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Preliminary results from RESET-RA Study announced; demonstrating ACR20 efficacy of implanted vagal nerve stimulation at 12 wks (p=0.0209). 2-staged, multicenter, randomized, sham-controlled, double-blind pivotal trial, enrolled 242 RA pts https://t.co/gIVJd9F6Pk https://t.co/SNjWIa3raB

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Dr. John Cush RheumNow ( View Tweet)
Efficacy of Biologics in Patients with CKD A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy. https://t.co/rL2ZondUsE https://t.co/1hM237Jl83

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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)
RheumNow Podcast square

Pollution and Autoimmunity (7.12.2024)

d Jack Cush, MD

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

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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU

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Dr. John Cush RheumNow ( View Tweet)
Cost-Effectiveness of Biosimilars vs Leflunomide An economic evaluation of 25 099 rheumatoid arthritis patients found that treatment with biosimilar DMARDs were cost-effective compared with the conventional DMARD, leflunomide. https://t.co/lWJB1VL1CL https://t.co/lzra8suVqs

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Dr. John Cush RheumNow ( View Tweet)
kidneys

Efficacy of Biologics in Patients with Chronic KIdney Disease

d 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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5 yr results of 150 difficult-to-treat RA pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://t.co/cIUNcQ0r3F https://t.co/rNZaWu3Ocd

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Dr. John Cush RheumNow ( View Tweet)
In early arthritis (RA) pts there is no value in measuring for IgA-ACPA or IgA-RF, as there presence doesnt provide more than IgG-ACPA. In tREACH trial IgA-ACPA present in 23% & overlaped w/ IgG-ACPA in 94% (w/ IgM-RF in 90%). https://t.co/d8Xc4GBfEt https://t.co/qvujVx0RFf

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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)
cost.healthcare.jpg

Cost-Effectiveness of Biosimilars vs Leflunomide

d 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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Dead Words Eulogy Cover Image

ICYMI: Dead Words Eulogy

d Jack Cush, MD

The trouble with rheumatology may be the words we live by. Welcome to the eulogy for rheumatology 'dead words'. We're here today to celebrate the loss of rheumatology past. These are dead words in rheumatology, words fortified unfortunately by history and habit. The lexicon of rheumatology is unique, it's challenging and it's mostly incomprehensible to those who don't know...but those are the cornerstones of the greatest of medical subspecialties. 

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Predicting Palindromic Prognosis Dr. David Liew discusses abstract OP0127, "PREDICTING PERSISTENT INFLAMMATORY ARTHRITIS IN PATIENTS WITH PALINDROMIC RHEUMATISM: DEVELOPMENT OF SCORES FOR RISK STRATIFICATION", at Eular 2024 in Vienna, Austria. https://t.co/Yzr9feNjjF https://t.co/BKVbDv3e4E

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Dr. John Cush RheumNow ( View Tweet)
Leflunomide

ICYMI: 9 Facts about Leflunomide

d Jack Cush, MD

Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui. Here are some highpoints from this Medscape article and lecture.

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RT @drminidey OP0165- incidence & risk factors of D2T RA in an early RA cohort Factors assoc with D2T RA: 🩸 Seropositivity 🦴 Erosions 📈 Disease activity 📊 D2T pts have higher steroid doses & more commonly develop iatrogenic-related #comorbidities, e.g. osteoporosis

Dr. John Cush RheumNow ( View Tweet)

RT @drdavidliew "We’ve got better at treating RA over the last 20 years, and it’s genuinely saving lives. Something to be very proud of. Let’s not forget that! 5y mortality from DANBIO (still, we still have work to do in seropos RA in men!) #EULAR2024 OP0162

Dr. John Cush RheumNow ( View Tweet)

RT @drdavidliew "I’ve always thought new RA meds get prescribed to the most risky patients, and therefore you see more adverse events. Turns out it’s marginally true - maybe out to five years. Worth being careful of judging new meds too early! #EULAR2024 OP0114 @karolinskainst

Dr. John Cush RheumNow ( View Tweet)

Factors Affecting Hydroxychloroquine Adherence A study from the University of British Columbia has evaluated the trajectories of HCQ use in patients with incident RA and SLE between1997 and 2021, and identified factors associated with high adherence. https://t.co/kDUxVCfRGt https://t.co/1v79Vqdqo8

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Dr. John Cush RheumNow ( View Tweet)
New indications for JAK inhibitors There are several new positive RCTs for JAK inhibitors. We are so familiar with RA, PsA, SpA, axSpA and non radiographic axSpA. https://t.co/yyayyPcN9L https://t.co/4IQfmvbg4G

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Dr. John Cush RheumNow ( View Tweet)
Shingrix in upadacitinib + MTX RA, in SELECT-COMPARE RCT: data now out to 60w good humoral and cellular response in most, even without MTX withheld (& good safety too) Important for our JAKi-treated patients to get the protection they need #EULAR2024 OP0020

Dr. John Cush RheumNow ( View Tweet)

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