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"Don't You Know Who I am?" (5.17.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?
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Legal (Not So) Merry-Go-Round of Alendronate Atypical Fractures
Dr. Gregory Curfman, MD (Executive editor of JAMA) writes on the chronological legal progress of a lawsuit stemming from rare instances of atypical femoral fractures associated with bisphosphonate (alendronate) use.
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Antacids can Diminish Bone Density
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EurekAlert!
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.
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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
Dr. John Cush RheumNow ( View Tweet)
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)
Metanalysis of 26 reports and 195 juvenile Dermatomyositis pts (age 4.9 yrs) treated w/ JAK inhib (tofa, rux, & bari); Good improvement in 90%, 69% & 93%, respectively. JAK indication refractory skin dz (35%) or muscle involvement (29%). TIME FOR RCTs!! https://t.co/Vtm2n9BWV1 https://t.co/1bXZokW1AO
Links:
Dr. John Cush RheumNow ( View Tweet)
Review article of Interstitial Lung Dz Assoc w/ Systemic Sclerosis. SSc-ILD prevalence ranges 25-95%; ILD is a main cause of morbidity and mortality, contributing to 35% of deaths https://t.co/8mMFbDu4gi https://t.co/nQ4GfNcMWt
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Dr. John Cush RheumNow ( View Tweet)
Alot of murky "research" on Platelet-rich plasma (PRP). This RCT of120 pts having anterior cruciate ligament reconstruction (half randomized to PRP) shows no PRP benefit, no significant improvement of knee symptoms & function post ACLR https://t.co/AwkCAq1QFb https://t.co/YP0hJd7soc
Dr. John Cush RheumNow ( View Tweet)
Retrospective cohort study compared 5825 #AS pts vs 28,356 matched controls; showed an increased risk of pulmonary embolism w/ AS; not present pre-Dx ((0.4% vs 0.2%), but incr post-AS Dx (PE IR 11.6 vs 6.8/10KPY: adj HR 1.70;; p<0.001) https://t.co/wSkAMozvnL https://t.co/5Q470QkAxe
Dr. John Cush RheumNow ( View Tweet)
K Kuhn et al: Altered tryptophan catabolism by microbiome may contribute to inflammatory arthritis. Tryptophan increases indole leading to ncreases in serum IL-6, TNF, and IL-1β; splenic RORγt+CD4+ T cells, & IL-23 and IL-17 production https://t.co/i9le12QZm2 https://t.co/akeXxWnQ9o
Dr. John Cush RheumNow ( View Tweet)
Substitute Measures of Inflammation (many dervied from the CBC)
https://t.co/b2AuVERJQn https://t.co/QXZ8GthsMW
Dr. John Cush RheumNow ( View Tweet)
My Cancelled Lecture Slides
Listen to last week's podcast for more context!
https://t.co/C3bm2psfxZ https://t.co/sjIgDiVKtK
Dr. John Cush RheumNow ( View Tweet)
Infectious Mortality in ARD
Infectious conditions are a significant cause of mortality in ARD. Among patients hospitalized with an infection, we compared in-hospital and long-term (3-year) mortality between those with and without ARD.
https://t.co/p4n5Los89F https://t.co/vUBLC9TDDG
Dr. John Cush RheumNow ( View Tweet)
Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush RheumNow ( View Tweet)
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/ZYPZcfKrBD https://t.co/ZGYFNVgN0s
Dr. John Cush RheumNow ( View Tweet)
A unique study in military medicine of 1.5 million ED visits reveals the dynamics of high-rank and high-power patients and doctors, and the care they get/provide
https://t.co/hbsUt1s9YR
@ScienceMagazine @sdschwab @vini_singh_ https://t.co/RIjq4awgeR
Links:
Eric Topol EricTopol ( 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/eWnNqVUpK9 https://t.co/yNp4GYHYKu
Dr. John Cush RheumNow ( View Tweet)
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/3HWWoCMXfI https://t.co/TuYgzRJEzR
Dr. John Cush RheumNow ( View Tweet)
Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://t.co/CXdcEdWXhW https://t.co/j0ktehf9Sm
Dr. John Cush RheumNow ( View Tweet)
2023 Top 3 paper from JAMA Derm - 122 plaque psoriasis pts (mild-mod w/ PASI=3.1) & low vit D levels (~14.9), Rx w/ PBO vs vit D 20 000 IU/wk x 4 mos during winter; no signif vit D Rx benefit for PASI, MD global, DLQI or 25-OH levels(< than expected) https://t.co/8W5abvydY6 https://t.co/rKJjkiHwC6
Dr. John Cush RheumNow ( View Tweet)