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Dr. Jack Cush muses on the news, journal reports, FDA announcements and the 2024 BSR abstracts just released.
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Patients with rheumatoid arthritis (RA) all have a unique and diverse set of antibodies that are involved in the development of the disease.
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Analysis of the German RABBIT registry shows that systemic inflammation, more so than disease activity, strongly influences all-cause mortality in patients with rheumatoid arthritis and prevalent interstitial lung disease (RA-ILD).
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In an open-label, randomized, non-inferiority trial, rheumatoid arthritis patients in remission were subject to tapering of disease-modifying antirheumatic drugs (DMARDs), and while maintenance of remission was seen in some, many DMARD tapering patients did flare and were unable to maintain flare-free survival compared to those on stable conventional synthetic DMARDs.
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Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.
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Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?
Dr. John Cush
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Danish registry study shows positive association between maternal autoimmune Dz & childhood cancer. AID assoc w/ all child CA (OR=1.25), ALL (1.52), Burkitts (2.69), CNS tumors (1.45). RA mothers AID had higher risk of all cancers (OR=2.1) https://t.co/EYHyHzOboc https://t.co/FNRrvySI8P
Dr. John Cush
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UK Early Inflammatory Arthritis Audit of 20,060 RA pts (~12k on MTX; 5K csDMARD; ~2.5K no DMARD). Serious infections (SIE) hosp rate was 3.19/100PY, death 0.1/100PY. SIE risk incr w/ age, smoking, Hi DAS28 & HAQ. 1 unit DAS28, SI risk increased by 8% https://t.co/OrNh8oYE3y https://t.co/DqbeibNMbp
Dr. John Cush
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50 active RA pts RCT Rx w. either low dose IL-2(n=26), IL-2+TCZ (9) or control (15). All improved clinically by DAS28-ESR, but IL-2 Rx pts had signif proliferation of Tregs, w. decr inTh1, Th2, & Th17 cells. TREG #s correlated w/ ESR drop (r=0.54) https://t.co/1tF63FuXzx https://t.co/M5TWsa6zI4
Dr. John Cush
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Single center retrospective 173 pts w/ CTD-ILD - 34% Sjogren’s, 30 RA, 25 systemic sclerosis, 6 UCTD, 3% idiopathic inflam myositis, 1,2% MCTD, 0.6% SLE. NSIP most common (60%) inSS & SSc; UIP more common in RA. 6 died, mostly infection https://t.co/IL2tnVDtoQ https://t.co/Ada49Qv5XL
Dr. John Cush
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Chikungunya arthritis Metanalysis & good full-read review - 8 studies showing chronic arthritis (CCA) in minority of infected;, polyarticular, looks like RA, few seropositive, few w/ erosions on imaging. CCA may be progressive w/ irreversible damage https://t.co/Da7bKtM6oC https://t.co/OGBbIiGAc5
Dr. John Cush
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CPPD in seronegative RA? Among 364 RA patients - 73% seropositive & 26% seronegative (n=96). Amongst latter, 18 pt (18.9%) met CPPD-disease criteria. CPPD+ pts were more likely to be older & have Hx of acute episodic arthritis https://t.co/XO0J6Adaa0 https://t.co/3ouUCPshoh
Dr. John Cush
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Practice Metrics Use by Rheumatologists in RA. 54% of Rheums do "some" measure, Most used: HAQ 36%, RAPID3 27%, CDAI 18%, Vectra 13%. More than 35% do NOT measure
https://t.co/FOlyCSFF25 https://t.co/3S36tDlgcE
Dr. John Cush
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RA-ILD at Higher Risk for Serious Infection and Death
A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.
https://t.co/cjmcNi0ZqL https://t.co/wUXNWNeyOa
Dr. John Cush
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Retrospective study of hand/feet Xrays in early/suspected #RA due to low prevalence of erosions (4.4%) seldom leading to change in Dx (2pts; 0.3%) or prognosis change (0.4%). Seronegative had less erosions; Longer Sxs not assoc w/ erosions https://t.co/YCj04ZlQJq https://t.co/fHf6EvGOyc
Dr. John Cush
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ICYMI: Top 5 Clinical Pearls in RA Management
https://t.co/zWRXzHTtIo https://t.co/rbitB9oWQG
Dr. John Cush
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Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
Dr. John Cush
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Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
Dr. John Cush
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In RA, previously affected Jts more likely to flare ("joint-specific memory") ?mediated by synovial resident memory T cells, predominantly CD8+ T cells, with a restricted TCR repertoire, responding to specific Ags by releasing chemokines & cytokines https://t.co/VfFZ03yZYL https://t.co/npX3TGDe5A
