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Continue the Methotrexate, Leave the Cannoli

Jack Cush, MD

Placebo responses are to be expected in rheumatoid arthritis (RA) clinical trials, but are such placebo responses affected by continuing background DMARDs like methotrexate (MTX) even though there was an inadequate response (IR) to MTX? 

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Abatacept Most Effective Early and in Seropositive RA

Jack Cush, MD

An open-label, 2 year study evaluated the efficacy and safey (drug retention) of subcutaneous (SC) abatacept (ABA) in active rheumatoid arthritis (RA) and showed superior responses when ABA was given to biologic-naive and seropositive RA patients. 

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ICYMI: 2021 Rheumatology Year in Review

Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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ICYMI: Drug Survival Differences in RA, PsA, SpA and PsO

Jack Cush, MD

Drug survival may be the best measure of efficacy and safety. A study of novel therapy durability (survival) in patients with RA, axial spondyloarthritis, PsA, and psoriasis shows that while all these drugs are approved for said conditions, drug survival varies by condition, suggesting an ongoing need for individualized treatment.

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What Worries You, Masters You (7.1.2022)

Jack Cush, MD

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.

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Novel Anti-TNF Shines in Rheumatoid Arthritis Trial

MedPage Today

A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said.

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Two Week Methotrexate Hold with COVID-19 Vaccination

Jack Cush, MD

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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Risk of hospitalized infection (SIE) goes up with #RA disease activity. Study of 3,254 RA Pts with 529 SIE - SIE rates lowest with remission (3.8/100PY), vs low dz activity (6.6/100PY; OR 1.60) vs moderate activity (8.8/100PY; OR 183) https://t.co/EWbX7N7fiG https://t.co/Y8bRn2XATF

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Dr. John Cush RheumNow ( View Tweet)
Sometimes the journey impacts as much as the destination. TREAT-EARLIER now @TheLancet: pre-RA (CSA+MRI) DBRCT: po MTX for 1y (+im mpred120x1) vs placebo eventual RA same but persistent benefit at 2y (1y post-MTX cessation): function, Sx, presenteeism, MRI a short thread🧵1/7 https://t.co/64b7us6hvS

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David Liew drdavidliew ( View Tweet)

Rheums: Got a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/QUTIbK3r89 https://t.co/FZcTLREida

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Dr. John Cush RheumNow ( View Tweet)
Rheumatologist Survey: What do you rely on MOST in diagnosing Still’s disease? Sxs? Labs? Both? Criteria? Fever? Vote here: https://t.co/oANKpKqJA5 https://t.co/LIjRSBHNBi

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Dr. John Cush RheumNow ( View Tweet)
#OP0004 #EULAR2022 In line with EULAR President’s preech to go Digital, Prof Mosca highlighted a study which showed assessment of joints in RA could be done by taking photos and analysed their dorsal skin folds using convolutional neural network cc: @Yuz6Yusof : https://t.co/mn48vXtGad
Dr. John Cush RheumNow ( View Tweet)
Novel Anti-TNF Shines in Rheumatoid Arthritis Trial A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said. https://t.co/fTmWeIrVD5 https://t.co/LPk2Ok2gac

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Dr. John Cush RheumNow ( View Tweet)
Placebo Works Best in Combination Analysis of two large clinical trial datasets shows that placebo response rates in randomised controlled trials (RCTs) of patients with rheumatoid arthritis are better when the patient continued background MTX. https://t.co/JmNGRQWv6L https://t.co/77LdcTwCvl

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Dr. John Cush RheumNow ( View Tweet)
Video: Post Hoc Analysis of the ORAL Surveillance Study https://t.co/PVzfYlzdQa https://t.co/0RpA3CfTEE

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Dr. John Cush RheumNow ( View Tweet)
Study of new onset #RA & undiff arthritis pts starting Rx 2005-2010; mean F/U 104 mos, 11% died. Steroids (<7.5/d) given to 44% initially, ultimately 57% w/ 20% recv >7.5/d. Steroids did not increase mortality (HR 1.35 ; 0.74, 2.47) or hospitalization https://t.co/KNpobs1UwH https://t.co/sjddMBKOeE

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Dr. John Cush RheumNow ( View Tweet)
It's time to exonerate methotrexate in causing or exacerbating fibrotic interstitial lung disease in #RA patients https://t.co/AuEIWn8Pc4 https://t.co/razVTF6fFX

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 7 studies shows that oral anticoagulants need not be discontinued for joint injections or aspiration. Only pts w/ hemorrhage after 5427 procedures, over 32-yrs. INR values of 3 bleeding cases was 1.9, 2.3, and 3.4. https://t.co/pCxDqzXGHQ https://t.co/ExZkXSliFo

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Dr. John Cush RheumNow ( View Tweet)
Modest Benefits of Diet on Arthritis A EULAR taskforce reviewed the literature on the effects of diet and lifestyle behaviors in RMDs, and found little evidence suggesting dietary factors can substantially affect the outcomes in people with RMDs. https://t.co/D31l7dlq9v https://t.co/Kt80Yp74ro

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Dr. John Cush RheumNow ( View Tweet)
Japanese claims data study looked at hospitalizable infections (SIE) in RA pts based on age: young (16-64 y), old (65-74y), very old (>75y) and showed age related increase in SIE - 3.2, 5.0, and 10.1 SIE/100PY, respectively. (#s unaffected by biologic use)https://t.co/deaGy3g0Ai https://t.co/2A5mB8n4FK

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Dr. John Cush RheumNow ( View Tweet)
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