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Sequential Belimumab and Rituximab in SLE

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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ACR Applauds Lower Negotiated Prices for Common Arthritis Drugs

Jack Cush, MD

The American College of Rheumatology praised the recent announcement from the Centers for Medicare & Medicaid Services (CMS) that their initial drug pricing negotiations have reduced costs for select medications, including significantly lower prices for Enbrel and Stelara, which are frequently used to treat rheumatic diseases.

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Higher Cancer Rates (8.16.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

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CARRA Consensus Treatment for Refractory Juvenile Dermatomyositis

Jack Cush, MD

CARRA has developed consensus treatment plans for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in patients with refractory, moderately severe juvenile dermatomyositis. Juvenile dermatomyositis is the most common form of idiopathic, inflammatory myositis in childhood, with an estimated incidence of 3.2 per million children per year in the United States.

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Biologics Prevent AA amyloidosis progression to ESRD

MedPage Today

One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.

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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

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

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Efficacy of Biologics in Patients with Chronic KIdney Disease

Jack Cush, MD

A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly equivalent

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Cost-Effectiveness of Biosimilars vs Leflunomide

Jack Cush, MD

An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar disease-modifying antirheumatic drugs (DMARDs) were cost-effective compared with the conventional DMARD, leflunomide.

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Study of 425 RA pts & 36 mo. bDMARD retention rates w/ TNFi, IL-6i & ABA based on renal funct (eGFR: ≥60, 30–60, <30 mL/min) showing little effect of CKD w/ TNFi (45%, 28%, 34%), IL-6i (47%, 67%, 71%) & CTLA-4Ig (50%, 31%, 33%), maybe lower w/ TNFi & higher w/ IL6i… https://t.co/FhXoSnEfG1 https://t.co/N29nLBOoUj
Dr. John Cush RheumNow ( 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)
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)
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)
Systematic review: RX of macrophage activation syndr (MAS), included 57 reports, 1148 MAS pts (889 sJIA, 137 SLE). Most effective was high-dose GCs, IL-1 (83%) & IFNγ (93%) inhibitors, especially in sJIA-MAS. Also Ciclosporin, etoposide, Ruxolitinib https://t.co/4EnMOnlcYl https://t.co/PQnAZLvVwq

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Dr. John Cush RheumNow ( View Tweet)
NEW VIEWPOINT—Arthritis complicating inflammatory bowel disease—the future is now https://t.co/FyojGF6Pvx @DrLauraCoates #GITwitter https://t.co/kMewGTDQTc

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The Lancet Rheumatology TheLancetRheum ( View Tweet)
From LG cohort of myeloid neoplasms (861 MDS, 640 AML, 112 MDS/MPN, 89 MPN) autoimmune Rheum Dz (AIRD) found in 7.7% (lit suggests 8-30%), less in AML (4.7% vs 9.5% others). Common: RA (42%), CTD(18%), PMR (14%), vasculitis (12%), AxSpA (7%). https://t.co/ZXxOrZBunZ https://t.co/m5nIgrhohw

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Dr. John Cush RheumNow ( View Tweet)
174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/AreLBseJDq https://t.co/OyIOkiUOT1

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Dr. John Cush RheumNow ( View Tweet)
IRIS-RA, a failed phase 2 study of Nipocalimab, an anti-FcRn mAb severe active RA not responding to TNFi. 53 seropos. RA pts did not achieve primary endpt of better DAS28-CRP at Wk 12 (but Nipo was numerically better & signif lowered RF, CCP, but not CRP) https://t.co/52HLsfpKLS https://t.co/eEifXA6MpP

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Dr. John Cush RheumNow ( View Tweet)
174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/vy7czYwv1Z https://t.co/R2cYdNZ3V0

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Dr. John Cush RheumNow ( View Tweet)
FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/IVsGwqpiJK https://t.co/4epOHdNHbO

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Dr. John Cush RheumNow ( View Tweet)
FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/BmNPk6zN6o https://t.co/fbzHQmPmH5

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Dr. John Cush RheumNow ( View Tweet)
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