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The art of talking about risks with our patients
On the first day of EULAR 2024, I am debating Janet Pope.
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Humira Clobbers Biosimilars in Battle for Part D Coverage
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Medpage Today
Just about every Medicare Part D prescription drug plan on offer this year covers the original version of adalimumab (Humira), whereas only about half will pay for any of the several biosimilar versions currently approved, researchers found.
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Final countdown to #EULAR2024 and we'll be there. We'll be sharing recaps, videos, and more. Are you ready for it?! https://t.co/BSrRATfxwt
Dr. John Cush RheumNow ( View Tweet)
Is Cannabis Safe? (6.7.2024)
Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!
https://t.co/tmCra58mYf https://t.co/KbMIDipvpI
Dr. John Cush RheumNow ( View Tweet)
Danish Registry study of 1.9 million chronic pain pts, shows chronic use of medicinal cannabis (5391) is assoc w/ a significant risk of new-onset arrhythmia {180d RR 2.07; 1-year RR 1.36). No significant association for acute coronary syndrome https://t.co/VT3X8lVWaD https://t.co/BMqVapFkuU
Dr. John Cush RheumNow ( View Tweet)
CATCH cohort study of 547 Early RA pts shows higher Tender > Swollen joint differences is assoc. w/ worse n patient-reported outcomes (PROs) in all domains (phys function, social , pain, sleep problems, fatigue, anxiety, depression) -- Isnt this FM ? https://t.co/4Bk8VGQNB6 https://t.co/K7kO5q990v
Dr. John Cush RheumNow ( View Tweet)
Cohort study of 25 315 women followed 25 years shows adherence to the Mediterranean diet associated with a 23% reduced all-cause mortality - explained by lipids, inflammation markers and BMI; more than cholesterol or glycemic measures https://t.co/nprDKXMWKp https://t.co/ofoHd8xF8D
Dr. John Cush RheumNow ( View Tweet)
Prospect study 174 SLE HCQ-Rx pts w/ whole-blood HCQ levels during pregnancy. 30 w/ flares(17%; 2.3% severe) & 28(16%) adverse preg outcomes. HCQ levels didnt predict APOs. BUT low (≤500) or no (≤200 ) HCQ levels assoc w/ severe maternal flares (9-13%) https://t.co/CHdd9Tuamk https://t.co/fFTr5MpiCx
Dr. John Cush RheumNow ( View Tweet)
Medicare & Optum claims data study of 2851 #RA pts w/ breast cancer (BC). In 3 mos before BC 27028% received bDMARDs. W/in 1st 3 yrs post-BC Dx 24-26% were receiving bDMARDs. 70% of RA pts on steroids without change w/ time https://t.co/51NcXv0xyc https://t.co/461NZiFvDO
Dr. John Cush RheumNow ( View Tweet)
National Psoriasis Foundation’s 2019 Annual Survey of 1,570 #PSO pts found among 801 w/ PsA most (59.6%) report unacceptable levels of disease activity, which is associated with increased prevalence of depression and limitations in social participation. https://t.co/HtWcAhZ6Zu https://t.co/pdC4IjIxmj
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Dr. John Cush RheumNow ( View Tweet)
Flavinoids (herbs, cherries, berries) have clinical efficacy in #Gout. Review of the mechanisms of flavonoids in gout includes:
- Cox-2 inhibition
- Lowers xanthine oxidase activity (mediated thru inflammasome, NOD/TLR4, NFKB, OAT1 & OAT3 transporters https://t.co/UC55GGZBCJ https://t.co/L6nE3BMIj1
Dr. John Cush RheumNow ( View Tweet)
Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis
A new study led has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events.
https://t.co/VVKR2G91VQ https://t.co/ZZNLJpoyNA
Dr. John Cush RheumNow ( View Tweet)
Cannabis Use is Common, But is it Safe?
Two current JAMA reports suggest that cannabis use is not only common, but that if heavily used may increase mortality rates.
https://t.co/ue9IRcbkCm https://t.co/IiG1RsIJiS
Dr. John Cush RheumNow ( View Tweet)
Is there an Increasing Risk for Tick-Borne Disease ? JAMA article purports this to be so..... I think not - not unless you live in endemic areas. Other wise these still are rare, rare or misdiagnosis based on serologic inaccuracies - just my opinion.https://t.co/zkMPYPCW3r https://t.co/ZfnWgV6aMY
Dr. John Cush RheumNow ( View Tweet)
2023 EULAR classification criteria for hand osteoarthritis
A EULAR consensus group has established classification criteria for overall hand osteoarthritis (OA) and its subtypes (interphalangeal OA and thumb base OA).
https://t.co/wIgjYB2rXF https://t.co/TjSILyC4IT https://t.co/3x6YtXW81u
Dr. John Cush RheumNow ( View Tweet)
Israeli study shows the prevalence of Psoriatic arthritis has tripled since 2006
- 2006: 0.073%
- 2016: 0.165%
- 2022: 0.221%
~2 fold higher rate if Jewish, High SES, Obese
https://t.co/RMWcIZvfjb https://t.co/9H6sauSEZK https://t.co/Fhj64pADdJ
Links:
Dr. John Cush RheumNow ( View Tweet)
Ankylosing spondylitis Tx w/ Tofa- How quick do they respond? Post hoc analysis 269 pts:
- 4 wks for Pain >30%
- 4 wks for ASDAS improved ≥ 1.1 points
- 8-24 wks for ≥ 50% improved pain, enthesitis, AM stiffness, BASDAI & fatigue
https://t.co/YOZgRLfPNc https://t.co/egkG76gz2E https://t.co/ZknXhKE0N4
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Dr. John Cush RheumNow ( View Tweet)
FDA has approved upadacitinib (Rinvoq), for use in pediatric patients (age >2 years) w/ active polyarticular juvenile idiopathic arthritis (pJIA) & psoriatic arthritis (PsA), after inadequate resp/intolerance to TNFi. Also available as oral solution. https://t.co/dZ21V2cKwR https://t.co/QADVP2w3Tz
Dr. John Cush RheumNow ( View Tweet)
Review of the Scleroderma spectrum disorders (full-read) https://t.co/Z7cUrVeGRR https://t.co/VkYag0uZnX https://t.co/QK6bfcYBoF
Dr. John Cush RheumNow ( View Tweet)
Full read review on Psoriasis Flares; risks:
- mechanical stress
- infections
-dysbiosis
-drugs (Lithium, B-blockers, HCQ, tetracyclines, ACEi, IFN)
- environment(smoking, obesity)
-lifestyle
- stress
- hormonal/metabolic https://t.co/WfCzcG9XNM https://t.co/ZNeKxjtHSA https://t.co/sJDoSfFOL4
Dr. John Cush RheumNow ( View Tweet)