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CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.
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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors
Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
RA Lung Disease Portends Poor Outcomes
A retrospective Harvard affiliates study shows that rheumatoid arthritis (RA) patients with lung disease have higher mortality, especially respiratory and infection-related mortality than those without lung disease (LD).
Pesticides and Rheumatoid Arthritis?
MedPage Today
Women exposed to pesticides through farm work or as farmers' wives face increased risk for developing rheumatoid arthritis, a new analysis of Agricultural Health Study data indicated.
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NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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Molecular profiling of RA synovium predicts biologic responses
Machine learning analysis of pre-treatment synovial tissue biopsy from rheumatoid arthritis (RA) patients starting either etanercept (ETN), tocilizumab (TCZ) and rituximab (RTX) revealed
MTX or TNFi use in elderly #RA pts w/in a year of Dx of melanoma was not associated with increased mortality. This included melanoma in situ (48%), localized (47%) and regional (5%) melanoma. Steroid use however was assoc w/ reduced survival. https://t.co/QOXfEf51S1 https://t.co/6BPtEV6sOU
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TNFi are relatively contraindicated in RA pts w/ #MS. Literature review suggests for pts w/ MS and RA, teriflunomide and anti-CD20 therapies are the most suitable, and Cladribine may also be considered https://t.co/gIVaJ7Kwn0 https://t.co/1ar0q2OnzB
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Survival in #RA pts undergoing cervical spine surgery is not good! Retrospective study of 139 RA pts who underwent Cx surgery shows higher mortality risk if they are older, w low albumin levels, high-dose pred. and have subaxial subluxation. https://t.co/hKvgaas2gh https://t.co/ygtJjb4mVl
Dr. John Cush RheumNow ( View Tweet)
RA Lung Disease Portends Poor Outcomes
A retrospective Harvard affiliates study shows that rheumatoid arthritis (RA) patients with lung disease have higher mortality, especially respiratory and infection-related mortality than those without lung disease (LD). https://t.co/13h2u26ecb
Dr. John Cush RheumNow ( View Tweet)
Pesticides and Rheumatoid Arthritis?
Women exposed to pesticides through farm work or as farmers' wives face increased risk for developing rheumatoid arthritis (RA), a new analysis of Agricultural Health Study (AHS) data indicated.
https://t.co/ISddKbnxMY https://t.co/E5tpX5D70X
Dr. John Cush RheumNow ( View Tweet)
Diminishing trend in serious infections assoc w/ TNFi use in inflammatory arthritis over the years. ICEBIO study 1387 Rx w/ 1st TNFi 2003–2018 (vs 6936 comparators. Over tme the SI rate dropped 52% (IRR 0.48; 0.25–0.94), but not for controls (Abx use stable) https://t.co/jDsKlCrd0p
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New ICD-10 Diagnostic Code -- R76.81 -- for ’At-Risk RA’ (AKA Clinically suspect arthralgia or Pre-clinical RA); this applies to pts w/ abnormal RF or ACPA without having RA. Thanks to Dr. Kevin D. Deane for leading this effort. https://t.co/14I6RCZrXb https://t.co/YxTwPB0YDQ
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La Paz study of 903 RA pts; 136 (14.5%) were D2T-RA, 96 for inefficacy. They define early vs Late D2T-RA=44.5 mos, & differed>> Early D2T-RA (1/3) pts more likely to have anxiety or depression (76% v 0), higher CRP @6mos, & time to develop D2TRA (35 vs 70 mos) https://t.co/KFG68y9Uq5
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Full read overview of new imaging modalities for inflammatory arthritis, including high-res.quantitative CT, ultra-high field MRI), PET, fluorescence optical imaging, optoacoustic imaging, contrast-enhanced ultrasonography - all with artificial intelligence analysis https://t.co/rbHiPWAAFP
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MTX lowers risk of serious infxn (SI) - UK Observational study of 17 472 newly Dx RA (2018–2023); 10K on MTX, 4,540 other csDMARDs; 13680 corticosteroids (GC). 1307 SI (3/100 PY) w/ reduced adj HR 0.72 (95% CI: 0.63–0.82). 311 SI-related mortality (IR 0.69;0.61–0.77) https://t.co/iuxAivtrYZ
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Sulfasalazine as a preventative against Pneumocystis (PJP). 594 RA pts & 848 Rx episodes - 181 on SSZ, 667 controls. W/ 850 Pt-Yrs F/U, 21developed PCP, 3 died of PCP. SSZ significantly lowered PJP risk (p = 0.003, rate ratio = 0.05; 95% CI 0.00–0.34). https://t.co/PAgBaJGldR https://t.co/PuTxGXTeRS
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Molecular profiling of RA synovium predicts biologic responses
Machine learning analysis of pre-treatment synovial tissue biopsy from RA patients starting either ETN, TCZ and RTX revealed high accuracy prediction of 16 week outcomes unique to each biologic. https://t.co/4d6NEY6JN6
Dr. John Cush RheumNow ( View Tweet)
MTX lowers risk of serious infxn (SI) - UK Observational study of 17 472 newly Dx RA (2018–2023); 10K on MTX, 4,540 other csDMARDs; 13680 corticosteroids (GC). 1307 SI (3/100 PY) w/ reduced adj HR 0.72 (95% CI: 0.63–0.82). 311 SI-related mortality (IR 0.69;0.61–0.77) https://t.co/YhJV3vyAmB
Dr. John Cush RheumNow ( View Tweet)
Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the https://t.co/gjJOjZhSHU
Dr. John Cush RheumNow ( View Tweet)
