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Drug Choices After First TNF Inhibitor in RA

Jack Cush, MD

TNFi are frequently used first line in RA patients; and a new analysis shows that repeat use of TNFi dominates over the use of non-TNFi biologics when the initial TNFi therapy has failed. This retrospective analysis of commercial insurance records analyzed the patterns of drug use in adult RA patients who switched to their second biologic or targeted disease-modifying antirheumatic drug.

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RheumNow Podcast – COVID Marching Amidst the Madness (8.27.2021)

Jack Cush, MD

We have a lot of news, information and approvals to review and discuss, though I need to begin with what's weighing heavily on my mind. After, we'll dive into what we learned this week.

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ACR Guidance on Timing of 3rd Dose Booster with Immunomodulatory Drugs

ACR Press Release

The American College of Rheumatology has issued an updated version of its COVID-19 Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases following recent recommendations from the CDC that certain immunocompromised patients receive a third dose of an availabl

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The Predictive Value of Morning Stiffness

Jack Cush, MD

A prospective study evaluated the value and associations with morning stiffness in patients with clinically suspect arthralgia, and found that the presence of morning stiffness increases the odds of inflammation (as detected by CRP and MRI synovitis).

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Passive Smoke Exposure and Rheumatoid Risk

Jack Cush, MD

A current report in Arthritis & Rheumatology examined the Nurses Health Study II data set and shows that parental smoking, and passive exposure to children, can later lead to an increased risk of adult-onset incident seropositive rheumatoid arthritis (RA).

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NIAID will study COVID‐19 Booster Vaccine in Autoimmune Disease Non‐Responders (including MS, RA, SLE, Scleroderma,pemphigus); 20 sites, 600 pts (taking MTX, MMF or RTX) w/ poor resp to mRNA vax & recv 3rd booster vax. https://t.co/YwCvGnX21F https://t.co/th2WoRv1ng

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1458 RA patients (74% seropositive) followed longitudinally for ROM & surgical outcomes. Seropositive and seronegative patients had loss of ROM over time (7–13%/Yr), and surgical needs. T2T approaches should be followed irrespective of RF status https://t.co/ohmDTLfP9S

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A current report in Arthritis & Rheumatology examined the Nurses Health Study II data set and shows that parental smoking, and passive exposure to children, can later lead to an increased risk of adult-onset incident seropositive RA. https://t.co/szl5L7DGJG https://t.co/vAXBNPxsWU

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 36 studies, 608 RA-Bronchiectasis among 8569 RA pts; pooled bronchiectasis prevalence in RA was 18.7% (range 15.5% to 20.7%). Risk factors: older age, longer RA duration, genetics (CFTR & HLA), undetectable MBL biomarker https://t.co/SSRoTCYkHf

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2021–22 influenza season coincides with continued COVID infx & Sxs may be confused betw both. ACIP Influenza vaccination guidelines: 1. Annual flu vaccine rec to all >6mos; 2. COVID Vax can be given w/ Flu Vax; 3. give before Nov 2021 https://t.co/oIkl50GI0W

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#ClinicalPearl My pt’s rheumatoid nodules ⬇️ when she continued off her #methotrexate post #CovidVaccine. She restarted her JAKi + #plaquenil https://t.co/FqNX9k7FUN
Janet Pope Janetbirdope ( View Tweet)
Cognitive impairment (CI) is not a consequence of having rheumatoid arthritis (OR = 1.12, 0.80–1.58). Population survey study of 4262 adults >50 yrs. 63% of RA had normal cognition , 25% w/ CI, 12% dementia (similar to non-RA- 66%, 22%, 12%) https://t.co/7RFOk8Nrkm

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Among pregnant women, receipt of the BNT162b2 vaccine was associated with a 78% lower risk of incident SARS-CoV-2 infection. Cohort study tincluded 15 060 pregnant women in Israel. No adverse pregnancy outcome difference in Vax Pts https://t.co/jXUjaKIfUV

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A current report in Arthritis & Rheumatology examined the Nurses Health Study II data set and shows that parental smoking and passive exposure to children, can later lead to an increased risk of adult-onset incident seropositive rheumatoid arthritis (RA). https://t.co/szl5L7DGJG https://t.co/yxoEquyLjP

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Dr. John Cush RheumNow ( View Tweet)
Rheums--have a question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/wzNmOzH4VE https://t.co/QJn6Uo3lbM

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European Commission has approved tofacitinib (Xeljanz) to treat active polyarticular juvenile idiopathic arthritis & juvenile psoriatic arthritis (PsA) > 2yrs old, not responding to DMARDs (as tablet & new oral solution (weight-based dosing) https://t.co/FyqZI0qsYa

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Watch Now: Using Vitamin D in RA https://t.co/QXYVsa5jzP https://t.co/J9zxOUVRVY

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The CDC has reported that mRNA vaccine effectiveness against COVID-19–associated hospitalizations was sustained over 24 weeks; but there is evidence of waning protection amongst the immunosuppressed. https://t.co/UpQjFgKTpE https://t.co/3dQ2jacwJD

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#RA & Driving studied w/ installed auto sensor-based instrumentation - 23 controls compared to 33 RA pts (1292 driving hrs): shows RA & worsening Dz severity assoc w/ poor vehicle control; Braking/accelerating & steering variability liked to CDAI levels. https://t.co/umXGAbuicz https://t.co/EYxVVkzxR8

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New podcast available for download wherever you get your podcasts! We review the big stories on RheumNow this week. https://t.co/dbX9RN8ji5 https://t.co/WEf7yCR9km

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