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Methotrexate Nodulosis (1.19.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. How good (or not) are rheumatologists and what to do about MTX nodulosis?

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Rheumatologists and the Early Diagnosis of Spondyloarthritis

d Jack Cush, MD

SPACE study of adults referred to rheumatology with less than 2 years of chronic back pain (CBP), shows that only one-third can be reliably diagnosed with axial spondyloarthritis (axSpA).

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Rituximab Efficacy in MAINRITSAN Long-Term Studies

d Jack Cush, MD

The original randomized controlled, prospective MAINRITSAN study of 115 patients (87 with granulomatosis with polyangiitis, 23 with microscopic polyangiitis, and 5 with renal-limited ANCA-associated vasculitis [AAV]) demonstrated superiority of rituximab (RTX) over azathioprine (AZA) for maintenance of remission at 22 months in ANCA-associated vasculitis patients after CYC remission induction.

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QD Clinic - RA, SSZ, & MI RA with a myocardial inflarction - which DMARD? https://t.co/FqnouGylMN https://t.co/KzmLctKZBI

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QD Clinic - GCA & Steroid Weaning Weaning steroids in chronic GCA patient https://t.co/HtrzP43Ivr https://t.co/xZZlNmeqP1

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CMS Final Rule on Prior Authorization Reforms Prior authorizations and paperwork are killing medical providers; the good news is that a new CMS rule may lessen the burden. https://t.co/bw4Mt06Zgz https://t.co/6B2TXSZuZO

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Fertility and Rheumatoid Onset British women whose capability of bearing children either started late or ended early -- were at increased risk for developing RA, compared with women with earlier menarche or later menopause, researchers found. https://t.co/SwxTvntqY2 https://t.co/bmwrLWwtke

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Network meta-analyses of 153 trials & 8713 patients w/ chronic pain from TMJ disorders; Most effective (pain & function) were CBT, PT-assisted jaw mobilisation, trigger point injx, jaw exercise/stretching, manipulation, & acupuncture https://t.co/b4kTuWg9QH https://t.co/7SJs0sLtK2

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You can still attend RheumNow Live! This 1.5-day long meeting offers pre-learning modules, shorter, concise lectures with clinical context and audience input, more discussion time, and sessions that are relaxed and comprehensive. Register: https://t.co/iWiFunwbNH https://t.co/3HmR7qqTMT

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Data from the American Rheumatology Network (2014–2021) shows that among 15182 new TNFi initiations, only 45% had a dz activity measure (CDAI/RAPID3); and of these, only 47% had a TJC, SJC or pain score. Can you treat HTN without measuring BP? https://t.co/SsnF7Taky1 https://t.co/LN72IAWs8n

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Tic-Borne Disorders Causing Chronic Arthritis? Findings from a population based cross-sectional study suggests that while up to 20% of patients have antibodies to tick-borne exposures, only a minority reported musculoskeletal symptoms. https://t.co/FWhCl3v8oH https://t.co/NDgvKYva11

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New download available! Seasonal Flu Vaccination in RA Patients https://t.co/pLz8yo28QM https://t.co/7rKymy79jI

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IL-17 pathway as a target in giant cell arteritis - full read review of pathogenic role of IL-17 and Th17 cells, in #GCA; backed up by the phase II proof-of-principle TiTAIN study showing potential efficacy of secukinumab in GCA pts https://t.co/2qX1F6ZP6J https://t.co/zoknjDgMQy

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QD Clinic - Suspend MTX How Long? Pregnancy and MTX - how long do you have to be off? https://t.co/pTz8nlHpWN https://t.co/YrG7cKgbvF

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QD Clinic - To Aspirate or Not RA patient in need to an injection; do you aspirate first? https://t.co/lOA5glSmfs https://t.co/FUvBFa8H7Q

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Excited to be talking at https://t.co/hposbnLVdD!! As usual, @RheumNow screen-grabbed me at an opportune moment 🤣😆 Highly recommend the conference; register live/online at the link above! https://t.co/XewJXRASi8

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Mike Putman EBRheum ( View Tweet)
2023 EULAR Non-pharmacological Management of Hip and Knee Osteoarthritis: 2023 update EULAR has published the 2023 updated recommendations for the optimal non-pharmacological management of hip and knee osteoarthritis (OA). https://t.co/B7hE9jaGuo https://t.co/WCZ0VNcdKR

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Mayo study shows multimorbidity in RA increases serious infx (SI) risk; 911 RA pts (56 yrs, 2/3 seropositive) 17% had SI (3.9/100PY). Hi risk morbidities(bipolar Dz, CKD, COPD,, chr skin ulcers) were assoc w/ 3 to 5-fold increased SI risk https://t.co/qorKp96KTm https://t.co/o5FaMKMskA

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Japanese retrospective study compared RA pts on JAK inhib vs bDMARDs (n=62 ea) having orthopedic surgery; JAKi- pts had more postoperative flares (29% v 12%, P=.01), esp if JAKi held >11d (p.04). No diff in other postop complications https://t.co/E2fJS3N7KU https://t.co/4H00TgXVr2

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What do you know about monogenic and polygenic autoinflammatory diseases? Join Drs Liebowitz and Mehta as they review the challenges of these conditions. https://t.co/TXJbpD3yB4 https://t.co/QGDaZdqrqz

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Dr. John Cush RheumNow ( View Tweet)
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