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DMARDs for Early Rheumatoid Arthritis Have Cardiovascular Benefits

d RheumNow

Patients with RA have up to a three-fold increased risk of mortality versus the general population, largely due to an increased incidence of premature CVD, such as atherosclerosis and heart failure.

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Metanalysis presented at European Association for the Study of Diabetes (EASD), involving 1,629,854 participants and found #RA was associated with a 23% higher chance of developing T2D, compared to the diabetes risk within the general population https://t.co/Qff7gpzves

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast – Lupus Delights (9.18.20)

d Jack Cush, MD

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

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The RheumNow podcast is up! Lupus delights - Lupus & Diet, Drug induced lupus & brand new biologics for SLE. Good news on immunosuppressives, colchicine and baricitinib in COVID-19 patients. . Watch it here https://t.co/Ymsd3eXN5d or listen to the podcast https://t.co/20FOr3qu3X

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow podcast is up! Lupus delights - Lupus & Diet, Drug induced lupus & brand new biologics for SLE. Good news on immunosuppressives, colchicine and baricitinib in COVID-19 patients. . Watch it here https://t.co/Ymsd3eXN5d or listen to the podcast https://t.co/20FOr3qu3X

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Dr. John Cush RheumNow ( View Tweet)

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Has the Risk of Hip Fracture Changed over Time?

d Jack Cush, MD

Data from the Framingham Heart Study has shown that hip fracture incidence has decreased over time, probably resulting from improved lifestyle changes (less smoking and heavy drinking). 

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Uncontrolled retrospective observational study of 31 RA-ILD DMARD refractory pts treated with RTX showed RTX to reverse the PFTs decline (∆%pFVC +8.06%; ∆%pDLCO +12.7%) while reducing median prednisone dose at 1 yr. @32 mos, 74% still on RTX. https://t.co/AVQCm2MpDk

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Dr. John Cush RheumNow ( View Tweet)

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Mediterranean Diet May Reduce Risk of RA

d Jack Cush, MD

Arthritis and Rheumatology reports that a Mediterranean diet (MD) is capable of reducing the high risk of RA among women who have smoked tobacco. The results stem from the E3N Study, a French prospective cohort study that collects dietary data on 98,995 women since 1990. An MD score was derived from standardized questionnaires.

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Systematic literature review of the incidence of SpA subtypes: psoriatic arthritis overall IR of 9.7 per 100.000 PYs; AS overall IR of 4.8/100kPY, and reactive arthritis overall IR estimate of 3.4/100KPY. Little on undifferentiated spondyloarthritis https://t.co/U8yqk30cWb

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Dr. John Cush RheumNow ( View Tweet)

post hoc analysis of Xrays in tocilizumab poly JIA pts Rx for 2 years in the TENDER and CHERISH trials, shows Tocilizumab may delay radiographic progression in children with sJIA and children with pcJIA with only 3-12% showing xray progression by 2 methods https://t.co/qwREzsaR1L

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast - ACR Reproductive Health Slides (9-11-20) Dr Jack Cush reviews the 2020 ACR Reproductive Health Guidelines This past week we presented an overview to the new 2020 ACR ACR 2020 Reproductive Guidelines - Contraception & Counseling https://t.co/vnPh2EQZ0a https://t.co/T4y69DYIH7

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Dr. John Cush RheumNow ( View Tweet)
Discontinuing TNFi before wk 20 is feasible in RA and JIA pregnancy with well- controlled Dz. OTIS study of 490 women compared 25% who D/C TNFi before wk 20 vs 41% taking TNFi after wk 20. D/C TNF not assoc w/ clinical worsening in the 3rd trimester. https://t.co/DtHvQ2rbWY

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Dr. John Cush RheumNow ( View Tweet)

New data on tocilizumab in pregnancy, upshot is: "Tocilizumab concentrations in cord blood and infant serum were 80–90% of those in maternal serum" https://t.co/SEmyTnL7dy

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast - ACR Reproductive Health Slides (9-11-20)

d Jack Cush, MD

Dr. Jack Cush reviews the 2020 ACR Reproductive Health Guidelines presented all week here on RheumNow. 

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Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil. Data from 84 papers, 611 male exposures, 5986 pregnancies https://t.co/VgEsrXhfdh

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Dr. John Cush RheumNow ( View Tweet)

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ACR 2020 Reproductive Guidelines - Lactation Guidance

d Jack Cush, MD

In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.

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The PARA study shows among 249 pregnancies (2002-08), breastfeading was less in RA - at 4-6, 12 & 26 wks postpartum 43%, 26% and 9% of the RA breastfed (vs 63%, 46% &; 41% in controls). Many patients D/C breastfeeding so they could start medication. https://t.co/2205YnoHsb https://t.co/mMyLgMNFfM

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Dr. John Cush RheumNow ( View Tweet)
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ACR 2020 Reproductive Guidelines - Medication Use with Pregnancy

d Jack Cush, MD

The American College of Rheumatology (ACR) has published guidelines to manage reproductive health issues in rheumatic disease (RMD) patients before, during and after pregnancy.

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Free full read review "Postnatal Care of Woman with Rheumatic Dz". 46% of RA pts will flare postpartum; breast feeding is ok w/ most biologics; Hold Live vaccines if Pt is on a biologic during pregnancy; VTE prophylaxis essential for 10 d–6 wks postpartum. https://t.co/Ol23S0GiEW

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Dr. John Cush RheumNow ( View Tweet)

QD Videos from RheumNow Live. "I wanna get pregnant" (a controlled RA patient on tocilizumab) https://t.co/vfLgQPrl98

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Dr. John Cush RheumNow ( View Tweet)

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