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An Epidural Letdown (4.4.2025)

Jack Cush, MD

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

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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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Cardiac-MSK Patients at Highest Risk for Falls and Death

EurekAlert!

A new study by researchers at Peking University and the Chinese PLA General Hospital has found that multimorbidity—living with multiple chronic diseases—is closely associated with worsening fall conditions and mortality among middle-aged and older adults in China.

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Predicting Premature Death with Multimorbidity

Jack Cush, MD

Machine learning (ML) models were used to predict premature death in inflammatory bowel disease (IBD) patients with multimorbidity, the co-occurrence of 2 or more chronic conditions. 

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Targeting Obesity in Rheumatic Disease Patients

Jack Cush, MD

Sattar et al. has published an informative overview of the effect of obesity on rheumatic and musculoskeletal diseases (RMDs). They estimate that nearly 70% of RMD patients are overweight or obese.

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2024 Rheumatology Year in Review

Jack Cush, MD

2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians.  While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list (in no particular order) of 2024 developments and desires that may change rheumatologic practices.

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Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients

Jack Cush, MD

Annals of Internal Medicine has published a  Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk by 45%, but increased the risk for major adverse cardia

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Increased Mortality In Arthritis Patients with COPD

EurekAlert!

People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study.

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KORAIL (Korean RA-ILD) prospective cohort study of CT and biomarkers showed 35% ILD progressed over 3 yrs. Higher baseline KL-6 (HR 1.37) & hSP-D (1.51) levels assoc w/ progression. Increasing KL-6 at 1 yr showed the greatest progression (∆KL-6: HR 2.0) https://t.co/efowyCp1qu https://t.co/JVd7sRKzVF

Links:

Dr. John Cush RheumNow ( View Tweet)
Korean insurance claims study (2008–2021) 183,212 psoriasis & PsA pts, found Biologic Rx assoc w/ lower risk of new-onset & recurrent MACEs vs phototherapy (adj HR, 0.45 & 0.34). Nonbiologic systemic Rx lowered MACE risk (v photoRx) only in pts w/ prior Hx MACE (0.79) https://t.co/08wNm1AbpC
Dr. John Cush RheumNow ( View Tweet)
Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw
Dr. John Cush RheumNow ( View Tweet)
JAK-pot Collaboration of 15 registries looked at MACE risk in RA pts and found NO incr CV risk during 1st 2 yrs of JAKi (vs TNFi) use. 51233 pts; 828 incident MACE; in 73008 Rx courses (16K JAKi, 35K TNFi, & 21K OMA bDMARDs). JAK adj IRR: 0.89;0.63 to 1.25 (vs TNFi); bDMARD-OMA https://t.co/MAZrGfCNrU
Dr. John Cush RheumNow ( View Tweet)
Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/AxQVoXoxxx
Dr. John Cush RheumNow ( View Tweet)
Cardiac-MSK Patients at Highest Risk for Falls and Death A study by Peking University and Chinese PLA General Hospital found that multimorbidity, having multiple chronic diseases, is linked to worsening falls and higher mortality in middle-aged and older adults in China. https://t.co/R47w77zSwP
Dr. John Cush RheumNow ( View Tweet)
Korea National Health Insurance Database review shows that risk of mortality in Behcets patients is 28% higher than gen. population; highest in 1st 12 mos (OR 2.66). Major causes were CA, CVD, GI (viscus rupture), respiratory, & infections. Higher in younger pts. https://t.co/vWJrUN9C0H
Dr. John Cush RheumNow ( View Tweet)
Veterans Admin (VA) EHR study of #RA-associated ILD (n 1047), matched 237 RA-ILD pts who Rx w/ TNFi vs 237 Rx w/ non-TNF biologics (mean age 68y; 92% male). Death & Resp hospitalisation were similar (adj HR 1·21, 1·27), as was mortality (1·15), Resp mortality (1·38) https://t.co/03LV5B4FSV
Dr. John Cush RheumNow ( View Tweet)
Increased Mortality In Arthritis Patients with COPD A new study published in the January 2025 issue of Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, a peer-reviewed, open-access journal, finds that people with chronic obstructive pulmonary disease… https://t.co/6WCtfcrSaq https://t.co/ydVtBxqy37
Dr. John Cush RheumNow ( View Tweet)
Retrospective review of 781#RA pts; 78 Dx w/ILD (77 subclinical, most UIP on HRCT). w/ mean 10 yrs F/U, death rate was 1.5 vs. 7.1 per 100PY (without v with ILD) SMR equal betw RA & gen pop. but 2x higher in RA w/ ILD. Mortality higher w/ ILD (HR~3), age and low BMI… https://t.co/Vj0acewmK8 https://t.co/N1wHTjMfTr
Dr. John Cush RheumNow ( View Tweet)
Still's Dz Afro-Caribbean study of 58 pts (57% AOSD). Sex differed betw kids F 36% vs F71% in adults. Kids had signif more typical skin rashes (100 vs 29%), coronary artery dilation (16 vs 0%), & MAS (52 vs 9%). Adults signif more polyarthalgia (91 vs 32%) & lung dz (51 vs 4%).… https://t.co/AYKNazgio5 https://t.co/1yQgeMiwku
Dr. John Cush RheumNow ( View Tweet)
MMWR: Idiopathic Pulmonary Fibrosis Mortality in the United States Idiopathic pulmonary fibrosis (IPF), a progressive lung disease characterized by scarring and worsening lung function, has a poor prognosis. An estimated 21% of IPF deaths might be attributable to occupational… https://t.co/FQpotKrgzR https://t.co/hruzwcD1E6
Dr. John Cush RheumNow ( View Tweet)
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