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GI Perforations with Tocilizumab Greater than Other Biologics

Jack Cush, MD

A study from a Swedish population shows the real-world risk of gastrointestinal (GI) perforations in rheumatoid arthritis (RA) patients taking biologics finds that the risk was greatest in RA patients taking tocilizumab (TCZ), compared with RA patient taking tumour necrosis factor inhibitors (TNFi) and other non-TNFi biologics.

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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)

Jack Cush, MD

Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.

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Extrapulmonary Manifestations of COVID-19

Jack Cush, MD

A new article in Nature Medicine delineates how our understanding of COVID-19 infection has evolved over time, such that the infection outomes may be worsened by extrapulmonary manifestations; notably thrombotic, cardiac, renal, gastrointestinal hepatic, neurologic, and other complications.

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Liver Abnormalities in Psoriatic Arthritis

Jack Cush, MD

A new report in the Journal of Rheumatology shows that liver abnormalities are common in psoriatic arthritis (PsA) and may be associated with obesity, more severe disease and select therapies.

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RheumNow Podcast – Enough Already with Weaning (6.19.20)

Jack Cush, MD

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

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Antibiotic use is associated with a higher rate of IBD (aOR 1.88; 1·79–1·98) based on a prospective case-control study from the Karolinska that compared 23,982 new IBD pts w/ 117,827 matched controls followed over 10 years. https://t.co/FbCVU5GEFo

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Dr. John Cush RheumNow ( View Tweet)

BMS has announced deucravacitinib: the generic name for its Tyk2 inhibitor (BMS-986165) - 15 long makes it a new rheum labeling record. It's being studied in Psoriatic arthritis, psoriasis, lupus and inflammatory bowel disease. https://t.co/E2x2lelktO

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Dr. John Cush RheumNow ( View Tweet)

Hong Kong study Myositis-specific autoantibodies in 201 pts with idiopathic inflammatory myopathies (IIM) shows MDA-5 (14%), TIFF-1γ (14%), Jo-(12.4%). MDA5 seen w/ DM, digital ulcers, amyopathy, ILD. TIF1γ was associ w/ refractory rash and cancer https://t.co/3E365F5SON

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 7 RCTs looked at melanoma risk comparing 34 029 biologic Tx vs 135 370 non-biologic conventional systemic Tx pts, showing no signif. increased risk in IBD (RR 1.20; 0.60-2.40), RA (pRR 1.20; 0.83-1.74), or psoriasis (HR 1.57; 0.61-4.09) https://t.co/PCOddiwKv0

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Dr. John Cush RheumNow ( View Tweet)

Literature review suggests that TNF inhibitors are safe to use in NAFLD and may show a beneficial effect on hepatic tissue. TNFi should be prescribed with caution in patients w/ cirrhosis as the data are conflicting. https://t.co/uynkNNCxdt

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Dr. John Cush RheumNow ( View Tweet)

Retrospective cohort of 147 Adult-Onset Stills Dz pts finds 18 (12.3%) with lung dz (LD) at the diagnosis of AOSD. AOSD-LD were older, w/ more myalgia, LN, pleuritis, ab,dominal pain, more systemic Dz, higher ferritin and more mortality (%39 vs 10%). https://t.co/2phEFwi6n2

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Dr. John Cush RheumNow ( View Tweet)

45 yr adult male w/ Kawasaki-like multisystem inflammatory syndrome w/ COVID-19 infx: presented w/ 6d fever, sore throat, diarrhea, LN, BLE pain, conjunctivitis, tachycardia, ESR 120, CRP 546 mg/L, high Troponin; Rx and resolved w/ IVIG & TCZ https://t.co/cyRBJccKop

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Dr. John Cush RheumNow ( View Tweet)

FDA has approved a 6th adalimumab biosimilar - called Hulio (adalimumab-fkjp) with indications of rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis, psoriasis. https://t.co/zMNsDjVewU

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Dr. John Cush RheumNow ( View Tweet)

PRES - Posterior reversible encephalopathy syndrome. Review of US hosp records finds 3125 cases. Rheum Dz associations include ANCA+ vasculitis (OR 9.3), PsA (4.6), Scleroderma (6.6), SLE nephritis (7.5), SLE (2.4); also renal failure, pre-/eclampsia https://t.co/uLQxU3RNuD

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Dr. John Cush RheumNow ( View Tweet)

Rituximab (RTX)-associated autoimmune disease flare is rare and only seen in 7/185 pts (3.4%); all w/ type II mixed cryoglobulinemia vasculitis. Flare occurred a median 8 days post RTX, as acute kidney insuf, purpura with myocarditis or GI involvement https://t.co/pgvyddFnAd

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Dr. John Cush RheumNow ( View Tweet)

If you treat #SLE patients, Do you get a renal biopsy before starting therapy for Lupus nephritis?

Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 8 studies and >130,000 patients shows that IBD (Crohns & UC) have a significantly higher risk of developing #RA (RR = 2.59; 95% CI: 1.93–3.48). https://t.co/ipYRZ6DQPQ

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Dr. John Cush RheumNow ( View Tweet)

NEJM case report of PD-1 inhibitor induced immune related colitis successfully treated with tofacitinib 10 mg bid for 30 days - patient improved after 5 days of TOFA. https://t.co/skfU6TKnlK

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is Up! New FDA approvals for secuminumab, canakinumab, risk of GI perforations, tocilizumab in COVID, Weaning DMARDs/Biologics and Blacks with AS. Watch here>> https://t.co/2fTQPJ5iSr Listen to the podcast on Soundcloud>> https://t.co/uPklKQEauE

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Dr. John Cush RheumNow ( View Tweet)

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