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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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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?
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Medpage Today
A Janus kinase (JAK) inhibitor outperformed tumor necrosis factor (TNF) blockers for substantially reducing rheumatoid arthritis (RA) symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.
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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).
The criteria require two mandatory criteria to be met:
ACR Calls on CMS for Enhanced Transparency & Reporting
The American College of Rheumatology has submitted its response to the Centers for Medicare & Medicaid Services (CMS) request for information and feedback from stakeholders on how best to enhance Medicare Advantage data capabilities and increase public transparency.
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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
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/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
Dr. John Cush RheumNow ( View Tweet)
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
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/HfhOWHHfvt https://t.co/9QOYNvLaBS
Dr. John Cush RheumNow ( View Tweet)
Systemic sclerosis sine scleroderma in children is more aggressive than in adults. 18 juvenile vs 38 adults - ssJSSc more female (39% vs 89%), more digital pitting scars/ulcers (35 vs 10.5%), Pulm (50 vs 24) & CV (50 vs 3%); w/ more deaths https://t.co/l4f5bH1IX1 https://t.co/viQcD3tN9V
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Australian study of informal caregivers (not iworking) of arthritis pts shows excess cose of $388 million (in 2015), expected to increase to $576.9 million by 2030. Informal caregivers less likely to work, due to the demands & duties of their caregiving https://t.co/Gw1eIBN6WW https://t.co/h1TY0BtaSE
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Disjointed incomplete arthritis care! 82 arthritis pts w/ new complaints surveyed; 29% went to the ED (1/3 repeat visit) for arthritis flare. Only 26% referred to a rheumatologist of which 38% were unable to do so in the time frame suggested. https://t.co/f3RbhdKL8u https://t.co/C1iRsQoiAJ
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Canadian study of 44,438 older adults (age 76) w/ gout found only 52% reached serum uric acid (SUA) target w/in 12-mos, improving from 45% (2010) to 61% (2019). ULT adherence was 55%, also improved annually. Only 3.5% Rx by Rheumatologist! https://t.co/vAc8myxiRm https://t.co/gcMz379iPH
Dr. John Cush RheumNow ( View Tweet)
Review of 31 FDA Rheum drug approvals betw 1995-2021 showed patient-reported outcomes seldom reported or published. Despite meeting MCID (57%) & significance (85%), 1/3 PROs not reported & 10% remained unpublished (4yrs later) https://t.co/pvGhTxlP03 https://t.co/t3VEHw7FJv
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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/lGvIHb8wfZ https://t.co/8BiTnTNJzO
Dr. John Cush RheumNow ( View Tweet)
Review of the Scleroderma spectrum disorders (full-read) https://t.co/xaIxf8q0Tj https://t.co/kxFiQTqKqV
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Boxed Warnings in Derm:
- Topical Calcineurin inhib (atopic dermatitis): rare risk of cancer
- IL-17 Inhibitors (PSO, PsA): exacerbation of IBD (38 RCTs: only 12/16,690 new IBD case
- Psoriasis and suicidality: suicide risk same w/ or without treatments https://t.co/HsjO78NtjP https://t.co/v9Pys8RwcH
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/kgj18lG12G https://t.co/NN2FlPSngW
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TriNetX US claims study of 7580 RA pts Rx w/ tofacitinib or adalimumab found Tofa signif. more likely to cause dyslipidemia (HR 1.250), but no difference betw TOFA & ADA in MACE (HR 0.995; 0.76–1.3) or all-cause mortality (HR 1.4; 0.89–2.2) https://t.co/83CGng2R9e https://t.co/QfD4ePuTER
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ACR’s Run at Goliath (PCPs) (5.31.2024)
The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?
https://t.co/DQOkhowU0b https://t.co/MK9aVe7Yaf
Dr. John Cush RheumNow ( View Tweet)