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Withdraw DMARDS after remission?
The possibility of withdrawing DMARDs after patients achieve remission has been in our minds for a while. Yet when our patients ask whether it is a good idea to taper or stop their DMARD when they are doing well, most of us don’t have a black or white answer for them.
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Race to the top: how high will treatment response rates in RA reach?
We have become accustomed to the 60/40/20% rule for the outcome of ACR 20/50/70 respectively for biologics and targeted synthetic DMARDs.
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Plotting Future ACR Convergence Meetings (11.24.2023)
In this week's podcast, Dr. Jack Cush reviews the ACR Convergence 2023 meeting and proposes how to best learn at your next large medical meeting.
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National pharmacovigilance database review (1992 to 2021) identified 2217 "Falls", most serious, most in women (61%), & 38% in 18–64 yr olds. Falls attributed to immunomodulators (17%), 24% Fxs & 1 in 7 classified as adverse drug rxns (343) https://t.co/tpUPDc8x09 https://t.co/jdssH7oCjF
Dr. John Cush RheumNow ( View Tweet)
UK study 336 GCA pts shows after 12 mos of tocilizumab, TCZ stopped (w mean pred 2mg/d) & GCA flares at 6, 12 & 24 mos was 21%, 35% & 49% respectively; requiring prednisolone dose increase to 20 (10-40) mg/day (34% were major relapses) https://t.co/EZ78ciNK0R https://t.co/R1qFsvnhoF
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"Protein kinases: drug targets for immunological disorders". Great full-read review from J Shea et al. Reviews Hx, biology, clinical use and safetey of Kinase targeted therapy. https://t.co/qBc0ng1Z9h https://t.co/Qm8PFpNxQF
Dr. John Cush RheumNow ( View Tweet)
NEJM Clinical Images: Scleromyxedema (cutaneous mucinosis w/ a paraproteinemia).53-yoM w/ itchy rash, Raynauds, dysphagia, burning dysesthesia hands; Waxy papules across forehead & hands w/ skin thickening & finger contractures. Skin Bx & SPEP done https://t.co/vkpYGNd3Uw https://t.co/T5gVPRBrhh
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Dr. John Cush RheumNow ( View Tweet)
Cancer and TNF inhibitors
Cancer risk minimisation is a high priority for people with rheumatic diseases, as it is for the general population. Tumor necrosis factor inhibitors (TNFi) have a long history of association with cancer risk discussions
https://t.co/iWnBTqX1eV https://t.co/lDEyM0c2yo
Dr. John Cush RheumNow ( View Tweet)
How early is early in psoriatic arthritis? Is there a window of opportunity for treatment in PsA to ensure optimal outcomes? https://t.co/jHrA1M05Qr https://t.co/jcU13Y4CRm
Dr. John Cush RheumNow ( View Tweet)
Effective Treatments for Rheumatoid Arthritis ILD
The ACR guidelines for the diagnosis and management of interstitial lung disease, which includes RA-ILD, has been one of the most controversial topics in the runup to ACR Convergence.
https://t.co/qJBeM0jdom https://t.co/vdhcHOvHBI
Dr. John Cush RheumNow ( View Tweet)
Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab
Acute anterior uveitis (AAU) is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA), affecting up to 50% of patients in some age groups.
https://t.co/uhlnpmLwoP https://t.co/NRW0PlD43a
Dr. John Cush RheumNow ( View Tweet)
Undiagnosed IBD in AxSpA
Dr. Eric Dein (Summit, New Jersey) discusses Abstract #0495 presented at the ACR 2023 Convergence meeting in San Diego.
https://t.co/QAC6fhSQ7Q https://t.co/BxNQwQ9nwc
Dr. John Cush RheumNow ( View Tweet)
The impact of SGLT2-inhibitor on SLE outcomes
SLE is associated with increased risk of cardiovascular events due to both traditional and disease-specific risk factors.
https://t.co/hyyMVQg3xV https://t.co/fLxh0vlTze
Dr. John Cush RheumNow ( View Tweet)
Are Rheumatologists doing Enough for Cervical Cancer?
Should rheums be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at #ACR23 suggests this should be an important conversation with our lupus patients.
https://t.co/VFobM0T3u7 https://t.co/L45N3tsTdN
Dr. John Cush RheumNow ( View Tweet)
Substudy of the ADVOCATE trial looked at 214 ANCA assoc vasculitis pts treated with #RTX; avacopan Rx showed improved recovery of renal function, faster reduction in albuminuria and lower glucocorticoid toxicity compared to a prednisone taper. https://t.co/91PtvQfoIr https://t.co/ZjYCVP5lqG
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Long term F/U of early RA, T2T RCTs (n 1616) finds excess mortality > 10yrs for BeST (SMR 1.32) & IMPROVED (SMR 1.33) RCTs; highest in ACPA+ smokers (SMR 2.80 & 2.14); Cancer main cause. SMR incr 34% & 13% for ea 1 pt incr in DAS https://t.co/2DdHMGIlOk https://t.co/7bnCOzB8vd
Dr. John Cush RheumNow ( View Tweet)
Infections During Treatment of GPA with Rituximab
Dr. Richard Conway (Dublin, Ireland) discusses abstract 1584 presented at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/eKi3KExEnk https://t.co/b9G9w5e9tc
Dr. John Cush RheumNow ( View Tweet)
Watch and Weigh In: Upadacitinib for Pain: Is That Real?
Dr. David Liew reports on abstract 0429 at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/AbD9UpXQfY https://t.co/iRgUnNInuD
Dr. John Cush RheumNow ( View Tweet)
Computer Vision: Is It Ready for RA Assessment?
Dr. David Liew reports on abstract 0402 and 1293 at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/4rQDjFXjH2 https://t.co/8FM40kh3bw
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Hemophagocytic Lymphohistiocytosis in Still's Disease
Dr. Bella Mehta discusses abstract 1143 presented at the 2023 ACR Convergence meeting in San Diego, CA.
https://t.co/bFeGK6MTcc https://t.co/cxJg6rQ7gm
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