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NSAID Prescribing Decreasing
Multinational metanalyses of data between 1989 and 2022 shows that NSAID prescriptions have decreased over time, and differs according to geographical locations.
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Allergic Drug-Induced Arthritis (5.19.2023)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. This week we delve into some odd associations, repeat drug warnings and the consequences of antirheumatic therapies.
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Peresolimab's Potential in Rheumatoid Arthritis
Peresolimab is a humanized IgG1 monoclonal antibody that acts as a programmed cell death protein 1 (PD-1) agonist (stimulator). The NEJM reports that PER met its efficacy primary endpont in treating patients with active rheumatoid arthritis (RA).
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One in Ten is Bad! (5.12.2023)
This week on the Podcast Dr. Jack Cush reviews the news and journal articles, including the risks of dying, developing RA or autoimmune disease!
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Swedish registry review of #MTX initiation in early #PsA vs #RA (n 3642each). 2 years after MTX start, 71% of PsA vs 76% of patients with RA remained on MTX & the majority (66%/60%) had not started another DMARD, or a biologic (77%/74%) https://t.co/nTJO04sn65 https://t.co/gLjKzj2c74
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Study of 481 incident RA:
- no risk of RA w/ tea, alcohol & sugar-soft drinks
- Incr RA risk seen w/ coffee [≥4 vs ≤1cup, HR=1.24;p=0.04] & diet drinks [HR=1.66;never-smokers]
- Reduced RA risk w/ mod EtOH (ever-smokers;HR=0.63) & wine (seropos RA) https://t.co/RQFpxXUT11 https://t.co/ew2imYMLnJ
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One in Ten has Autoimmune Disease
A UK population-based study suggests that autoimmune diseases affect approximately one in ten individuals.
https://t.co/a2VbAO0Fc6 https://t.co/69Yl9OTtKY
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Did you miss Tuesday Night Rheumatology this week?
This webinar features highlights from:
Preclinical RA – To Treat or Not To Treat
Year of the JAKi
Fibroblast/Stromal Cells
https://t.co/yVQLtG6fEe https://t.co/WMXcKdqwdP
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Dr. John Cush RheumNow ( View Tweet)
Another NHANES survey of US adults shows increased prevalence of RA for those exposed to high levels of polycyclic aromatic hydrocarbons (PAH)(OR: 1.8; p=0.02). 90% of the smoking effect on RA risk is mediated by PAH https://t.co/N93MbKspRM https://t.co/uqH75vOZrA
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Dr. John Cush RheumNow ( View Tweet)
Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/0mC7PxF0DU https://t.co/klbnwjcPbM
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Dr. John Cush RheumNow ( View Tweet)
Study of 481 incident RA:
- no risk of RA w/ tea, alcohol & sugar-soft drinks
- Incr RA risk seen w/ coffee [≥4 vs ≤1cup, HR=1.24;p=0.04] & diet drinks [HR=1.66;never-smokers]
- Reduced RA risk w/ mod EtOH (ever-smokers;HR=0.63) & wine (seropos RA) https://t.co/gPZkTl9rid https://t.co/khYEZYFotl
Links:
Dr. John Cush RheumNow ( View Tweet)
Downs Syndrome (1/700) & autoimmune mechanisms - Downs has a 4-6 fold higher risk of JIA, type 1 diabetes, autoimmune thyroid disease and coeliac disease. https://t.co/wVUDRCS96I https://t.co/RosPAkRnPA
Dr. John Cush RheumNow ( View Tweet)
DDW 2023 study claims microscopic colitis (MC) pts had a 2fold higher risk of #RA. 11,293 MC pts matched 1:5 w/ population controls. With 8 yrs of F/U, RA was found in 1.1% of MC vs 0.6% controls (adj HR 1.92 (95% CI = 1.56-2.34). https://t.co/R5faYDoaAq https://t.co/qiaOMgOyLR
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Dr. John Cush RheumNow ( View Tweet)
Stop RA trail:
Plaquenil didn’t prevent RA in patient with pre clinical RA. Kevin Deane #RNL2023 @RheumNow https://t.co/gO9QKbAues https://t.co/gEpuBvDpj5
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#RNL2023 @RheumNow
There are a lot of RA Rx on market now - do we need more?
Dr. Brenner: YES
Stromal targets like LIF/LIFR, Notch3, cadherin-11 offer upstream benefits for our difficult to treat RA patients that don't respond to tradition cs/bDMARDs https://t.co/Og1vvbTRO9 https://t.co/WyqPH0lgkd
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JAKinib safety takeaways
- avoid in older population 65 yo, malignancy, CV risk, VTE risk
- appropriate in younger pts without VTE/CVD risk factors
#RNL2023 @RheumNow https://t.co/mFvvqJ9Jbp https://t.co/A76tR2S1Rb
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Dr. John Cush RheumNow ( View Tweet)
#RNL2023 @RheumNow
Dr. Stanley Cohen: possible adverse effects of JAKi
-Herpes zoster, other infections
-Malignancy
-Occasional cytopenias
-LFTs (with DMARDs)
-Incr Cr or CPK
-Acne
-Incr lipids
-GI perf
-VTE
Which do you counsel with your patients? https://t.co/zncCw3jlK7 https://t.co/AHhDyxaumM
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Dr. John Cush RheumNow ( View Tweet)
Dr. Stanley Cohen on JAKinibs:
Very concise and informative timeline on the multiple JAKinibs approved for multiple conditions
@RheumNow #RNL2023 https://t.co/ulLh2HikUt https://t.co/0kR8CNZvsV
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Dr. John Cush RheumNow ( View Tweet)
How do you prevent RA in at-risk patient?
Smoking cessation! Healthy weight and exercise! Diet! Periodontal health! 🚭🏋️🥕🦷
Education follow-up!
Not robustly proven to prevent/delay RA, but may be more important than early DMARD intervention! Kevin Deane, MD
#RNL2023
Dr. John Cush RheumNow ( View Tweet)
STOP-RA study on HCQ preventing RA...
HCQ did NOT prevent RA development in pre-RA pts
@RheumNow #RNL2023 https://t.co/uZRqAxWyyo https://t.co/02qUN4Hhrc
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Dr. John Cush RheumNow ( View Tweet)
