View Tweet)

Rapid release Tylenol gelcaps are slower to dissolve than cheaper tablets https://t.co/NBBDnl2SEt

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Dr. John Cush RheumNow ( View Tweet)

Our brief year in review video on #biosimilars for @RheumNow at #ACR18: my hope is for interchangeability pathway to become final ASAP w 3 switch studies to push the marketplace so patient costs drop & access to treatment rises! https://t.co/WrK7UBOeNq

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Angus Worthing MD AngusWorthing ( View Tweet)

Teaching 5th graders about the wonders of rheumatology and hoping to help with the inevitable national shortage of rheum professionals #GATI https://t.co/w8vkGpM4zf
Julio Gonzalez japaoli19 ( View Tweet)
The definition of POLYPHARMACY? Mine is when the med list requires 2 pages or when the patient cannot remember Rx names/dose due to #Drugs. Another is "many different medicines used concurrently to treat a single disease or coexisting diseases." Polypharmacy comes with high Risk

Dr. John Cush RheumNow ( View Tweet)

CCP+ RA patient starts out with 8 tender, 6 swollen and DAS=5.1. Put on MTX and TNFi and quickly goes into remission (0 joints) at month 6, 12, 18. At next visit what do you do w/ meds?

Dr. John Cush RheumNow ( View Tweet)

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

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Dr. John Cush RheumNow ( View Tweet)
Analysis of disease activity in 354 patients with ANCA associated vasculitis (AAV) enrolled in 4 trials shows 13% with ESRD and 19% died. Disease activity at 3 & 6 mos predicted later ESRD or death https://t.co/NZu1kJuFF2

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Dr. John Cush RheumNow ( View Tweet)

Large database study of incident gout (n = 41,446) shows chronic kidney dz (CKD stage ≥ 3) was nearly doubled in gout patients (adj HR 1.78 95% CI 1.70, 1.85) and that urate lowering therapy lowered CKD risk by 40% (HR 1.31) https://t.co/5kM1TigSIf

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 28 studies, 52,520 psoriasis cases shows high prevalence of sexual dysfunction (40-56%) and erectile dysfunction (34-81%), with strong associations with anxiety, depression, genital psoriasis and increasing age. https://t.co/2myhgWEW1a

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Dr. John Cush RheumNow ( View Tweet)

Anticoagulation (AC) advice from #ACR18 - Stony Brook study of Temp artery bx found 20/27 pts on AC prior to procedure - Data from 16pts showed continuing AC found only 3/16 with minor bleeding adverse events - Abst #2782 https://t.co/TDsdfO27J9.

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Dr. John Cush RheumNow ( View Tweet)

NEJM publishes the CIRT trial - Methotrexate given to stable atherosclerosis patients for nearly 3 years was equal to placebo in the prevention of cardiovascular outcomes (MI, CVA, death, unstable angina). Story covered on RheumNow https://t.co/YCdwzKD9Da

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Dr. John Cush RheumNow ( View Tweet)

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