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Defining Difficult Rheumatoid Arthritis

Jack Cush, MD

‘Difficult-to-treat RA’ is an oft-used term that carries various clinical qualities and therapeutic disappointments. A EULAR Task Force was established to develop recommendations for the management of difficult-to-treat rheumatoid arthritis and as a first step, have put forth their definition of this rheumatoid arthritis (RA) subset.

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Filgotinib Approved by the EMA for Rheumatoid Arthritis

Jack Cush, MD

On Friday, Gilead and Galapagos announced that the European Commission (EC) has granted marketing authorization for filgotinib (trade name, Jyseleca) their oral, once-daily, JAK1 inhibitor for the treatment of adults with moderate to severe active rheumatoid arthritis (RA) who have resp

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Young Adults are Driving Up COVID-19 Rates

CDC/MMWR

CDC reports that since June 2020 individuals infected with COVID-19 have largely been young adults in the 20-29 year age bracket. Moreover, younger adults appeared to be driving community transmission of COVID-19. 

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DMARDs for Early Rheumatoid Arthritis Have Cardiovascular Benefits

RheumNow

Patients with RA have up to a three-fold increased risk of mortality versus the general population, largely due to an increased incidence of premature CVD, such as atherosclerosis and heart failure.

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RheumNow Podcast – Lupus Delights (9.18.20)

Jack Cush, MD

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

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Has the Risk of Hip Fracture Changed over Time?

Jack Cush, MD

Data from the Framingham Heart Study has shown that hip fracture incidence has decreased over time, probably resulting from improved lifestyle changes (less smoking and heavy drinking). 

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Danish comparison of 15K RA, 301K Diabetes adn 75K gen population; RA assoc w/ increased risk of CHF (HR 1.51), MI (HR 1.58), stroke (HR 1.22) vs gen. population; but RA had 20-40% lower CHF/MI/CVA than diabetes pts (who had highest 10 yr mortality). https://t.co/R20EUPAlML

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is up! COVID effects on Rheum; drug approvals, Difficult RA, SLE complement & remission. Watch it here> https://t.co/490T6k1ytk or listen to the podcast on iTunes> https://t.co/FHJv01AAbC OR on souncloud> https://t.co/dAJ0827c3B

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Dr. John Cush RheumNow ( View Tweet)

Swiss cohort of 666 axSpA, RA & PsA pts seen before, during & after COVID; consults dropped 52%, remote visits increased 129%, & non-compliance slightly increased during COVID (axSpA 20% vs 13% before, p=0.003); but no incr in flares(<15%) or Dz activity https://t.co/lWb7WCwGbN

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14203 early RA cohort looked at adherence to quality standards of care (DMARD use, steroids, early F/U care) and showed adherence lessened need for future hospitalisation (adj HR 0.85); most impact from early DMARDs, worst from steroid use https://t.co/hzICGWyht2

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Dr. John Cush RheumNow ( View Tweet)

Today Janssen announced the FDA has approved golimumab (Simponi Aria) for use in children (> 2yrs) with active Polyarticular Juvenile Idiopathic Arthritis and for pediatric Psoriatic Arthritis https://t.co/ntWJXjEJvc

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Dr. John Cush RheumNow ( View Tweet)

Pfizer announced the FDA has approved tofacitinib (Xeljanz) in children (>2yrs) w/ polyarticular JIA. Approval based on a 225 pt, Phase 3, 18 wk Open Run-in followed by 26-wk randomized, withdrawal study of placebo vs tofa 5 mg qd (or wt based oral soln) https://t.co/9Xo3lriINH

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Among a 112 patient inflammatory myositis cohort, inclusion body myositis was rare (4 pts) - they tend to be older (67 yrs), male predominance, lower CK (1326-1968), less severe weakness 3.75/5) and poor response to immunosuppressives. https://t.co/VxLOAjstWo

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Dr. John Cush RheumNow ( View Tweet)

Swedish GWAS study of >850,000 individuals shows Genetically predicted BMI (obesity) significantly increases RA riskk, but no correlation of RA risk to waist-to-hip ratios. https://t.co/YkzwjPOVyE

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Dr. John Cush RheumNow ( View Tweet)

Cluster analysis of 168 antiphospholipid pts shows that having arterial thromboses and cardiovascular risk factors was associated with mortality and poorest prognosis in APS. https://t.co/Nb7lZNu4jT

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Ann Int Med shows again that steroids increase serious infection risk in a dose dependenet manner, but even 5 mg of prednisone or less also gives a small but significant risk of serious infection in RA patients on DMARDs (claims data from Medicare & Optum) https://t.co/bj41SqKP0K

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Dr. John Cush RheumNow ( View Tweet)

Outcomes survey of 229 relapsing polychondritis patients shows that 59% had auricular-onset (AO) and 21% had respiratory -onset (RO), 20% w/ miscellaneous-onset (MO- eye MSK CNS). Poorer prognosis seen in RO & MO subgroups than AO subgroups https://t.co/rzVU42z3EA

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis presented at European Association for the Study of Diabetes (EASD), involving 1,629,854 participants and found #RA was associated with a 23% higher chance of developing T2D, compared to the diabetes risk within the general population https://t.co/Qff7gpzves

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow podcast is up! Lupus delights - Lupus & Diet, Drug induced lupus & brand new biologics for SLE. Good news on immunosuppressives, colchicine and baricitinib in COVID-19 patients. . Watch it here https://t.co/Ymsd3eXN5d or listen to the podcast https://t.co/20FOr3qu3X

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Dr. John Cush RheumNow ( View Tweet)

Uncontrolled retrospective observational study of 31 RA-ILD DMARD refractory pts treated with RTX showed RTX to reverse the PFTs decline (∆%pFVC +8.06%; ∆%pDLCO +12.7%) while reducing median prednisone dose at 1 yr. @32 mos, 74% still on RTX. https://t.co/AVQCm2MpDk

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Dr. John Cush RheumNow ( View Tweet)

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