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Cross-sectional survey of 3200 PsA/Pso patients. 65% had both joint & skin involvement. Latter pts had worse QoL, work impairment, higher TJC (5.2) & SJC (4.8) (vs 2.0 & 1.5); more flares (35 vs. 23%, p < 0.001). Jts bigger burden (62%) vs skin (38%) https://t.co/mpmpF4LiLR

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Dr. John Cush RheumNow ( View Tweet)

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Low Risk of COVID in Biologic Treated Rheum Patients

d Jack Cush, MD

In an Annals of Rheumatic Disease report, Italian investigators performed consecutive testing for SARS-CoV-2 (IgM and IgG) between 25 March to 25 May 2020 and compared test results between rheumatic disease (RMD) patients and the general population. 

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Metanalysis of 7 RCTs looked at melanoma risk comparing 34 029 biologic Tx vs 135 370 non-biologic conventional systemic Tx pts, showing no signif. increased risk in IBD (RR 1.20; 0.60-2.40), RA (pRR 1.20; 0.83-1.74), or psoriasis (HR 1.57; 0.61-4.09) https://t.co/PCOddiwKv0

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Dr. John Cush RheumNow ( View Tweet)

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Risankizumab Outduels Secukinumab in Psoriasis

d Jack Cush, MD

The IMMerge trial has demonstrated the superiority of interleukin (IL)‐23 over IL-17A inhibition adults with plaque psoriasis.

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FDA has approved a 6th adalimumab biosimilar - called Hulio (adalimumab-fkjp) with indications of rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, ankylosing spondylitis, adult Crohn’s disease, ulcerative colitis, psoriasis. https://t.co/zMNsDjVewU

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Dr. John Cush RheumNow ( View Tweet)

Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash. AAV w/ skin Sxs have more systemic dz (GN, alveolar hemorrhage) https://t.co/egPdW2IEnu

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Dr. John Cush RheumNow ( View Tweet)

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ICYMI: The Nine Lives of Hydroxychloroquine (Updated)

d Martin J. Bergman, MD

Hydroxychloroquine is one of many medications frequently used in rheumatology practice. Its remarkable versatility is attested by its routine use in lupus, in patients with an autoimmune coagulopathy, in patients with rheumatoid arthritis, as well as in those with a low-level inflammatory arthropathy.

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Is IL-23 Better than IL-17 Inhibition in Psoriasis?

d Jack Cush, MD

Data presented at the recent American Academy of Dermatology meeting suggests that interleukin (IL)-23 inhibition with risankizumab was more effective than the IL-17 inhibition (secukinumab) based on a 52 week randomized head-to-head trial in moderate to severe psoriasis patients.

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The CHMP of the European Medicines Agency has recommended the label expansion of IL-17 inhibitor, Cosentyx (secukinumab) for the treatment of moderate-to-severe plaque psoriasis in children and adolescents aged 6-18 years. https://t.co/1qYL5ASkrg

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Dr. John Cush RheumNow ( View Tweet)

Tocilizumab may be effective in refractory ocular-, neuro-, vasculo-Behcet's. Study of 47 Behcet's pts Rx w/ TCZ - good at ocular (24/25), CNS (6/6), vascular (7/7) & amyloidosis(2/2) but less effective w/ oral/genital (8/21), skin (6/14) or joints (4/11) https://t.co/lKY8D706bi

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Dr. John Cush RheumNow ( View Tweet)

23 yoF with 1 mos digital ulcers, hair loss, sicca Sxs, dysphagia; No sclerodactyly but finger tips cyanotic w/ distal pitting scars, ischemic ulcers, periungual erythema & dilated nailfold capillaries (no hemorrhages). +tests for ANA, Ro52, Ro60 and Scl-70 Abs. How to treat?

Dr. John Cush RheumNow ( View Tweet)

EULAR 2020 Roundup

Virtual EULAR 2020 Round Up

d Jack Cush, MD

In this week's podcast, Drs. Artie Kavanaugh and Jack Cush present highlights from the virtual EULAR2020 meeting held June 3-6, 2020. Featured reports include the SELECT-CHOICE study, the EXCEED trial, Avacopan in AAV, BeST mortality outcomes, BLISS-LN study, biosimilars and tofa in systemic sclerosis.

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Day 3 - Top 5 from EULAR 2020

d Jack Cush, MD

These were my top abstracts from Thursday, 4th of June at EULAR 2020:

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#EULAR2020 #op0051 presence of Structural Enthrseal Lesions (SEL) in PSO associated w/higher risk of progression to PsA: 37.5%If SEL present vs 3.4% no SEL/no arthalgia& 15.2% no SEL/+arthralgia. Highest risk in PSO w/SEL+arthralgia at 42.8% @RheumNow https://t.co/7knYXeap7l
Olga Petryna DrPetryna ( View Tweet)
#EULAR2020 #op0028 12 wk ph3 RELIEF study: Apremilast effectively relieves OU pain and OU number after 12 wks of 30 mg bid Rx. Great proportion of APR PTs achieved >10 mm &>30 mm improvement in OU pain @RheumNow https://t.co/p71sz9XL0e
Olga Petryna DrPetryna ( View Tweet)
#Upadacitinib #psoriaticarthritis Upa works in PsA including imaging and when they show it surprising good PASI scores as well https://t.co/ZWqj8ythHB
Peter Nash drpnash ( View Tweet)
#guselkumab #axialdisease - who would have thunk it - IL23 p19 works in axial involvement PsA with radiology! https://t.co/TaSFBJFRnx
Peter Nash drpnash ( View Tweet)
Primary Sjogren’s syndrome showed benefit of leflunomide + #Hydroxychloroquine vs placebo - past neg RCT of HCQ for PSS Sicca (dry eyes/mouth) so is it just leflunomide that works or combo? Likely pt selection - arthritis and rash likely respond to either @RheumNow @CRASCRRheum https://t.co/lsIeG2uv2H

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Janet Pope Janetbirdope ( View Tweet)

ASAS modification of the Berlin algorithm and the duet algorithm for diagnosing axSpA : results from the screening in axSpA for psoriasis, iritis, and colitis cohort: Abstract FRI0298 #EULAR2020 @RheumNow https://t.co/BkG7c2riRb https://t.co/f63MsxWmd3

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Dr Philip Robinson philipcrobinson ( View Tweet)
Another Italian COVID-19 dermatology report: 1,193 skin psoriasis patients on TNFi, IL17,IL23,IL12/23 & apremilast: 22 patients infected, of those 5 hospitalised, none died https://t.co/HpN908qsHd

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Dr Philip Robinson philipcrobinson ( View Tweet)

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