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RA, hands, MCP, deformity

Combo Methotrexate and Leflunomide Safety in RA

Jack Cush, MD

Methotrexate and leflunomide (LEF) are the most widely prescribed DMARDs worldwide; yet biologic DMARDs are the newest and best selling agents for rheumatoid arthritis worldwide.

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Cardiovascular Prevention Lacking in Rheumatoid Arthritis

Jack Cush, MD

An increased cardiovascular disease (CVD) risk in rheumatoid arthritis is well known and feared but an RA cohort study suggests that preventive medication use in RA patients lags behind that seen in diabetes mellitus (DM).

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US News & World Report Ranks Best Rheumatology Hospitals

Jack Cush, MD

Medscape has published the annual U.S.

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Rheumatoid Poor Outcomes Not Linked to Comorbidity

Jack Cush, MD

Disease activity leads to poor outcomes; but does comorbidity add to this?  A recent analysis suggests that while comorbidities do not affect long-term, functional outcomes, sociodemographic factors do affect outcomes in rheumatoid Arthritis (RA).

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syringe, pill, DMARD, Treatment, therapy

DMARD Effects on COVID-19 Outcomes

Jack Cush, MD

Sparks and colleagues have published data from the Global Rheumatology Alliance noting that among rheumatoid arthritis (RA) patients afflicted with COVID-19 infection, there was little influence of their baseline biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drug

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Growing Cannabis Use in Arthritis Patients

Jack Cush, MD

The National Databank for Rheumatic Diseases reports a significant increased in cannabis use amongst arthritis patients between 2014-2019, suggesting patients are more frequently engaged in self-management of pain and the unmet need for a pain relieving, opioid-sparing alternative.

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Canakinumab Fails to Improve COVID-19 Survival

Jack Cush, MD

JAMA has published the findings of trial wherein the anti–interleukin-1β antibody canakinumab (CAN) failed to improve survival in patients hospitalized with severe COVID-19.

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Arthritis as a Harbinger of Pediatric Cancer

Jack Cush, MD

Lancet Rheumatology has published a cohort analysis showing that a small but significant subset of children presenting with arthralgia or arthritis may have a pediatric malignancy.

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Potential Birth Defects with Hydroxychloroquine

Jack Cush, MD

Hydroxychloroquine (HCQ) is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use.

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New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate The ACR has issued new guidelines on the treatment of RA, addressing questions about initial treatment with methotrexate and minimizing reliance on glucocorticoids. https://t.co/J9wmcZr17D https://t.co/Tf3G9sFgm9

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Fracture Risk with Low Dose Steroid A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures. https://t.co/HcYpx8IDcB https://t.co/iVPjJHLNBX

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Fracture Risk with Low Dose Steroid https://t.co/HcYpx8IDcB A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures. https://t.co/1bc5nyZUzG

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Steroid (GC) withdrawal studied in T2T RA cohort of 207 RA pts (F/U 39 mos); Only 60% discontinued GC, w/ low risk of flare. BUT D/Cs were SLOW w/ only 9.7%, 26.6%, 48.0% & 58.6% at 6 mos, 1, 2 & 3 yrs - median time to cessation = 27 mos https://t.co/h02aueYKwN

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In a study of 15123 RA pts >50 yrs; 1640 osteoporotic fractures occurred. Low-dose glucocorticoids (≤7.5 mg/D) was not associated with overall risk of OP Fx (adj HR 1.14) but was assoc w/ increased risk of vertebral Fx (adj HR 1.59, 1.11–2.29) https://t.co/ZJtYAAQ3KW

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ICYMI: 263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stabilized their FVC, DLCO, Chest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/1dGufcsRpC

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Study of 647 RA pts wanting to get pregnant finds only 3.9% SSA+ & 1.1% SSB+ (higher in RF+ pts); ~1/2 had SSA titre of >240 units/mL - but No cases of neonatal lupus or heart block seen. In a French register, SSA related CHB was 1.5% https://t.co/FmZzPpmB7D

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Carpal Tunnel Syndrome has an annual incidence of 0.4%. Population based study shows more likely in women, 50-59 years, w/ obesity, gout, rheumatoid arthritis or a prior hx of wrist injury. https://t.co/X7U5yh0R3l

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Rheums--Have a rheumatology 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/kKoBTHWX6z

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ICYMI: New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate https://t.co/J9wmcZr17D https://t.co/9fUNrdVWuP

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Of 100 newly diagnosed #RA patients, Foot Involvement was the 1st manifestation in 29%. Pattern: 59% w/ forefoot involvement, 27% hindfoot and 14% midfoot. Pts were 58-63% RF+/CCP+. https://t.co/OGS2Fzfgg3 https://t.co/AKCj4pipYG

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