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Burnout Threatens the Rheumatology Workforce Conundrum

Jack Cush, MD

There is a shortage of rheumatologists in Canada and the recent 2020 Canadian Rheumatology Association (CRA) Workforce and Wellness study shows that the shortage may be compounded by rheumatologist burnout, especially among young and female physicians. 

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CC Genotype and Thiopurine Toxicity

Jack Cush, MD

Annals of Internal Medicine reports that thiopurine toxcicity risk is associated with the "CC" genotype and that azathioprine discontinuation was associated with hematopoietic toxicity and lower thiopurine doses. 

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Two Week Twitter (6.17.2022)

Jack Cush, MD

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.

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Not All RA Drug Classes Are Created Equal

MedPage Today

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.

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JAK/STAT pathway in pyoderma gangrenosum: a new therapeutic highway?

Aurelie Najm, MD, PhD

Pyoderma gangrenosum (PG) is rare, but often associated with different forms of arthritis, in particular rheumatoid arthritis and inflammatory bowel diseases. 

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EULAR 2022 Top 10 Abstracts (6.10.2022)

Jack Cush, MD

Dr. Jack Cush reviews the top abstracts from EULAR 2022  As chosen by me with the  aid of the RheumNow EULAR faculty.

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CV risk factors not equal when considering magnitude of risk

Janet Pope, MD, MPH, FRCPC

What can we learn from Oral Surveillance?



The Oral Surveillance trial has almost become a household word for rheumatologists.

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Can we stop RA before it happens?

David Liew, FRACP

Rheumatologists have long hoped and wondered whether the right type of early intervention could prevent rheumatoid arthritis occurring in at-risk individuals.

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Military biobank of serial serum samples was used to identify biomarkers of imminent RA (vs reactive arthritis or healthy controls). Soluble programmed cell death receptor-1 (sPD-1) best predicted seropos. RA w/in 6mos of Dx. Specif >89%; sensitivity 48% https://t.co/djOGhLeCIi https://t.co/DzKqwteQku

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Dr. John Cush RheumNow ( View Tweet)
#EULAR2022 has concluded but you can find all our coverage here https://t.co/s62OVJPQ86 https://t.co/QAvPQYCABj

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Balance and falls studied in 228 #RA pts (24-85 yrs) followed x 1yr; 20% had at least one fall; risks included Age (OR 1.04), HAQ (OR 1.62), low FICSIT-4 score (OR 2.38) & 1-leg standing (OR  2.14). 1-leg stand is a good screening tool https://t.co/u9v8unC0gA https://t.co/oD0sgFxiQm

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Small study 34 biologic-naive RA pts starting abatacept. Remission achieved 47.1% of early and 23.5% established RA. Remission @ 6 mos predicted by Baseline LOWER IL-6 levels ≤ 8.4 pg/ml, (66.7%) and CD4+CD25+FoxP3+ cells ≥ 6% (83.3%) https://t.co/N93E9M4M15

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There are 494K PCPs in the USA, While up to 1/3 will "refill" DMARDs, only 6-9% are confident or knowledgeable in "initiating" DMARD therapy in #RA. GIGANTIC NEED FOR PCP education in MSK & Rheum Dz https://t.co/VjgWWDt3nX https://t.co/dTRXxsrzG5

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Study of interferon (IFN) gene signature (IGS) finds IGS elevated in half of early RA pts; high IGS portends higher DAS28, fewer EULAR good resp & higher IFN-α; the latter assoc w/ epigentic changes, more lymphoctye activation. IFN-α as a biomarker? https://t.co/BHC98OR30A https://t.co/SRE7KVaoha

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Dr. John Cush RheumNow ( View Tweet)
GLORIA Study Pred vs PBO in >65yrs RA x 2 years. 451 Pts & DAS28 4.5. 79% on DMARDs (14% biologics) Upside: Lower DAS28 -0.37 & less Xray progression -1.7 Sharp units Downside: 24% more AE (mild infxns), signif.small lowering of lumbar BMD -1% You Decide https://t.co/RRq0WcFsXz https://t.co/xLxjPPSMhh

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CV risk factors not equal when considering magnitude of risk What can we learn from Oral Surveillance? The Oral Surveillance trial has almost become a household word for rheumatologists. https://t.co/LHZTVZh4AK https://t.co/2SlxrG7UpQ

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Can we stop RA before it happens? Rheumatologists have long hoped and wondered whether the right type of early intervention could prevent RA occurring in at-risk individuals. https://t.co/vU4tRr7UJh https://t.co/cikU9pwaiT

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Watch: RA Potpourri on Day One EULAR 2022: Not An Ugly Duckling https://t.co/Lp25lP6ZZY https://t.co/wd5GCbaCLR

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Video: Residual Pain in RA Dr. Maxime Dougados discusses OP0052 at #EULAR2022. https://t.co/gu1Svegss8 https://t.co/G1rRizG9gW

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Dr. John Cush RheumNow ( View Tweet)
Canadian study of 50,883 RA pts shows only 58% saw a rheumatologist yearly for 5 yrs. If >65 yrs, Rheum care assoc w/ DMARD use in 82%; but was only 31% if not under Rheum care. Worse rheum retention with age >81, male, lower SES, older Rheums https://t.co/xUxWaksgsE

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