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All in the Family (8.23.2024)

d Jack Cush, MD

Dr. Jack Cush picks highlight reports from the past week on RheumNow.com, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history.

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pedigree.genetics.family.history

A Family History of Arthritis?

d Jack Cush, MD

Using data from the population based All of Us (AoU) Research Program, a self reported history of arthritis and related conditions was associated with an increased risk for arthritis, osteoporosis, and carpal tunnel syndrome.

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Lipids and Inflammation in Rheumatoid Arthritis

d EurekAlert!

In the realm of chronic inflammation, lipid abnormalities are well-recognized as pivotal contributors to the progression and clinical manifestations of atherosclerosis.

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#Injection of PIP Mid joint capsule but above midline to avoid collateral ligament #ClinicalPearl #MedTwitter #MedEd #RheumX #RheumEd #MedX https://t.co/N9dBHB0rsf

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Janet Pope Janetbirdope ( View Tweet)
ACR Applauds Lower Negotiated Prices for Common Arthritis Drugs The ACR praised the recent announcement from the CMS that their initial drug pricing negotiations have reduced costs for select medications, including significantly lower prices for Enbrel and Stelara, which are… https://t.co/GXl6y87ZaF https://t.co/A2N4Ehg8Dk
Dr. John Cush RheumNow ( View Tweet)
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Sequential Belimumab and Rituximab in SLE

d Jack Cush, MD

Could disease control in active systemic lupus erythematosus (SLE) patients be improved by the sequential use of subcutaneous belimumab (BEL) and intravenous rituximab (RTX)? A double blind trial has shown that sequential BEL and RTX was not superior to BEL alone in SLE.

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Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/J9FCdkId8H https://t.co/uJylDP3IIp

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Dr. John Cush RheumNow ( View Tweet)
Less Mortality with GLP-1 Agonists in Rheumatic Patients A recent study in PLOS ONE found that treating type 2 diabetes with GLP-1-RAs lowered the risk of mortality and cardiovascular events in patients with IMIDs and type 2 diabetes. https://t.co/MzCG7WvrDS https://t.co/0RPIfOO0s7

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/GV6WjsqZBH https://t.co/9l9qyJpg3I

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Dr. John Cush RheumNow ( View Tweet)
Among the 1st 10 drug prices Negotiated by Medicare - Two are for Rheums: - Etanercept; original price $7,106/Mo], negotiated price $2,355 (67% decr) - Ustekinumab: for original price $13,836/mo, negotiated price $4,695 (66% decr) https://t.co/eexr4Acrbi https://t.co/fE0aoD8vA3

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Dr. John Cush RheumNow ( View Tweet)
More Noninflammatory Pain in Difficult to Treat RA A Canadian cohort of difficult-to-treat rheumatoid arthritis (D2T RA) patients shows significantly more non-inflammatory pain in D2T RA compared to patients responding to b/tsDMARDs. https://t.co/XRH9q0gNyq

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Dr. John Cush RheumNow ( View Tweet)

CV,risk,MI,heart,cardiac

Less Mortality with GLP-1 Agonists in Rheumatic Patients

d Jack Cush, MD

A recent article in PLOS ONE has shown that treatment of type 2 diabetes with glucagon-like peptide-1 receptor agonists (GLP-1-RAs) was associated with a significant lowering of risk of all-cause mortality and major adverse cardiovascular events in patients with immune-mediated inflammatory diseases and type 2 diabetes.

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The Burden of Rheumatoid Arthritis (2018–2020) A recent study that quantified the economic and humanistic burden of RA in the US showed significantly higher health care expenditures, particularly medication costs, and suboptimal quality of life in RA. https://t.co/1v3CDtZC0l https://t.co/WPWuOvpkfa

Links:

Dr. John Cush RheumNow ( View Tweet)
hands.stiff2_.jpg

More Noninflammatory Pain in Difficult to Treat RA

d Jack Cush, MD

A Canadian cohort of difficult-to-treat rheumatoid arthritis (D2T RA) patients shows significantly more non-inflammatory pain in D2T RA compared to patients responding to b/tsDMARDs.

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Mass General Brigham Study 172 RA-ILD pts w/ 6.5 yrs F/U (age 62 yrs): noted (4%) lung transplants & 44 (26%) ILD-related deaths. FVC rapidly declining pts (14%) had aOR 19x lung transplant & aOR 2.8 ILD-related death. Slow decline in 54%, no decline 32% https://t.co/fKDnJIu9a7 https://t.co/ondzN4WZ1F

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Dr. John Cush RheumNow ( View Tweet)
cost.healthcare.jpg

The Burden of Rheumatoid Arthritis (2018–2020)

d Jack Cush, MD

A recent study that quantified the economic and humanistic burden of rheumatoid arthritis (RA) in the USA showed significantly higher health care expenditures, particularly medication costs, and suboptimal quality of life in RA.

Read Article
lung,cancer,blue,mass

Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease

d Jack Cush, MD

A matched cohort study from the Veterans Health Administration shows that rheumatoid arthritis patients have a >50% increased risk of lung cancer, and a 3-fold higher risk of lung cancer in RA-interstitial lung disease (ILD).

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Breast CA (BC) & TNFi - study of 2 cohorts (Optum commercial * SEER/Medicare) found that 17% & 16% of BC pts received TNFi. 1 yr overall survival was no different +/- TNFi (HR= 0.77 & 0.84); but BC survival better on TNFi (HR 0.28; 0.08–0.98) vs csDMARDs. https://t.co/cGqT80rGTR https://t.co/n7i5VNFkVT

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Dr. John Cush RheumNow ( View Tweet)
Review of Inflammatory vs non-inflammatory pain in RA - Pain may be more than inflammation - Residual plain is a problem - Consider damage vs FM - Central vs. Neuogenic pain https://t.co/JUgc5IsgMq https://t.co/CRekJsAP04

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Dr. John Cush RheumNow ( View Tweet)
Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/5chrS3sW8i https://t.co/twSv4Zs9r3

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Dr. John Cush RheumNow ( View Tweet)

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