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RETRO - Taper or Not: You Decide

d Jack Cush, MD

A prospective, phase 3 trial of rheumatoid arthritis (RA) patients in sustained remission has shown more than half will flare if disease-modifying antirheumatic drugs (DMARD) therapy is tapered or discontinued and that remission is best maintained by continued DMARD therapy.

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ICYMI: Upadacitinib RA program (5306 pts) the risk of H. zoster by Rx and dose (HZ/100PYs) MTX = 0.8/100PY ADA+MTX= 1.1/100PY UPA 15 mg= 3.0/100PY UPA 30 mg = 5.3/100PY Hence there is a 4-5X risk of HZ w/ JAKinhibitors https://t.co/wo9ih5PJ77 #RheumNow https://t.co/h1GoGzADdv

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Upadacitinib RA program (5306 pts) the risk of H. zoster by Rx and dose (HZ/100PYs) MTX = 0.8/100PY ADA+MTX= 1.1/100PY UPA 15 mg= 3.0/100PY UPA 30 mg = 5.3/100PY Hence there is a 4-5X risk of HZ w/ JAKinhibitors https://t.co/wo9ih5PJ77 https://t.co/Zv9sSRBSHb

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Dr. John Cush RheumNow ( View Tweet)
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Prevalence of Arthritis Rising in the USA

d MMWR

The latest CDC estimates of the national prevalence of arthritis and arthritis-attributable activity limitations (AAAL) show a continued increase in absolute number: 58.5 million (23.7%) U.S. adults have arthritis, 25.7 million (43.9%) of whom have AAAL. 

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2125 RA pts in RCTS w/ baricitinib entered a long term F/U study. baricitinib pts had less XRay damage over 5 yrs; 5 yr No Xray progression was 60% on baricitinib 4 mg; 66% baricitinib 4 mg+MTX; vs 41% on just MTX monotherapy. https://t.co/pLuQCDSf6g https://t.co/wFs3G0DrJ7

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Malnutrition and Quality of Life in Elderly RA Patients https://t.co/4hEFTSaCga https://t.co/OPK3ThWqst

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Malnutrition and Quality of Life in Elderly RA Patients

d Jack Cush, MD

Rheumatoid arthritis (RA) imparts a significant disabilty and quality of life (QoL) limitations worsened by aging, but also by malnutrition.

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RA patients had a higher 30-day rehospitalization than OA after TKR (OR 1.11) and THR (OR, 1.39). While infections, postoperative complications, cardiac did not differ, RA TKR had less VTE, but RA THR had higher VTE risk (OR, 2.41) https://t.co/QlOWngcEnJ

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In case you missed it— A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern. Read more… https://t.co/n82PpZ7a96 #RheumNow https://t.co/SmOBX0701N

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In case you missed it: Patients with rheumatoid arthritis (RA) who had a history of cancer did NOT have an increased risk of new or recurrent cancers if treated with biologic therapies, a meta-analysis found. #RheumNow https://t.co/jM9oiRin2M https://t.co/RknVHmZK98

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RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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A placebo controlled RCT of canakinumab in 31 Adult Stills pts with arthritis showed responders (by DAS28) had signif reductions in calprotectin, IL-1RA, IL-18, IL-at wk 4. Unfortunately: didnt look at fever, rash, serositis, etc. https://t.co/p4Fohos2iU

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Early Diastolic Dysfunction in Premenopausal Women with RA https://t.co/2pyzT20RCF https://t.co/8viSUbpywX

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Analysis of 508 #RA pts (over 10 yrs) in the BeST study shows joint swelling at baseline resulted in half w/ re-swelling later and significantly increased risk of same joint swelling during follow-up (OR 2.37, 95% CI 2.30 to 2.43, p<0.001) https://t.co/a7zH4YRAkq

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Are you an Expert in Still's disease, Periodic Fevers, FMF or Autoinflammatory Dz? I will add you to our expert referral listing on https://t.co/LYd3dtU295. DM me to get on the list! https://t.co/lt8YMPOpK2 https://t.co/QxXHMvayTG

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Dr. John Cush RheumNow ( View Tweet)

Are you an Expert in Still's disease, Periodic Fevers, FMF or Autoinflammatory Dz? I will add you to our expert referral listing on https://t.co/LYd3dtU295. DM me to get on the list! https://t.co/lt8YMPOpK2 https://t.co/QxXHMvayTG

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Dr. John Cush RheumNow ( View Tweet)
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Early Diastolic Dysfunction in Premenopausal Women with RA

d Jack Cush, MD

A two-dimensional/Doppler echocardiography of rheumatoid arthritis (RA) detected premature, clinically quiescent diastolic function.

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drug,capsules,antibotic

Early Antibiotic Use Increases JIA Risk

d Jack Cush, MD

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of juvenile idiopathic arthritis (JIA), although infections during fetal life or childhood did not increase risk of JIA.

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Post-Arthroscopic Increase in Septic Arthritis

d Jack Cush, MD

A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern.

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Prospective study of 77 RA patients in remission --> vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7/8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVArvG #RheumNow https://t.co/dxRWhu8CJX

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