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Canakinumab Tapering in Still's Disease

Jack Cush, MD

You can reduce - but not stop - canakinumab therapy in patients who are in complete clinical remission in children with systemic juvenile idiopathic arthritis.

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Filgotinib Decision Delayed by FDA

Jack Cush, MD

On August 18th, Gilead and Galapagos received a complete response letter from the FDA, which will delay consideration of filgotinib for the treatment of moderate-to-severe RA.

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Upadacitinib is Superior to Methotrexate in Early RA

Jack Cush, MD

In a head-to-head trial against methotrexate, JAK1 inhibition with upadacitinib was shown to be more effective in early, DMARD-naive RA patients. Here are the primary results.

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RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Jack Cush, MD

Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.

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Rheumatic Diseases, Drugs and COVID-19 Guidelines

Jack Cush, MD

Several recent publications have focused on the risk and outcomes of rheumatic disease (RDD) and autoimmune patients who become infected with SARs-CoV-2.

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Infliximab Use Near Surgery is Safe

Jack Cush, MD

Risk factors for perioperative infections include age, comorbidity, rheumatoid arthritis and steroids to name a few; whether concurrent use of TNF inhibitor (TNFI) therapy adds to this risk has been debated. In a study of elderly patients receiving infliximab infusions, infliximab use prior to surgery did not change the risk of post-operative infections.

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DMARD Use Does Not Increase COVID Hospitalization

Jack Cush, MD

An observational study of patients with systemic autoimmune inflammatory rheumatic diseases (AIRD) who also had COVID-19 disease shows that AIRD increased the risk of hospitalization, but that the use of disease-modifying antirheumatic drugs (DMARDs) were not associated with hospitalization.

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Thromboembolic Risk with Tofacitinib in RA, PsA and UC

Jack Cush, MD

An analysis of the tofacitinib (Xeljanz) drug development program in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ulcerative colitis suggests a low level risk for venous (VTE) and arterial thromboembolism (ATE).  

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Mayo clinic: Theres a delay in diagnosing Seronegative RA - 1st joint swelling to diagnosis of RA was 187 days for seroneg vs 11 days for seropositive patients (P<.001). Seronegative RA less likely to achieve remission (28% vs 50% at 5 years) (P=.007) https://t.co/Hgewjmt1CL

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Dr. John Cush RheumNow ( View Tweet)

Are there delays in Dx-ing RA? 2019 UK NHS study shows median delays from 1st Sx to seeing a rheumatologist was 27 weeks, with 20% seen w/in 1st 3 mos. Includes a patient delay (5.4 wks), GP delay (6.9 wks) & hospital delay (4.7 wks) https://t.co/vwNALZKkiR

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Dr. John Cush RheumNow ( View Tweet)

Filgotinib Decision Delayed by FDA. Instead of being the next approved RA drug, the FDA issued a complete response letter; citing concerns over sperm studies and the risk/benefit behind the 200 mg dose. Delay till 2021? 2022? https://t.co/6MHiGtOxCM

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Dr. John Cush RheumNow ( View Tweet)

Forward study of 18,754 RA patients who experienced 1,801 CVD events and found CVD risk reduction with TNFi (HR 0.82 [95% CI 0.72-0.94]) and abatacept (HR 0.50 [95% CI 0.30-0.83]) compared to csDMARDs over & above MTX alone (use vs. non-use: HR 0.82) https://t.co/YVfKWjkvxU

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NY Times article about a "guy and aching legs". 48 yrs old w/ myalgias, wt loss, SOB, sinusitis, high inflammatory markers, pulmonary infiltrates, microscopic hematuria, red & swollen ears; but no fever/chills. You're a rheumatologist, you know the Dx. https://t.co/fbrRMNA5u4 https://t.co/JFOcM0MBxB

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Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast - The SARS-CoV-2 Update (8-14-20) Dr. Jack Cush highlights the latest numbers on COVID-19 and its impact on Rheumatic Patients. Also, Top 4 best sellers, new take on NR-Ax-SpA & enthesitis https://t.co/IJAHGynSNd

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up: The SARS-CoV-2 Update with info on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors. Watch it here> https://t.co/1WUZQJajgW or podcast listen here>> https://t.co/IJAHGynSNd

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Dr. John Cush RheumNow ( View Tweet)

Check out my Virtual Video Exam - 5 minutes of a combo of Simon Sez and the Macarena hits the high points of a functional virtual examination. https://t.co/iwHTJKQtEC

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Dr. John Cush RheumNow ( View Tweet)

Mortality study of 18,943 patients with PMR and 87,801 matched controls from the Clinical Practice Datalink with 8 yrs of followup finds NO increase in mortality in PMR patients adjusted MRR 1.00 [95% CI 0.97, 1.03]). https://t.co/moZwiuhOxC

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast - Why we Love Rheumatology Fellows (8.7.20) Watch it here>> https://t.co/ftrycqoWRR or Listen to the podcast on iTunes or on SoundCloud>> https://t.co/gi5hO0HaIl

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Dr. John Cush RheumNow ( View Tweet)

Hong Kong study Myositis-specific autoantibodies in 201 pts with idiopathic inflammatory myopathies (IIM) shows MDA-5 (14%), TIFF-1γ (14%), Jo-(12.4%). MDA5 seen w/ DM, digital ulcers, amyopathy, ILD. TIF1γ was associ w/ refractory rash and cancer https://t.co/3E365F5SON

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Dr. John Cush RheumNow ( View Tweet)

RA is associated with a 24‐35% lower risk of type 2 diabetes. Claims data comparison of 449,327 RA, general non‐RA, hypertension, OA, or PsA patients finds a lower risk of T2DM in RA (7/1000PY) and highest w/ HTN (12.3/1000PY) https://t.co/uZn5qaImO9

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Dr. John Cush RheumNow ( View Tweet)

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