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Infection and Rituximab-linked Immunoglobulin Deficiency
A minority of immune-mediated inflammatory disease (IMID) patients treated with rituximab (RTX) are expected to develop and depressed immunoglobulin (Ig) levels. A recent cohort analysis suggests that RTX-induced Ig deficiency was not associated with an increased risk of severe infecti
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Washington Post: Case of Delayed Rheum Diagnosis
The Washington Post recently published a "medical mystery" case titled, "Medical Mysteries: A rolled ankle set this runner down a painful path", which tells the tale of how and why rheumatologists are often not consulted or are consulted too late.
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Top 10 Pharma R&D Budgets in 2023
Pharma budgets have undergone significant changes coming out of COVID. This year Merck & Co. has knocked Roche from previous years of leading in research and development (R&D) budgets and investments.
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Insights on Postinfectious ME/CFS
The medical community is challenged by myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS - its origins, pathogenesis outcomes and treatment. JAMA has reviewed a recent Nature paper wherein an NIH led team of multidisciplinary experts performed an inpatient study of postinfe
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91 #SLE pts w/ no baseline synovitis, underwent Ultrasound exams. 10 yrs later, 31 had clinical progression of arthritis. Pts w/ progression, 75% had baseline subclinical synovitis on US vs without progression 77% did NOT have an abnormal US at baseline https://t.co/MN9wkNgsQV https://t.co/ozgvjFI531
Dr. John Cush RheumNow ( View Tweet)
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/NKtI5iFKeb https://t.co/G5T0YEdEkO
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Ides of March (3.15.2024)
Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.
https://t.co/s87j9fXQNA https://t.co/QNDXweNAvp
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/9u0Lujlkqf https://t.co/gVOvwd54Z1
Dr. John Cush RheumNow ( View Tweet)
UAB study shows the US adult rheumatology workforce grew clinically active adult rheumatology workforce grew 23% betw 2009-2020; including a 43% increase in women. Number of Rheums (5,667) grew 23% and APPs (379) grew 141%. https://t.co/sVPoNIUZUu https://t.co/4myGYaUtcd
Dr. John Cush RheumNow ( View Tweet)
US Trends in RA DMARD Use 2017-2021
A trend analysis of disease-modifying anti-rheumatic drugs (DMARDs) shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use.
https://t.co/vQmVyAjIaL https://t.co/tSJ4H5XtnU
Dr. John Cush RheumNow ( View Tweet)
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children
MIS-C is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.
https://t.co/PN2MPQxqSR https://t.co/eIzB4pjner
Dr. John Cush RheumNow ( View Tweet)
In RA, NO selective response with Seropositivity. Study of 28 eligible RCTs shows pts Rx w/ cs- or bDMARD that seropositivity did not predict better bDMARD response (ACR20 RRR ~1). Comparable resp in RF+ & RF- w/ TNFi or non-TNFi bDMARDs. https://t.co/AUWPgkzayt https://t.co/om9AYhNsQ9
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9 Facts about Leflunomide
Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui.
https://t.co/X9lyrOs3D7 https://t.co/TGh2LnGdJ8
Dr. John Cush RheumNow ( View Tweet)
Retro study 109 oligoarticular JIA pts (~8 yrs) Rx w/ intraarticular steroids w/ 4.3 yrs F/U: 38% needed no Rx, 15.5% needed more IAS; 46% systemic Rx(MTX; 8 mos) &22% biologics(2.2 yrs later). @FUV 89% were inactive. Persistence predicted by ANA+ & B27+ https://t.co/5YLkYyA84l https://t.co/wClhEiKOIw
Dr. John Cush RheumNow ( View Tweet)
Japanese study of 672 autoimmune pts on TNFi & tocilizumab - 1.6% (n=9) developed non-tuberculous Mycobacteria (NTM) infx post biologics. 2 disseminated NTM, 2 died. NTM pts had higher mortality [(22% vs 2.6%) & took more steroid (17 vs 3 mg, P=0.004).https://t.co/fGGafrTeiL https://t.co/DkmiC2hVEA
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JAMA Review of DMARD Use in Rheumatoid Arthritis
JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs".
https://t.co/fpAigPpKzv https://t.co/GkbqW2BxpA
Dr. John Cush RheumNow ( View Tweet)
JAK-pot: 46913 Rx courses on JAKi, TNFi, other MOA. Rx D/Cs for AEs:
- TNFi = JAKi (HR 1.0)
- Other MOA > JAKi (HR 1.11)
- TNFi < tofacitinib (0.81)
- TNFi > baricitinib (1.15)
- TNFi < JAKi; if >65yrs w/ CV risk (0.79) https://t.co/jCtLG3SNvP https://t.co/FN5U5Z1M9M
Dr. John Cush RheumNow ( View Tweet)
Effective Treatments for Still's Disease
A systematic review of pharmacological treatments for adult-onset Still disease (AOSD) supports the efficacy of tocilizumab (TCZ), anakinra (ANK), and canakinumab (CNK).
https://t.co/r7RGD5WlvO https://t.co/Jfq7zPR0ci
Dr. John Cush RheumNow ( View Tweet)
JAK inhibitors maybe an option in refractory Juvenile Dermatomyositis. Metanalysis of 26 reports (195 pts) JDM Rx w/ JAKi (median 5 rys); most Rx w/ tofacitinib (57%), ruxolitinib(27%), baricitinib (15%), w/ Improvement in 90%, 69%, 93%, respectively. https://t.co/tfISYVtwUN https://t.co/zv88Vdy6c0
Dr. John Cush RheumNow ( View Tweet)
Again, a High Mortality with Depression and RA
Last week we reported on a Korean study showing a 66% elevated mortality risk in RA patients with depression. This week, a new report shows depression in RA increases the mortality risk by more than 5 fold.
https://t.co/C7Z7djny4S https://t.co/J9B6DUqcIC
Dr. John Cush RheumNow ( View Tweet)