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Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?
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Annals of Internal Medicine reports a study of more than 75,000 persons screened for monoclonal gammopathy of undetermined significance (MGUS) and found no association between autoimmune rheumatic disease (AIRD) and MGUS.
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Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?
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A long-term hydroxychloroquine users study found that 2.7% developed retinopathy, and identified risk factors as increasing age, female sex, chronic kidney disease stage 3+ and tamoxifen use.
Dr. John Cush
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NHANES study of 2500 #RA pts, found a significant correlation between an inflammatory diet (meas by DII score) and inflammatory indices like systemic immune-inflamm Index (SII) & neutrophil-lymphocyte ratio (NLR) https://t.co/sWXZRrG6hV https://t.co/9IcLDF1Jlo
Dr. John Cush
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NON-treatment of 18,318 VA pts (RA, SpA, PsA) = 41% not Rx DMARDs w/in 12 mos of Dx. Signif higher odds if Black (HR 1.13), Hispanic (1.14), Charlson Comorbidity ≥2 (1.15), opiate use (1.09). DMARD use ^ if married, w/ erosions, female MD, Rheum Dx https://t.co/TaYC27oIOz https://t.co/qjfAGI5L5g
Dr. John Cush
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FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq https://t.co/Xmu8g35MXR
Dr. John Cush
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MarketScan Claims & Medicaid study of incident AS, PsA, or RA (2010–2017) that Opioid use was highly prevalent in AS (36%), PsA (30%), & RA (44%) in the year prior to Dx & during the 1st Yr. Is this PCP or Rheumatologist mismanagement? https://t.co/YsCOLZUCfS https://t.co/b33uNg6Ucx
Dr. John Cush
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Insurance claims data studied 7580 newly Dx RA (2018-2020) - 1998 tofacitinib vs 5582 adalimumab. After propensity matching, dyslipidemia was signif. higher w/ TOFA (HR 1.25), BUT no differences in MACE (HR 0.995) or all-cause mortality (HR, 1.4; NS) https://t.co/ZJ7uHWTycS https://t.co/A6tSm4RipS
Dr. John Cush
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Retrospective 170 RA pts Rx w/ IFX, ADA, & CZP shows CZP levels didnt differ w/ low or HI RF; but high basel RF linked to lower IFX & ADA drug levels, W/O DAS28 differences, but more IFX/ADA D/C w/ Hi baseline RF levels (80% vs. 75% vs. 33% CZP, p=0.002) https://t.co/OVUcKAgJ5a https://t.co/kzWd8jHXs3
Dr. John Cush
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K Kuhn et al: Altered tryptophan catabolism by microbiome may contribute to inflammatory arthritis. Tryptophan increases indole leading to ncreases in serum IL-6, TNF, and IL-1β; splenic RORγt+CD4+ T cells, & IL-23 and IL-17 production https://t.co/i9le12QZm2 https://t.co/akeXxWnQ9o
Dr. John Cush
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Substitute Measures of Inflammation (many dervied from the CBC)
https://t.co/b2AuVERJQn https://t.co/QXZ8GthsMW
Dr. John Cush
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Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush
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In animal models, IL-22 may have protective effects against pulm fibrosis. Study of 66 new #RA pts (1/2 w/ ILD) & 14 controls. Serum IL-22 was signif lower in RA-ILD; and was inversely correlated with the severity of RA-ILD https://t.co/Rmr5N2JznH https://t.co/OZ1ZrgGXC3
Dr. John Cush
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Long term F/U of T2T in BeST (early RA 153) & IMPROVED (UA 282) pts 12 & 20 yrs after, the majority of RA & UA pts were in DAS remission (91% LDAS, 68% remission), & w/ limited functional disability (mean HAQ 0.6-0.8). Xray progression was mild https://t.co/J9AfSPhWoK https://t.co/SrVJywF2JI
Dr. John Cush
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Complex Autoantibody Patterns in RA
https://t.co/CHzUOUM2xD https://t.co/4fE7iLMwxM
Dr. John Cush
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Long term F/U of T2T in BeST (early RA 153) & IMPROVED (UA 282) pts 12 & 20 yrs after, the majority of RA & UA pts were in DAS remission (91% LDAS, 68% remission), & w/ limited functional disability (mean HAQ 0.6-0.8). Xray progression was mild https://t.co/vcL8Mnv0Ty https://t.co/lPVbNipFng
Dr. John Cush
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Complex Autoantibody Patterns in RA
https://t.co/WmaXmmP7dY https://t.co/4dFgFEZ84i
Dr. John Cush
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Systemic Inflammation and Mortality in RA-ILD
Analysis of the German RABBIT registry shows that systemic inflammation, more so than disease activity, strongly influences all-cause mortality in patients with RA-ILD.
https://t.co/Qjtg364Pv7 https://t.co/aTQxTcO6Yv
Dr. John Cush
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Full-read Overview of Macrophage Activation Syndrome - a rare complication of autoimmune inflammatory rheumatic dz; assoc w/ Still’s disease SLE, Kawasaki, dermatomyositis, RA, Sjögren’s. Precipitating factors, including genetics & infections reviewed https://t.co/LmL3BPmo6c https://t.co/OkfwpzNLAL
