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Naysayers & Disrupters (3.22.2024)
Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.
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CV Risk Early with Rheumatic Disease Diagnosis
A Finnish populaton study shows that the temporal relationship between cardiovascular (CV) comorbidities in rheumatic diseases (RMD) is seen early after the RMD diagnosis.
2023 EULAR Psoriatic Arthritis Recommendations
EULAR has updated its treatment recommendations from the prior 2019 guidelines, since which there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.
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Infection and Rituximab-linked Immunoglobulin Deficiency
A recent cohort analysis suggests that RTX-induced Ig deficiency was not associated with an increased risk of severe infection in IMID patients.
https://t.co/bNmYyYi2Vs https://t.co/MXKRbrrIJS
Dr. John Cush RheumNow ( View Tweet)
Series of Chronic Cutaneous Lupus responding to anifrolumab. 6 pts (4 DLE, 2 CCLE) betw 37-66 yrs old w/ Dz duration 10.5 yrs, 4 w/ SLE, all refractory to multiple therapies Rx w/ ANIF w/ Skin benefit. 1 developed herpes, 1 had worsening of nephritis https://t.co/6imLq3TDMu https://t.co/BMoIQhRtYs
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Biden signs executive order on womens health research ($200 million to NIH interdisc. women res), focus on:
- integrate Women’s Health Across Federal Research prgs
- fund Research on Women’s Midlife Health
- double funding Office Womens Health Research
https://t.co/28u9lLdboL https://t.co/sld0BxsSB8
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Dr. John Cush RheumNow ( View Tweet)
Join our experts, Drs Liebowitz and Mehta, as they provide insights on the differential diagnosis and management concepts in autoinflammatory diseases. Sponsored by Novartis Pharmaceutical Corporation.
https://t.co/doSRuW0nLq https://t.co/w65jVHienh
Dr. John Cush RheumNow ( View Tweet)
4873 gout pts w/ High SUA renally typed: UA overproduct. (ROA 9%); underexcreter (RUE 61%); combined (23%) or normal (7%)
ROL: older, lower SUA, tophi & DM
RUE: lower BMI, No DM
Combined: younger, HighBMI/SUA/eGFR & smoking
Normal: older, Low SUA/eGFR https://t.co/sfcIoR0YTN https://t.co/ulqP6XyKMa
Dr. John Cush RheumNow ( View Tweet)
Post-COVID POTS? Neurology cohort study of 16 pts - 81%F, mean age 36. Common Sxs:
- Palpitations & Fatuge in 2/3
- in <1/3: migraines, IBS, Raynaud’s
- Variable tilt test but High autonomic Sxs
No insights on Rx... https://t.co/I7MLjHAUDb https://t.co/hWnfJ9WWPX
Dr. John Cush RheumNow ( View Tweet)
We're gearing up for Tuesday Night Rheumatology all April long. Register today!
Our first TNR takes place 4/2 at 6:30pm ET and will focus on Success in Rheumatoid Arthritis.
https://t.co/FeeOdxOiRQ https://t.co/FNoCi6goQS
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Dr. John Cush RheumNow ( View Tweet)
FDA grants orphan drug designation to CAR T-cell therapy for systemic sclerosis https://t.co/KZKSy2sbNk https://t.co/5abz8MeYGK
Dr. John Cush RheumNow ( View Tweet)
Expert Panel Guidance on Managing Psoriatic Arthritis and Comorbidities
An expert panel has published their consensus guidelines for the management of psoriatic arthritis (PsA) and it's comorbidities in the journal Rheumatology.
https://t.co/pZjnW4dPxj https://t.co/Si9Gl3WgUx
Dr. John Cush RheumNow ( View Tweet)
Chronic MSK Pain and Earlier Retirement
Frequent musculoskeletal pain is linked with an increased risk of exiting work and retiring earlier, according to a new study published in the journal PLOS ONE.
https://t.co/f2skRvd6Dl https://t.co/K8bJjcGOSF
Dr. John Cush RheumNow ( View Tweet)
1st trimester exposure to Plaquenil is not assoc. w/ risk of congential malformations (MCM). Swedish registry data on 1007 births (453 exposed) & 2500 births (144 exposed) in SLE & RA, respectively. MCM risks in SLE &RA were 3.4-5.7%, no diff betw groups https://t.co/lzbd7AQqy1 https://t.co/AsFYYBQQtm
Dr. John Cush RheumNow ( View Tweet)
post hoc of the PEXIVAS study 704 participants w/ severe ANCA vasculitis: 92% achieved remission & 23% had relapses (rate 10.3/100PYs)-- Neither plasma exchange nor glucocorticoid tapering regimen impacted relapse risk. https://t.co/UN6RujwZKc https://t.co/MsXKPwp9km
Dr. John Cush RheumNow ( View Tweet)
Stills pts w/ remission on Tocilizumab who stop TCZ, 50% will relapse in 1 yr. Lower relapse rate w/ longer TCZ use w/ prednisolone lowering. 38/48 AOSD Rx w/ TCZ were in remission after 6 mos. & 12 D/C TCZ - half flared after mean of 5.5 mos.https://t.co/L9XbUX8lXn https://t.co/Z4oixQR2oX
Dr. John Cush RheumNow ( View Tweet)
Infection and Rituximab-linked Immunoglobulin Deficiency
A recent cohort analysis suggests that RTX-induced Ig deficiency was not associated with an increased risk of severe infection in IMID patients.
https://t.co/mcEc0FpdpR https://t.co/S2vAXSWlso
Dr. John Cush RheumNow ( View Tweet)
Case of Delayed Rheum Diagnosis
The Washington Post recently published a case titled, "Medical Mysteries: A rolled ankle set this runner down a painful path", which tells the tale of how/why rheums are often not consulted or consulted too late.
https://t.co/rusIwlELHu https://t.co/5ePDh4aFDY
Dr. John Cush RheumNow ( View Tweet)
929 Sjogrens pts from 2 French cohorts subdivided into 3 Groups:
1. BALS: Hi B-cell activity, low Sxs (Dz activity worsened w/ time)
2. HSA: Hi systemic Dz
3. LSAHS: low systemic Dz, Hi Sxs
Lymphomas in 3-4% BALS & HSA
https://t.co/xI8qjLO8YQ https://t.co/Z2JBuKSUhi
Dr. John Cush RheumNow ( View Tweet)
French claims data study of Serious infections in 12K #PsA pts Rx w/ biologics (2015-2020) found 367 (3%) w/serious infxn (17/1000Pys). Compared to adalimumab, a signif. lower SIE risk was seen w/ ETN (HR 0.72), & ustekinumab (HR 0.57) https://t.co/oVomnKuYGJ https://t.co/y5DQatFoCa
Dr. John Cush RheumNow ( View Tweet)