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To TDM or Not in Rheumatology?
Therapeutic Drug Monitoring (TDM), especially for biologic therapies, has become a standard in gastroenterology, but shunned by most rheumatologists.
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The Inflammation Reflex (5.20.2022)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.
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Inflammatory Arthritis Spread by ATP and Neural Crosstalk
A novel study from the Journal of Experimental Medicine suggests that a reflex neural signaling at sites of inflammation may lead to spread to other inflammatory sites via and ATP-mediated neural crosstalk.
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Novel patient self-drawn capillary (CAP) tube blood testing for CRP/RF/CCP - YES, Pt does this at home! 49/50 seropos.RA pts successfully collected samples; , correlations w/ venous blood=excellent: CRP (0.992), CCP (0.984), RF (0.994) https://t.co/zLiwEpiyi9
Conclusions
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Dr. John Cush RheumNow ( View Tweet)
Watch: Treatment Choices in Refractory RA
Dr. Cush presents Treatment Choices in Refractory RA, during the RheumNow Live 2022 meeting held in March 2022. #MedEd
https://t.co/5wjLyVAS7o https://t.co/dnh8Y5Of4G
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Dr. John Cush RheumNow ( View Tweet)
To TDM or Not in Rheumatology?
Therapeutic Drug Monitoring (TDM), especially for biologic therapies, has become a standard in gastroenterology, but shunned by most rheumatologists. But now, EULAR has a recommendation...
https://t.co/u86Vd8bFGr
#MedEdTwitter https://t.co/IpKqPoWM9R
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Dr. John Cush RheumNow ( View Tweet)
Watch: Adherence to Rheumatoid Therapies
Dr. Michaud presents Adherence to Rheumatoid Therapies at the RheumNow Live 2022 meeting held in March. #MedEd
https://t.co/sCCnx82ptN https://t.co/GJE0Ktwm7B
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Dr. John Cush RheumNow ( View Tweet)
A Roadmap for Investigating Preclinical Autoimmunity Using Patient-Oriented and Epidemiologic Study Designs: Example of Rheumatoid Arthritis - a comprehensive overview of studies of preclinical RA and risk of RA https://t.co/DKbDXkvFyQ
Dr. John Cush RheumNow ( View Tweet)
It's our 8th year covering this important meeting! Join us June 1 - 4 for key opinion leader perspectives, clinical trial highlights and more, as we cover #EULAR2022. https://t.co/eHziBN3TWk
Dr. John Cush RheumNow ( View Tweet)
Study of 282 inflammatory arthritis (IA) pts Rx with TNFi, 11 (3/9%) had neutralizing anti-drug Abs (nADAb). nADAb+ was more likely in smokders; such had significantly worse Dz activity, physical function, & inflammatory markers https://t.co/TnEKGpTQ85 https://t.co/I0hv5X35P1
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Dr. John Cush RheumNow ( View Tweet)
VA and Marketscan data analysis ~345k RA pts shows multimorbidity increased in RA; over-represented are cardiopulmonary, cardiometabolic, and mental health and chronic pain disorders (OR 1.17 - 2.96). https://t.co/awcGQPAdiN https://t.co/c4mLkDzvCM
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Dr. John Cush RheumNow ( View Tweet)
Inflammatory Arthritis Spread by ATP and Neural Crosstalk
A novel study suggests that a reflex neural signaling at sites of inflammation may lead to spread to other inflammatory sites via and ATP-mediated neural crosstalk.
https://t.co/vaFjqCPKtp https://t.co/RQV6qFh1pw
Links:
Dr. John Cush RheumNow ( View Tweet)
Multimorbidity Burden in Rheumatoid Arthritis
Crowson and colleagues at the Mayo Clinic have shown that rheumatoid arthritis (RA) patients have a higher prevalence of multimorbidity with as many as 44 different morbidities of interest in RA.
https://t.co/O5U6VXalwa https://t.co/BzXyMGz0ms
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Dr. John Cush RheumNow ( View Tweet)
Join us on May 24 at 7pm for Tuesday Night Rheumatology: RA - Best Management
We’ll focus on:
Drug Cycling Vs Switching in RA
Janet Pope, MD, MPH, FRCPC
Multimorbidity in RA
Elena Myasoedova, MD, PhD
Preventing RA
Karen Costenbader, MD
https://t.co/Vc5uECptIo https://t.co/fu3qACdHkL
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Dr. John Cush RheumNow ( View Tweet)
From 4 Nordic Registries, 24083 RA patients starting 41K courses of bDMARDs shows RA patients had an 80% higher risk of acute coronary syndromes than in the general population. ACS risk on bDMARDs did not improve at 3yrs or 5 yrs https://t.co/TX3jnIXkrW https://t.co/I34UvWH3qd
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Dr. John Cush RheumNow ( View Tweet)
Ontario population study shows that musculoskeletal disorders account for 12.3% of all adult emergency dept. visits and 28.5% outpatient physician visits https://t.co/Sq9n7RkIYK https://t.co/lKtQqR5Ja3
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Dr. John Cush RheumNow ( View Tweet)
RCT (WBC) whole body cryotherapy (-130C x 3 min; 6 WBC in 14 d) in 56 RA pts. Pain at 2 wks was signif better in WBC than controls (-2 vs -0.88 ; p=0.003) & remained lower x 12 weeks (w less pain meds); Dz activity & Function improved but not signif @wk 12 https://t.co/K7a7CQ7rGj https://t.co/a8QgiDeJS6
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Dr. John Cush RheumNow ( View Tweet)
Watch: Pregnancy Paradox: How Stopping Drugs Leads to Greater Harm
Uma Mahadevan, MD talks about the pregnancy paradox and how stopping medications in pregnancy to protect the fetus can actually lead to greater harm.
https://t.co/HYO5BdjwzZ https://t.co/IGeZ3O8Dno
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Dr. John Cush RheumNow ( View Tweet)
Large Granular Lymphocyte Leukemia rarely assoc w/ #RA. LGL accounts for 2-5% of lymphoprolif. disorders; often assoc w/ Autoimmune Dz (mostly RA). RA w/ LGL presents with leukopenia, anemia, splenomegaly, onset after mean 6 yrs of RA https://t.co/AIz2edHDXp https://t.co/DoHKm3KS7d
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Dr. John Cush RheumNow ( View Tweet)
Machine Learning helps predict RA relapse: data from KURAMA, 210 RA pts (150 achieved remission; 60 relapsed). Using clinical, lab and US findings, ML identified US findings in wrist and MTP predictors of relapse https://t.co/9rhctim4Mh https://t.co/iK3JudOMsC
Dr. John Cush RheumNow ( View Tweet)
