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liver,hepaitis,pink,gb

New Hope for NonAlcoholic Fatty Liver Disease

Jack Cush, MD

The current issue of the NEJM has two articles on nonalcoholic fatty liver disease (NAFLD also called NASH - nonalcoholic steatohepatitis), one dealing with the prognoses, outcomes and mortality of NAFLD and another prospective and promising interventional trial in NASH patients. 

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RheumNow Podcast – Quackademia (10.15.2021)

Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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liver,hepaitis,pink,gb

Hepatitis B Reactivation with Rituximab and Abatacept

Jack Cush, MD

Hepatitis B reactivation is an uncommon complication of biologic therapy use. Now, a serologic study of  rheumatoid arthritis patients shows that HBV reactivation is seen with rituximab, and less so with abatacept, especially in patients without hepatitis B antibody (HBsAb) positiv

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RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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Effect of Diet on COVID Outcomes

Jack Cush, MD

A smartphone-based symptom study of COVID-19 patients has shown that a healthy plant-based diet was associated with lower risk and severity of COVID-19, especially amongst those living in areas with higher socioeconomic deprivation.

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RheumNow Podcast – High Science and Future Treatments (9.10.2021)

Jack Cush, MD

This week: high science that affect future treatments; breakthrough infections in our patients, and what's up with that; and soon your radiologist is going to be replaced by AI. This and more in our review of the news and journal articles from the past week.

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FDA, warning, side effect

FDA: New Cardiac and Cancer Warnings for All JAK Inhibitors

Jack Cush, MD

Today, Sept.1st, the FDA announced its decision regarding tofacitinib's safety concerns from the Oral Surveillance study - handing down warnings for not only Pfizer's JAK inhibitor, but also for other marketed JAK inhibitors from AbbVie and Eli Lilly & Co.

These safety concerns arise from the Oral Surveillance study - a large, post-marketing, safety trial of tofacitinib versus adalimumab in high risk patients. New warnings about the risks of cardiac events, death and cancer will appear as a revision to the "boxed warnings" in the product label (package insert) for all JAK inhibitors - tofacitinib, baricitinib and upadacitinib. 

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In pts w/o RF, liver bx prev suggestd if lifetime cumulative MTX dose was 1-1.5g, then 3.5-4g. All pts in centre offered Fibroscan liver stifness associations: - age, BMI - not cumulative MTX dose maybe survival bias, but what we're doing now is fine! #ACR21 ABST0786 @RheumNow https://t.co/I6IhS3jhmC
David Liew drdavidliew ( View Tweet)
Interesting study with Dr. Julia Manasson on gut and skin microbiome in monozygotic twins discordant for psoriatic disease. (red = Psoriatic). Gut ruminococcus bromii virtually absent in psoriatic pts. Eager to see further studies! #ACR21 Abst#0944 @RheumNow https://t.co/zrZPBAjh5p
Pedro Castillo _Castillo_Pedro ( View Tweet)
Monozygotic twin study in PsO patients showed a gut and skin microbiome difference compared to their "normal" twin ⭐️Ruminococcus decreased/absent in gut flora of PsO ⭐️microbiome differences even in healthy PsO skin Abs#944 #ACR21 @RheumNow #ACRBest https://t.co/VlfVh5Kt3Y https://t.co/W0eSqi77lx

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Robert B Chao, MD doctorRBC ( View Tweet)
MTX and liver: FibroScan scores compatible with liver fibrosis are significantly correlated w/ several parameters -BMI -waist circumference -male gender -age but NOT MTX cumulative dose in a cohort of 500+ patients. #Abst0786 @RheumNow #ACR21 https://t.co/RkSpVqN4qF https://t.co/9TENaR0WZ3

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Aurelie Najm AurelieRheumo ( View Tweet)
AxSpA pts share a gut microbiome signature with Crohn's disease and anterior uveitis pts ⬇️Blautia ⬆️Veillonella and Lactobacillus ⭐️SpA pts uniquely enriched in Collinsella Abs#0062 #ACR21 @RheumNow #ACRBest https://t.co/sdlHxNbhr8 https://t.co/r8eG9c9vwa

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Robert B Chao, MD doctorRBC ( View Tweet)
Is it time to consider targeting gut microbiome for treatment of AS? Large study identified: ⭐️Ruminococcus torques associated with FUT2 gene influences risk of developing AS Abs#0068 https://t.co/E1hL18KZbQ #ACR21 #ACRBest @RheumNow

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Robert B Chao, MD doctorRBC ( View Tweet)

"I don't want rheumatologist only use BLMB and nephrologist using only VCS." - Dr. M Petri on how we should work together with nephrologists on managing lupus nephritis. (She did give a final dig & added "BLMB can be used with any GFR") #ACR21 #GreatDebate @rheumnow

TheDaoIndex KDAO2011 ( View Tweet)

Nature has published a full read over of "Homing in on an oral link to inflammatory disease" how the microbiome may be a pathogenic link to diseases like RA. https://t.co/wwB9Eg9nsH

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Dr. John Cush RheumNow ( View Tweet)

Catastrophic Still's dz occurs early; compares 20 AOSD w/ organ failure vs 40 AOSD without. CAT-AOSD had shorter Dz duration, earlier Rx need; risks: younger; splenomegaly, liver, cardiac,lung involvement; ferritin level, no arthralgia https://t.co/8WIMd0JxZr

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Dr. John Cush RheumNow ( View Tweet)

US Preventive ServTask Force has advised that adults >60 yrs should NOT take daily preventative aspirin without a no hx of MI/CVD risk (the GI risks outweigh CV benefit). If 40-59 yrs, discuss w/ their MD if ASA would be beneficial https://t.co/jfqnBjwLLn

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Dr. John Cush RheumNow ( View Tweet)

Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib) https://t.co/MO4i5ngKkr

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Dr. John Cush RheumNow ( View Tweet)

32 RA pts; each w/ 2 stool samples >6 mos apart - stool metagenome sequencing stool samples and pt activity assessed. Microbiome most influenced by age, followed by those achieving minimum clinically important improvement https://t.co/unaEOOuP34

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Dr. John Cush RheumNow ( View Tweet)

UK study shows PreClin RA, Establ #RA 1) have increased bowel permeability; 2) gut permeability worsens w/ activity; 3) gut-permeability markers not affected by treatment; 4) in a RA Mouse model-blocking gut permeability ameliorates arthritis https://t.co/HZNl56cQnn

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Dr. John Cush RheumNow ( View Tweet)

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