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TNF Inhibitors or non-TNF Biologics - First Best Choice?

Jack Cush, MD

Prospective observational findings from the CORRONA registry of rheumatoid arthritis (RA) patients compared clinical outcomes between initial aggressive therapy using either a tumour necrosis factor inhibitor (TNFi) or a non-TNFi (biological disease-modifying antirheumatic drugs (bDMARDs) and tar

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RheumNow Podcast – Good Time Charlie…. (10.16.20)

Jack Cush, MD

Dr. Jack Cush sings the news and journal reports from the past week on RheumNow.com.

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Abatacept vs. Upadacitinib in Biologic Refractory Rheumatoid Arthritis

Jack Cush, MD

NEJM reports the results of the SELECT-Choice trial, a head to head study of upadacitinib (UPA) and abatacept (ABA) in biologic refractory rheumatoid arthritis (RA); 12 weeks results showed UPA was significantly more clinically effective than ABA using a DAS28-CRP remission, but ABA had fewer safety signals and serious adverse events.

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ICI Arthritis Tied to Cancer Progression

Cancer patients treated with immune checkpoint inhibitors (ICI) who develop severe arthritis may be at risk for progression of the malignancy, a single-center study suggested.

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Tofacitinib and Thromboembolic Risk

Jack Cush, MD

Mease and colleagues have reviewed the tofacitinib drug development and clinical trial data, finding the risk of venous (VTE) and arterial thromboembolism (ATE) to be low and augmented in patients with baseline cardiovascular abd VTE risk factors and those taking higher doses of tofacitinib (10 m

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Thrombotic Risk in Rheumatoid Arthritis Linked to Disease Activity

Jack Cush, MD

A large RA cohort study from the Swedish Rheumatology Quality Register shows a higher risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA)  and that risk is linked to RA disease activity. 

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RheumNow Podcast – Bad Disease & Bad Outcomes (10.9.20)

Jack Cush, MD

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

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Fractures from Delays in Denosumab Reinfusions

Jack Cush, MD

Denosumab is effective in osteoporosis when used on schedue, but research suggests that discontinuation leads to rapid reversal of effect; a new observational study has shown that delays in denosumab administration of more than 16 weeks results in an increased vertebral fracture risk, according t

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Oral Dysbiosis May Antedate Rheumatoid Arthritis

Jack Cush, MD

A study of oral microbiome in anti-cyclic citrullinated peptide (anti-CCP) positive at-risk individuals without synovitis (CCP+at risk) shows dysbiotic subgingival microbiomes and increased abundance of P. gingivalis compared with controls.

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Juvenile localized scleroderma was Rx w/ MTX or MMF (in MTX refractory) and compared retrospectively. Facial linear scler. more likely in MTX pts and MMF pts had pansclerotic morphea or mixed subtype. Outcomes were same at 9.4 yrs: inactive in 100% & 91% https://t.co/2X9SpqeLwx

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Dr. John Cush RheumNow ( View Tweet)

EUSTAR study of ILD in systemic sclerosis: 826 pts with SSc-ILD finds 27% with progressive ILD (mod-severe FVC decline >5-10%) over 12 mos. Predictive factors for FVC decline over 5 yrs were male sex, higher mRSS skin score and reflux/dysphagia symptoms. https://t.co/lLd2FrMIkx

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Dr. John Cush RheumNow ( View Tweet)

Study of 196 RA pts shows lung Dz common by chest CT, regardless of serostatus. RA lung=higher mortality (HR of 5.3). RA lung dz found in 28%; 16% had ILD, 14% bronchiectasis, 9.5% w pleural dz. RA lung dz in both seropositive (29%) & seronegative (28%) https://t.co/upNX7cvlWq

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Dr. John Cush RheumNow ( View Tweet)

Study of 5792 RA pts from 11 RCTs compared ACR Boolean remission with (4V) or without Pt Global scores (3V) using Xray & functional outcomes. 3V (TJC28, SJC28, CRP CRP mg/dL<=1) was as validi as 4V-remission in predicting Xray, less so functional, outcomes https://t.co/r1azrh3SHS

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Dr. John Cush RheumNow ( View Tweet)

Study of 222 RA pts on MTX given anti-GMCSF (otilimab) 22·5 mg, 45 mg, 90 mg, 135 mg, 180 mg, or PBO weekly x 5 wks, then EOW. @wk 24 DAS28-CRP <2·6 5%, 16%. 19%, 14%, 14% respectively and 3% in PBO. Otilimab failed to meet primary endpoint. https://t.co/14QqyeTcuP

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Dr. John Cush RheumNow ( View Tweet)

Lockdown worsening; UK survey 678 patients musculoskeletal diseases pts in late April 2020 shows 53% worsening of Sx; 1/3 had clinic/hosp access probs problems & most (88%) had no probs w/ getting meds; but 44% needed others to help them get meds. https://t.co/3efmTdHhQx

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Dr. John Cush RheumNow ( View Tweet)

1) If you are have diffuse scleroderma and have previously participated in a clinical trial, we need your help! You will be asked to watch video tutorial and answer a survey which will take you 20 minutes to complete. the study is supported by @WeAreSRUK @scleroderma @srfcure

Dr. Dinesh Khanna sclerodermaUM ( View Tweet)

Incredible lecture on the highest of therapeutics for rheumatoid arthritis by @BrighamWomens Dr Michael Weinblatt. Love this screen shot of A to Z for therapies prior to the methotrexate era. Z=Zero therapy (do nothing). Incredible advances since then! https://t.co/AOIMBJiulo
Jeff Sparks jeffsparks ( View Tweet)
"Prednisone >30 mg/day for > 4 weeks, patients should be on PJP prophylaxis." Image shows when to start/stop PJP prophylaxis Dr. Kevin Winthrop on Risks/Prevention of OI @UTSWRheum Grand Rounds @rheumnow https://t.co/nXuWYRxbgy
k dao KDAO2011 ( View Tweet)
Utilization study of 1031 tofacitinib vs 17,803 biologic DMARD Rx-patients shows 14% higher discontinuations w/ TOFA (HR 1.14), but pts who switched to tofacitinib from a bDMARD had longer persistence than pts switched to another bDMARD (HR 0.90) https://t.co/5cqloTTbjb

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Dr. John Cush RheumNow ( View Tweet)

Hellenic reigstry of 385 RA pts on DMARDs finds that, compared to remission or LDAS - those in persistent moderated disease activity had 50-80% more serious adverse events. https://t.co/3JA3VaMxeO

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Dr. John Cush RheumNow ( View Tweet)

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