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Complement assoc. studied by Petri & Durcan in 2399 SLE pts. 55% had low C3 (pesistently low 4%); 47% low C4 (3% persistently low). Low C4 is weak marker clinical & serological Dz. Low C3 linked w/ renal & serological Dz, Low C3/C4 linked to ACL, CVA, DVT https://t.co/KgF7HNEYu8

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Dr. John Cush RheumNow ( View Tweet)

Danish matched (1:4) cohort study shows COVID-19 pts taking NSAIDs had no greater risk of mortality, hospitalization, ICU admission, mechanical ventilation, or renal replacement therapy; study included 9,236 COVID PCR-positive & 2.7% were on NSAIDs https://t.co/OuUbJ9FxiM

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Dr. John Cush RheumNow ( View Tweet)

Lungs ILD

Comorbidities Impact Disease Activity in Spondyloarthritis

d Jack Cush, MD

An analysis of a large population-based cohort of axial spondyloarthritis (axSpA) patients shows that comorbidities are common and are associated with higher disease activity and higher levels of functional impairment.

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Dr Uma Mahadevan and colleagues have published guidelines for managing pregnancy in IBD patients. Rec coordinated care w/ maternal-fetal medicine subspecialist, GI doc, preconception planning, more on treatement https://t.co/oAFcGlOU2y

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Dr. John Cush RheumNow ( View Tweet)

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Treatment Options for Extraintestinal IBD

d Jack Cush, MD

Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation.  A recent review in GUT details the treatment options for patients with EIM.

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Comparative retrospective study of 251 ANCA+ pts with AAV (MPA or GPA) & severe renal Dz induction Rx with CYC or RTX, +/- PLEX. Remission equally achieved by CTX or RTX; addition of PLEX did not change outcomes. Predictors ESKD and death - eGFR <15 https://t.co/2lbGUS1ahv

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Dr. John Cush RheumNow ( View Tweet)

UK safety reminder that Baricitinib (Olumiant) has an increased risk of diverticulitis (incidence rate 0.16 per 100PY), esp. in those taking Steroids or NSAIDs. https://t.co/IfcV03e1p7

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Dr. John Cush RheumNow ( View Tweet)

Hepatitis B (Keep)

Hepatitis C Anti-Viral Drug-Induced Arthritis

d Jack Cush, MD

Curative direct-acting antiviral therapy (DAAT) for hepatitis-C virus (HCV) infection has been revolutionary, but a novel report shows that nearly one quarter of DAAT treated patients developed new onset or significant worsening of MSK symptoms, despite being negative for hepa

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RheumNow Podcast - The Bad News That's Fit to Print (8.21.20) Dr Jack Cush reviews this week highlights filgotinib rejection, delays in Diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX https://t.co/1oZtU14VOB https://t.co/rcWlbYVKYn

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Dr. John Cush RheumNow ( View Tweet)
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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

d Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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Antibiotic use is associated with a higher rate of IBD (aOR 1.88; 1·79–1·98) based on a prospective case-control study from the Karolinska that compared 23,982 new IBD pts w/ 117,827 matched controls followed over 10 years. https://t.co/FbCVU5GEFo

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Dr. John Cush RheumNow ( View Tweet)

BMS has announced deucravacitinib: the generic name for its Tyk2 inhibitor (BMS-986165) - 15 long makes it a new rheum labeling record. It's being studied in Psoriatic arthritis, psoriasis, lupus and inflammatory bowel disease. https://t.co/E2x2lelktO

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Dr. John Cush RheumNow ( View Tweet)

Hong Kong study Myositis-specific autoantibodies in 201 pts with idiopathic inflammatory myopathies (IIM) shows MDA-5 (14%), TIFF-1γ (14%), Jo-(12.4%). MDA5 seen w/ DM, digital ulcers, amyopathy, ILD. TIF1γ was associ w/ refractory rash and cancer https://t.co/3E365F5SON

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Dr. John Cush RheumNow ( View Tweet)

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GI Perforations with Tocilizumab Greater than Other Biologics

d Jack Cush, MD

A study from a Swedish population shows the real-world risk of gastrointestinal (GI) perforations in rheumatoid arthritis (RA) patients taking biologics finds that the risk was greatest in RA patients taking tocilizumab (TCZ), compared with RA patient taking tumour necrosis factor inhibitors (TNFi) and other non-TNFi biologics.

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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

d Jack Cush, MD

Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.

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The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 7 RCTs looked at melanoma risk comparing 34 029 biologic Tx vs 135 370 non-biologic conventional systemic Tx pts, showing no signif. increased risk in IBD (RR 1.20; 0.60-2.40), RA (pRR 1.20; 0.83-1.74), or psoriasis (HR 1.57; 0.61-4.09) https://t.co/PCOddiwKv0

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Dr. John Cush RheumNow ( View Tweet)

Literature review suggests that TNF inhibitors are safe to use in NAFLD and may show a beneficial effect on hepatic tissue. TNFi should be prescribed with caution in patients w/ cirrhosis as the data are conflicting. https://t.co/uynkNNCxdt

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Dr. John Cush RheumNow ( View Tweet)

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