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No Link Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined Significance
Annals of Internal Medicine reports a study of more than 75,000 persons screened for monoclonal gammopathy of undetermined significance (MGUS) and found no association between autoimmune rheumatic disease (AIRD) and MGUS.
SLE Cost of Care and Disease Activity
A longitudinal, multinational study shows that SLE patients achieving remission or low disease activity incur lower overall direct/indirect (DCs, ICs) healthcare costs than those with persistent activity.
Upside/Downside of Steroids in Lupus Nephritis
A systematic review of randomized clinical trials of patients with biopsy-proven lupus nephritis (LN) demonstrates both the benefits and harms to early glucocorticoid (GC) regimens on lupus outcomes.
Disparities in SLE care: adult Medicare cohort study of 1,036 SLE pts found 39% saw a rheumatologist q 6 mos & 28% had serologic tests. Least disadvantaged quintile had higher visit-based retention, but decreased serologic testing (aOR 0.80) https://t.co/lGoriPIMqV https://t.co/JF0RWZxRoU
Dr. John Cush RheumNow ( View Tweet)
Best Selling US Drugs in 2023
11 Skyrizi $10.1 billion
10 Dupixent $11.5 b
9 Biktarvy $13.15 b
8 Mounjaro $13.16 b
7 Keytruda $15.4 b
6 Stelara $15.87 b
5 Jardiance $15.89 b
4 Trulicity $16.3 b
3 Eliquis $22.1 b
2 Humira $35.3 b
1 Ozempic $38.6 b https://t.co/tiEwqyTB6D https://t.co/xghijiRFtW
Dr. John Cush RheumNow ( View Tweet)
384 Psoriasis pts followed mean 33 mos, 56 (14.6%) developed new-onset PsA. 311/384 (81%) had arthralgia (subclinical PsA) & 9.4% got PsA within 12 mos (23% by 36%). Subclinical more likely than PSO to get PsA (OR 11.7) https://t.co/D7n3ZpJURH https://t.co/vJcFgRcbx4
Dr. John Cush RheumNow ( View Tweet)
NON-treatment of 18,318 VA pts (RA, SpA, PsA) = 41% not Rx DMARDs w/in 12 mos of Dx. Signif higher odds if Black (HR 1.13), Hispanic (1.14), Charlson Comorbidity ≥2 (1.15), opiate use (1.09). DMARD use ^ if married, w/ erosions, female MD, Rheum Dx https://t.co/TaYC27oIOz https://t.co/qjfAGI5L5g
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Mayo Derm Study of 335 #SLE pts: 231 w/ skin manifestations. LE specific skin Dz signif assoc w/ photosensitivity, SM & U1RNP Abs. Pts w/ 2–4 mucocutaneous ACR criteria had less cytopenia & dsDNA Abs (P=0.004), but no assoc w/ systemic Dz https://t.co/f7PEerxKZw https://t.co/9kRW724cPq
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Full read review of the benefits & impact of hydroxychloroquine in #SLE. Benefits on:
- T cells, cytokines, TLR signaling
- VTE prevention
- Decr CV risks
- Glucose & lipid benefits
- Pregnancy
https://t.co/z9cooQwZux https://t.co/QumKoHgQDY
Dr. John Cush RheumNow ( View Tweet)
FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq https://t.co/Xmu8g35MXR
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Brazilian Registry of Spondyloarthritis study of 1096 SpA pts, found 73% HLA-B27 positivity. B27+ signif assoc w/ males, earlier onset/Dx, uveitis, +FHx. B27 negativity assoc w/ psoriasis, higher peripheral arthritis/disease activity, worse QOL, mobility https://t.co/ousSetEnrt https://t.co/ezSgHro8sQ
Dr. John Cush RheumNow ( View Tweet)
MarketScan Claims & Medicaid study of incident AS, PsA, or RA (2010–2017) that Opioid use was highly prevalent in AS (36%), PsA (30%), & RA (44%) in the year prior to Dx & during the 1st Yr. Is this PCP or Rheumatologist mismanagement? https://t.co/YsCOLZUCfS https://t.co/b33uNg6Ucx
Dr. John Cush RheumNow ( View Tweet)
Insurance claims data studied 7580 newly Dx RA (2018-2020) - 1998 tofacitinib vs 5582 adalimumab. After propensity matching, dyslipidemia was signif. higher w/ TOFA (HR 1.25), BUT no differences in MACE (HR 0.995) or all-cause mortality (HR, 1.4; NS) https://t.co/ZJ7uHWTycS https://t.co/A6tSm4RipS
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Legal (Not So) Merry-Go-Round of Alendronate Atypical Fractures
Dr. Gregory Curfman, MD writes on the chronological legal progress of a lawsuit stemming from rare instances of atypical femoral fractures associated with bisphosphonate (alendronate) use.
https://t.co/6Ipvw7tcKr https://t.co/VNrMg88AsH
Dr. John Cush RheumNow ( View Tweet)
Antacids can Diminish Bone Density
Proton pump inhibitors (PPIs), a specific class of antacid drugs, are among the most widely used medications of all. They are frequently prescribed to many groups of patients, including those with rheumatism.
https://t.co/Ii8DlDgBx7 https://t.co/cWN7v7PiIf
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Retrospective 170 RA pts Rx w/ IFX, ADA, & CZP shows CZP levels didnt differ w/ low or HI RF; but high basel RF linked to lower IFX & ADA drug levels, W/O DAS28 differences, but more IFX/ADA D/C w/ Hi baseline RF levels (80% vs. 75% vs. 33% CZP, p=0.002) https://t.co/OVUcKAgJ5a https://t.co/kzWd8jHXs3
Dr. John Cush RheumNow ( View Tweet)
Consensus Statements on Vitamin D
The “Controversies in Vitamin D” International Conference has published their proceedings on vitamin D metabolism, assessment, actions, and supplementation.
https://t.co/QGXbJdJpAC https://t.co/N1UkTi6u8C
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Small-molecule Drugs to Treat Systemic Lupus Erythematosus
A metanalysis of randomized controlled trials (RCTs) on treatments of systemic lupus erythematosus (SLE), confirm the efficacy of several targeted small-molecule drugs.
https://t.co/O3Y3KBngau https://t.co/wiB1EMtMFK
Dr. John Cush RheumNow ( View Tweet)
Interferons and Lupus Subsets
In a new study, researchers from Johns Hopkins Medicine say they have uncovered insights as to the relationship between interferons and lupus, which affects up to 1.5 million Americans.
https://t.co/Eo8q3IGPb7 https://t.co/gVyHJwZFwc
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Risk Factors for Hydroxychloroquine Retinopathy
A long-term hydroxychloroquine users study found that 2.7% developed retinopathy, and identified risk factors as increasing age, female sex, chronic kidney disease stage 3+ and tamoxifen use.
https://t.co/iC7eh0XLzE https://t.co/gDaWi4kt1h
Dr. John Cush RheumNow ( View Tweet)