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ICYMI: Hydroxychloroquine Dose and Risk for Incident Retinopathy

Jack Cush, MD

A cohort study in Annals of Internal Medicine shows that higher hydroxychloroquine doses was associated with progressively greater risk for incident retinopathy. The study aimed to assess the long-term risk for incident hydroxychloroquine retinopathy and examine the degree to which average hydroxychloroquine dose within the first 5 years of treatment predicts this risk.

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ICYMI: 25 Great Women in Rheumatology

Jack Cush, MD

I reached out to many leaders in rheumatology and asked: who are the great women in rheumatology who should be recognized? This was prompted by a smart article in Annals of Rheumatic Disease written by Drs. Tuhina Neogi (Boston) and Nicola Dalbeth (N. Zealand), entitled "Where are the women ‘Heroes and Pillars of Rheumatology’?

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ICYMI: Carpal Tunnel - Steroid injection vs. Night Splinting

Jack Cush, MD

A prospective, pragmatic, open-label, randomized trial conducted by the UK National Health Service, studied interventions in patients with carpal tunnel syndrome (CTS) and found no advantage to either CTS corticosteroid injection (CSI) or night splinting (NS) as the initial treatment of CTS.

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ICYMI: RA Disease Activity and Alcohol Use

Jack Cush, MD

Despite its well known toxicities, alcohol is known to be antiinflammatory. The effects of alcohol use in rheumatoid arthritis (RA) is less known, but a recent study suggests that alcohol consumption was dose-dependently associated with lower disease activity and higher health-related quality of life in RA patients.

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Scleroderma – Thick and Thin (6.30.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week from RheumNow.com. This week focuses on parodoxical psoriasis, scleroderma outcomes and subsets, and alopecia areata therapy.

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Paradoxical Psoriasis in Kids Taking TNF Inhibitors

Jack Cush, MD

A multicenter cohort study reported a large cohort of pediatric patients receiving TNF inhibitor therapy complicated by psoriasis, regardless of treatment indication or the specific TNF inhibitor.

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High BMI Increases Arthritis Risk

Jack Cush, MD

Obesity carries many risks, now a new study in Arthritis & Rheumatology shows that higher body mass index (BMI) increases the risk for several rheumatic diseases, especially in women for both gout and psoriatic arthropathy. 

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RT @drdavidliew : Tapering pred in RA - this just rings true from everyday clinic life. Some patients just seem to hit a wall at PNL 2.5. Sometimes it’s GC withdrawal arthralgias/tertiary adrenal insufficiency, but often it’s genuine inflammation. I still wonder why? POS0050

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RT @AurelieRheumo : The risk of osteoarticular infection following Staph aureus bacteremia is twice higher in RA (1/4) than non RA pop (1/8) Use of TNFi & orthopedic implants associated w/ OAI risk Mortality however similar in RA and non RA groups #EULAR23 POS0033

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RT @drdavidliew : Men trying to conceive were prev told to avoid MTX. Another myth busted Why? Spermatozoa lack the FPGS enzyme responsible for MTX-PG metabolism, the tiny amount of MTX-PG in sperm isn’t active. No quality issues! OP0224 #EULAR2023 https://t.co/i4WGmoWOwU)

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RT @Yuz6Yusof : #EULAR2023 #POS1075 Which biologics have the lowest retention rate in Elderly patients (=>65 yrs) in Rheumatoid Arthritis? Data from Italian registry showed 1/3 discontinued biologics at 2 yrs. IL6-i: lowest persistence; Abatacept: highest

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RT @Janetbirdope :What is the course of clinically suspect arthralgia in CCP+ vs neg? 781 pts, 136 got RA and sl more resolved symptoms. RA developed in both groups ACPA+ develop more rapidly -if resolution, still more MRI + vs neg. #EULAR2023 POS319. Diff patterns of progression

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RT @synovialjoints : The course of symptoms in CSA to RA showed greater severity in the ACPA+ group compared to the ACPA- group. This correlated with MRI-subclinical joint score, suggesting different underlying processes Khidir S Abst#POS319 #EULAR2023

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Paradoxical PsO (PP) studied in 2867 RA & 5316 SpA pts. 136 (1.7%) had paradox. Rxn, median 12 mos post TNFi [pustular (60%) or palmoplantar (31%)]. 73% PP favorably switched to other TNFi 46% or non-TNFi 27%. RA PP took SSZ, HCQ, LEF; SpA PP more smokers https://t.co/w1EQEvHbeG https://t.co/aAwKxdNYk1

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Paradoxical PsO (PP) studied in 2867 RA & 5316 SpA pts. 136 (1.7%) had paradox. Rxn, median 12 mos post TNFi [pustular (60%) or palmoplantar (31%)]. 73% PP favorably switched to other TNFi 46% or non-TNFi 27%. RA PP took SSZ, HCQ, LEF; SpA PP more smokers https://t.co/iYM3EOdSSM https://t.co/sruLP9adx3

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Why Patients Don't Take Medicines This report examines the characteristics of adults aged 18–64 who took prescription medication in the past 12 months and did not take medication as prescribed due to cost. https://t.co/zuPgMjKYbh https://t.co/62cG9LDYWi

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Medicare and Commercial claims analysis shows 1 #RA pts at risk for H Zoster 2 RA + HZ = more Hospitalizations & ED visits, esp in 30d after HZ 3 Higher total costsalso higher in month after HZ https://t.co/iKmvYDqj87 https://t.co/BeZCmMJse7

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Indian study of 943 AIRD patients (43% RA) starting biologics or JAKi, had TB screening with IGRA assay. 125 pts were IGRA pos. and had LTBI; 124/125 received anti-TB prophylaxis. IGRA Accuracy in predicting absence of TB reactivation = 99.6% https://t.co/KI9vGWpS59 https://t.co/Ne33P51koD

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Abatacept Safety Outcomes Across 7 European Registries A multinational registry analysis of rheumatoid arthritis receiving abatacept has shown that the safety profile of ABA remains unchanged with no new or increased risks of infection or malignancy. https://t.co/hAj3UZjbHJ https://t.co/eQHjEgelRM

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Cancer Risk From RA, Not the Drugs A large US claims analysis shows RA patients were nearly 2 times more likely (than those without RA) to develop lymphoma or lung cancer and that commonly used RA treatments were also unlikely to increase cancer risk. https://t.co/6yrc0TsT53 https://t.co/WRQzeFoR1Z

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