All News
Risks associated with mortality in VEXAS
Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome (VEXAS) took the centre stage when it was first introduced at ACR20 last year. It got everyone’s thinking that they might have encountered one or two patients in their rheumatology lifetime who might have this condition.
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FDA Puts Boxed Warnings on JAK Inhibitors
Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.
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Telemedicine Upside Interview with Dr. Alvin Wells
In spite of the transformative growth of telemedicine during the COVID-19 pandemic, rheumatologists use of telemedicine is waning, much like the use of masks. Dr. Jack Cush interviews telemedicine guru, Dr. Alvin Wells, on the current state of telemedicine and what the future holds for telehealth in rheumatology.
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Rheumatoid Arthritis, Dementia and Cognitive Dysfunction
Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies..
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Cytokine Inhibitor Lung Disease in Still's Linked to HLA-DRB1 Alleles
Pulmonary complications in the setting of Still's disease (juvenile and adult) has seldom but consistently been reported, including reports of pneumonitis, pulmonary hypertension and a severe or fatal lung disease, often associated with hypersensitivity to anticytokine therapy. A multicenter study reports that drug hypersensitivity and pulmonary reactions in Still's patients receiving IL-1 or IL-6 inhibitors is strongly associated with HLA-DRB1*15 haplotypes.
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DORIS - Defining Remission in Lupus
Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE. A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016.
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RheumNow Podcast - 60/40/20 Interview with Dr. Ed Keystone
Dr. Jack Cush interviews Professor Edward Keystone, MD (University of Toronto) on the origins and science behind the 60/40/20 benchmark and outcomes in rheumatoid arthritis.
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Safety of Psoriatic Biologics in Pregnancy
Little is known about the safety of newer biologic use during pregnancy, especially in patients who either conceive while on a biologic or must remain on a biologic during pregnancy (often the case with IBD and inflammatory arthritis).
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Does Control of Inflammation Lower Cancer Risk?
Dr. Jonathan Kay's provocative video addresses whether the increased cancer risk associated with tofacitinib (Tofa) seen in the Pfizer Oral Surveillance (1133) study represents a real increased risk, an increased risk relative to a decreased risk with TNF inhibitors (TNFi) or an actual decreased cancer risk (unknown as there was no placebo comparator in this trial).
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Improving Rheumatology Practice
How to best book patient appointments in rheumatology clinic? Should these be scheduled every 3 or 4 months regardless of patient status? Should they be scheduled by patient need or disease activity?
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RAPID3 in Assessing Psoriatic Arthritis
My research shows that up to 50% of rheumatologists measure something in the course of their daily assessments, and RAPID3 is most popular, being employed by 31% of rheumatologists.
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GLORIA Study - Is Prednisone Harmful in Elder RA?
The GLORIA study (ABST# 1678) was a pragmatic, blinded placebo-controlled randomized trial from Dr. Martin Boers and colleagues where they assessed whether prednisolone (vs. placebo) use would alter clinical outcomes over 2 years.
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An Old Friend – Methotrexate in Psoriatic Arthritis
Methotrexate (MTX) remains one of our most used and reliable tools against a variety of rheumatic diseases, including PsA. When the time comes, as it often does, to escalate from a MTX-monotherapy approach, we have several options. In clinic, initiation of these other medications has often been in the form of addition rather than substitution. But what do the patients want, and how much more is the MTX adding in those cases?
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More severe COVID-19 outcomes in African American, Hispanic individuals with SLE
A study from ACR21 convergence discussing data from the Global Rheumatology Alliance (GRA) describes the association between race/ethnicity on COVID-19 outcomes specifically in lupus patients.
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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)
The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.
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Racial/ethnic disparity in U.S. lupus nephritis mortality
At #ACR21, the plenary session included an analysis of deaths from SLE throughout the US comparing 1999 to 2019 (Abstract #0454).
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Psoriatic Arthritis: "What Matters" to Patients, Physicians
A study presented today by Mease et al. addresses the vital gap between what patients and physicians consider disabling because of PsA, and emphasizes “what matters” in a daily clinical encounter while dealing with PsA.
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Day 4 Report from ACR21
My favorite three presentations from day 4 (Tuesday) at ACR 2021 included the following.
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