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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!!
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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.
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Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis
A new study led by the University of Córdoba, the Maimonides Institute for Biomedical Research and the Rheumatology Department at the Reina Sofía University Hospital in Córdoba 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.
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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
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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
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NEJM Images - Polyarteritis Nodosa. 62 yoM with myalgias, wt loss, numbness, negative ANCA & HBV. Abdominal angiography shows multiple aneurysms. https://t.co/ONiQ82HWtj https://t.co/WIgOEywqAS https://t.co/ftjobeQDcL
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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/Sfu2UlLlwH https://t.co/z5TpNrDCWD
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Intl Consensus: Generalized Pustular Psoriasis... systemic inflammatory disease characterized by cutaneous erythema and ...sterile pustules.” ...with or without systemic symptoms. GPP may (b) acute... w/ widespread pustules or subacute w/ annular phenotype https://t.co/dsKsQQYyj4 https://t.co/FVoTaw7mPl
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When the EMR goes down, what do you do?
Dr. John Cush RheumNow ( View Tweet)
JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
A JAK inhibitor outperformed TNF blockers for substantially reducing RA symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
https://t.co/7BhFSwb1Ns https://t.co/Hf31OPgE0M
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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/r7hR1rkjb7 https://t.co/IBC0BpNlW8
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ACR Calls on CMS for Enhanced Transparency & Reporting
The ACR has submitted its response to the CMS)request for information (RFI) and feedback from stakeholders on how best to enhance MA data capabilities and increase public transparency.
https://t.co/vWPXlhmUGo https://t.co/Z8s3PZijqE
Dr. John Cush RheumNow ( View Tweet)
Study of 150 #PsA pts & Aortic stiffness (carotid-femoral pulse wave velocity (cfPWV) - cfPWV signif higher in PsA vs controls (p=0.034). , cfPWV assoc w/ Dz duration (r=0.3), systolic BP, GFR, RDW. cfPWV was superior to SCORE (16% vs 8.7%) at CV risk https://t.co/H6SbsIdXw0 https://t.co/Yt19QCk9TT
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Chinese study of 552 pts w/ ANCA Assoc. Vasculitis - 23 had cancer prior to AAV Dx; 43 after Dx (w/in 4.3yrs)= SIR: 2.24. CA mostly lung CA (SIR: 5), followed by kidney, bladder, ureter, prostate. Higher risk if male (HR:2.8) and older (per year, HR:1.04) https://t.co/xhH3uU3GCj
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NEJM CASE- 46 yoM with Arthritis (wrists, ankles) and maculopapular Rash (chest, back, legs); prior travel to Caribbean, C. America, HTN, Tachycardia, ESR 104 , nl CRP, but ^d-dimer 990. Scattered alopecia & nasal crusting. Vote your Dx https://t.co/3bdmbnSdlB https://t.co/0R4WK1SKI2
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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/4EnT8f8mcp https://t.co/EbbDP38M7T
Dr. John Cush RheumNow ( View Tweet)
202 adults w/ idiopathic inflammatory myositis (IIM) studied. Multiple myositis-specific Abs seen in 22% (2/3 w/ tRNA synthetase Abs (ARS+) & half MDA5+). Multiple MSA pts had better survival (HR 0.11), less RP-ILD, fever, rash; more muscle & dysphagia https://t.co/6PCMZJkuNn https://t.co/ElkJzPODaU
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Role of Diet in Gout Risk
Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.
https://t.co/cqP7G4KeWi https://t.co/zxiOeACb5u
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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/HfhOWHHfvt https://t.co/9QOYNvLaBS
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