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Best of 2019 - Are Non-TNF Biologics Superior to TNF inhibitors?

d Jack Cush, MD

Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis.

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Best of 2019 - Methotrexate and the Risk of Lung Disease

d Jack Cush, MD

Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.

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Best of 2019 - The Shame Behind Adalimumab Biosimilars

d Jack Cush, MD

JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).

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Review of 541,744 total knee replacement (TKR) in Australia (1999-2017) finds lower revision rates in RA vs. OA, but increased risk of infection in RA (esp. males) https://t.co/XA1jLoOEBo

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Dr. John Cush RheumNow ( View Tweet)

I would never allow my patient to self medicate or regulate their Prednisone or MTX, immunosuppresives or biologics. It's what they don't know that will hurt them.

Dr. John Cush RheumNow ( View Tweet)

Doctors know medicines. But when a doctor treats him/herself the adage is that he/she has a fool for a patient. Remind your patients of this next time they try to test themselves with out the input if an expert

Dr. John Cush RheumNow ( View Tweet)

Is the Serious infection (SIE) risk different between TCZ and TNFi? Not when used after failing 1 TNFi; But for biologic initiators, SIE risk was higher in TCZ compared to TNFi or ABA (based on claims data from 16074 TCZ matched to 33109 TNFi initiators https://t.co/ZHVWF9fIHF

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Dr. John Cush RheumNow ( View Tweet)

Kaiser Permanente study of 1,956 adult #SLE patients shows that only 58% of lupus pts were ≥80% adherent to hydroxychloroquine. Only age and increasing visits were predictive. Not predictive were the rheumatologist, center or socioeconomic factors. https://t.co/m0oN1OC9bn

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Dr. John Cush RheumNow ( View Tweet)

Since fasting is so hot right now, here is a hot off the press @NEJM review of it => Effects of Intermittent Fasting on Health, Aging, and Disease | NEJM https://t.co/Ijc0NSFa9s

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Philip Robinson philipcrobinson ( View Tweet)

Should we keep our patients with #gout on colchicine indefinitely (if no contraindications/intolerances) for their higher risk of MI/CVD? https://t.co/4bQds3u1oL

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Tuhina Neogi, MD, PhD Tuhina_Neogi ( View Tweet)

The ACR and EULAR have developed the first-ever international set of classification criteria for IgG4-RD, which was established and tested using a data-driven approach and multicriterion decision analysis – details: https://t.co/rI8dRM8kmO https://t.co/sTJ360Ouxb

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American College of Rheumatology ACRheum ( View Tweet)
Congrats & welcome new rheum fellows! Another competitive year, with rheum match rate (71.3%) behind GI (62.8%) but similar to CARDS (72.8%) & HONC (77.4%) Thankfully better than last year (65.1%) but still a lot of (well deserved!) excitement for the field! https://t.co/QDD5VCD8Rv
Mike Putman EBRheum ( View Tweet)
Patients and insurance companies in the United States pay higher prices for medications, imaging tests, basic health visits and common operations. https://t.co/oQrCSOE58j

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NYT Health NYTHealth ( View Tweet)

#DidYouKnow Sir #WilliamOsler died ☠️ of what he called “the old man’s friend” (#pneumonia)? Learn more about the “father of #InternalMedicine” during the 💯th anniversary of his death https://t.co/0O61Qctouq. #IMProud @mcgillu @UniofOxford @JohnsHopkins @Penn @RoySocMed https://t.co/1ZS79pZrhx

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ACP ACPinternists ( View Tweet)
The #Rheumatologist: Ellen M. Gravallese, MD, Begins ACR Presidency → https://t.co/ZO6ilPG0lk

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American College of Rheumatology ACRheum ( View Tweet)

Exciting work by colleagues in US, led by NIH. https://t.co/bGB75bOGFB. immunodominant peptides of topo 1, fibrillarin, and centromere protein A are homologous to viral protein sequences from the Mimiviridae and Phycodnaviridae families, suggesting molecular mimicry.@NIH_NIAMS

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Dr. Dinesh Khanna sclerodermaUM ( View Tweet)

Antiphospholipid syndrome incidence is 5 per 100k/Yr; lesser known complications include Libman Sachs valve dz, livedo reticularis, racemosa, skin ulcers/necrosis, GN, thrombotic microangiopathy, AVN, non-traumatic fractures https://t.co/rWlWZ39Lhd

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Dr. John Cush RheumNow ( View Tweet)

The Best Rheums go to the Best Meetings - RHEUMNOW LIVE - March 13-14-15 2020 Great Venue =Fort Worth. Short Lectures, interactive sessions, Q&A panels, TED (like) Talks, digital, streaming and much more. You dont want to miss this meeting! https://t.co/69Y3QyU3Wc

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Dr. John Cush RheumNow ( View Tweet)

Check out last weeks RheumNow Podcast - A Merry Lupus XMAS! videocast >> https://t.co/rFJQjVJIOc or the podcast >> https://t.co/blaXn1N5By

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Dr. John Cush RheumNow ( View Tweet)

Study of 690 ambulatory patients examined RDW, ESR, CRP and showed RDW is increased in inflammatory disorders (RA, SpA) and elevated RDW has a 48–95% sensitivity and 66–95% specificity for inflammatory disease. https://t.co/dSdG1WTJY8

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Dr. John Cush RheumNow ( View Tweet)

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