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RheumNow Podcast – Rheum Lives Matter (8.28.20)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week. Of mice and men in cartilage, the efficacy of JAK inhibitors in patients who are having skin problems, nrAxSpa has its own diagnostic code, metformin, talking about Back Talk, plus so much more.

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Hepatitis C Anti-Viral Drug-Induced Arthritis

Jack Cush, MD

Curative direct-acting antiviral therapy (DAAT) for hepatitis-C virus (HCV) infection has been revolutionary, but a novel report shows that nearly one quarter of DAAT treated patients developed new onset or significant worsening of MSK symptoms, despite being negative for hepa

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Treatments Differ Across Centers in Systemic JIA

RheumNow

Significant variations were seen across hospitals in the treatment of children admitted with new-onset systemic juvenile idiopathic arthritis (JIA), despite increasing evidence of the efficacy of biologics and the hazards of extended glucocorticoid exposure, a retrospective cohort study found.

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Do NSAIDs Increase Cardiovascular Risk in Osteoarthritis?

Jack Cush, MD

A longitudinal study of administrative data from British Columbia shows that nonsteroidal antiinflammatory drugs (NSAIDs) use increases the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients.

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Update on Polymyalgia Rheumatica and Giant Cell Arteritis

Jack Cush, MD

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has approved tocilizumab as a first-line glucocorticoid-sparing agent. 

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Selective Biologic Responses in Seropositive RA

Jack Cush, MD

The Journal of Rheuatology reports a pooled analysis of patients from 16 observational RA registries that examined the association between seropositivity (RF or ACPA) with biologic DMARDs responses; they showed better clinical responses when seropositive RA patients receive abatacept (ABA) o

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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UK safety reminder that Baricitinib (Olumiant) has an increased risk of diverticulitis (incidence rate 0.16 per 100PY), esp. in those taking Steroids or NSAIDs. https://t.co/IfcV03e1p7

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EHR review of acute MSK injuries (13+ million participants) finds prolonged opioid use in high-risk pts (workers' comp, VA pts, substance abuse ) to be 27% but only 6% in low-risk pts; persistent opioid increased w/ older age and physical comorbidity https://t.co/yCDGxpilDT

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AbbVie has submited Regulatory Application to FDA and EMA for upadacitinib proposed indication to treate active Ankylosing Spondylitis https://t.co/RPaOXCarEZ

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Study of 4 refractory juvenile dermatomyositis (6-20yrs) treated with baricitinib (4–8 mg/day) Significant improvement noted by week 4 in global activity, skin scores, weakness but little change in muscle enzymes or calcinosis. Steroids/other meds lowered https://t.co/GKGBXrogEm

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Metformin as cotherapy in RA? It lowers RA risk in animal models. >2500mg/d lowers risk incident RA in women. Japanese study shows it suppresses osteoclastogenesis and upregulation of inflammatory cytokines, protease and growth factor genes. https://t.co/UEDMgtqLZG

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Successful treatment of refractory palmoplantar psoriasis in a psoriatic arthritis patient with the JAK inhibitor tofacitinib https://t.co/bdhppoUkmz

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Mayo case controlled study of 212 autoimmune pts - half w/ CNS inflamm dz and half without. TNF inhibitor use was associated with an increased risk of inflammatory CNS dz (adj OR, 3.01; 1.55-5.82; P = .001); most of these occurred in RA pts (aOR, 4.82) https://t.co/8TsYxDhUZx

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Responses to switching TNFi in SpA go down w/ the 2nd TNFi. 1st TNFi @ 3 mos ASAS CII 51%; 2nd TNFi 41%; BASDAI @6 mo, 1st 46%, 2nd TNFi 33%. Compared to primary failure, pts w/ 2nd failure (OR 7.3 ) or toxicity (OR 9.1) had better ASDAS-I https://t.co/jMCUfBtxmY https://t.co/PBkQNOwVRQ

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Telemedicine: What's Changed and What Needs to be Addressed? An update on legislative changes, uncertainties, and the care gap post COVID https://t.co/HRAsEP7IL6 https://t.co/X6PL0W4tI7

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Gilead/Galapagos gets a setback for filgotinib, its JAK1 inhib, that was poised to be the next approved RA drug by FDA. Instead the FDA issued a complete response letter; citing concerns over sperm studies (MANTA, MANTA-RAy) & 200 mg dose. Delay till 2021? https://t.co/H0rLjOMXq8 https://t.co/vb4FDUUVoS

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Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast - The Bad News That's Fit to Print (8.21.20) Dr Jack Cush reviews this week highlights filgotinib rejection, delays in Diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX https://t.co/1oZtU14VOB https://t.co/rcWlbYVKYn

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The FDA approves Novartis'anti-CD20 mAb, Kesimpta (ofatumumab) for the treatment of relapsing forms of multiple sclerosis (MS). https://t.co/2DgA4Modds

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ATS Abstract: n=616 survey contrasts rheums (57%) & pulmonologists (43%) beliefs on RA associated ILD. Both preferred to use steroids, MMF, RTX for RA-ILD, but Rheums tend avoid ADA & LEF. Rheums (17%) & Pulms (24%) think MTX a risk factor https://t.co/W5gbu84FBv

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