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ACR Reacts to 2024 Medicare Physician Fee Schedule
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ACR
The American College of Rheumatology (ACR) expressed concern that the conversion factor included in the Centers for Medicare and Medicaid Services (CMS) CY 2024 Medicare Physician Fee Schedule and Quality Payment Program final rule is insufficient to address rising inflation.
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Anakinra Effective in Systemic JIA, Irrespective of HLA-DRB1 and IL1RN Variants
A prospective study of first line use anakinra in systemic juvenile idiopathic arthritis (sJIA) proved to be effective and without potentially allergic lung reactions.
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LANCET: Efgartigimod (neonatal Fc receptor mAb) shown effective in chronic #ITP. RCT, 205 pts with refractory ITP (Plt <30K for ~10.6 yrs) Rx w/ EFGR vs PBO. @24 wks EFGR incr Plt >50k in 22% vs. 6%). A larger RCT in progress https://t.co/uXyjYoXlyF https://t.co/jGroGNeD4W
Dr. John Cush RheumNow ( View Tweet)
Marijuana use is on the rise, including older adults. Data presented at 2023 AHA (cardiology) meeting suggests that marijuana user have higher risk of MI & CVA; & daily marijuana users were 34% more likely to develop heart failure (in hospitalized adults) https://t.co/EnEnf6pqdr https://t.co/GXSv30AFLr
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NEJM: Clinical Examination of the Cervical Spine (full read, with video). Great overview of Cx exam, useful in evaluation of axial neck pain, radiculopathy, or myelopathy; info on dermatomes, reflexes, Lhermites sign, etc https://t.co/EMizgh6Dtg https://t.co/6tdx1LBSDh
Dr. John Cush RheumNow ( View Tweet)
New download available, titled "Dealing with Infections"
https://t.co/hsOuJoFokg https://t.co/G3MZ9BQo0X
Dr. John Cush RheumNow ( View Tweet)
Oral Surveillance Study Alters Practice at VA
Safety risks found in a postmarketing trial with the JAKi tofacitinib (Xeljanz) appear to have influenced prescribing patterns across the class for RA patients in the VA health system, researchers found.
https://t.co/6WktHCkrI1 https://t.co/8wpAeLsBbw
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H. Zoster Subunit Vaccine Efficacy with JAK Inhibitor Therapy
Two recent reports suggest variable efficacy when JAK inhibitor (JAKi) treated patients are vaccinated with the recombinant herpes zoster subunit vaccine (RZV).
https://t.co/QEPQJkfSjE https://t.co/pFk2mF22ex
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Optimal Management of DQT
The treatment of DQT was examined by systematic review in JAMA, suggesting that local corticosteroid injection + a thumb spica immobilization was associated w/significant pain-relieving and functional benefits.
https://t.co/Qo5XGwCRsy https://t.co/58n74oFbfh
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Study of TNFi tapering in 108 axSpA patients in remission. Gradual tapering over 2 yrs resulted in flares in 99% (108).
- 27% flared at 2/3 dose
- 20% at 1/2 dose
- 27% at 1/3 dose
- 25% w/ discontinuation
WHY WOULD YOU DO THIS? I DONT! https://t.co/g8L7E4lcqG https://t.co/oaBILUrlmd
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BMJ State of the Art (full read) review of ADVANCES in LUPUS THERAPY (Morand EF, et al).
- Recent SLE RCTs
- Pathogenesis, genetics, epigenetics
- Phenotypes
- Emerging treatments
- Guidelines on Rx
https://t.co/qZFvQkaFeO https://t.co/r9IriOR8FF
Dr. John Cush RheumNow ( View Tweet)
FDA has approved secukinumab (Cosentyx) for use in adults w/ moderate to severe hidradenitis suppurativa. Recommended dose is 300 mg SC @ wk 0, 1, 2, 3 and 4 and then every 4 weeks thereafter. https://t.co/4f6Ew5KGmg https://t.co/SldJ6MXMw7 https://t.co/KfCww7doef
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Analysis of German RABBIT registry did not show more MACE events in pts w/ JAK inhibitors compared to other DMARDs. 154 MACE w/ 14203 Rx episodes (21218 Pt-Yrs). IRs were 0.68 JAKi, 0.62 TNFi, 0.76 bdMARDs and 0.95 csDMARDs; higher in CV risk pts https://t.co/luUK9M9IM9 https://t.co/z8lxjWscCR
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Metanalysis of 26 studies (2252) pts w/ HBsAg-/HBcAb+ RA treated with b/tsDMARDs, shows the pooled HBV reactivation rate was 2.0%
HBV reactivation higher w/ RTX (9%), ABA (6%), JAKi (1%); none w/ IL-6i or TNF-i
More reactivation if pt is HBsAb- (OR=4.56) https://t.co/V60nkUSpjj https://t.co/jnZKnY0Zuk
Dr. John Cush RheumNow ( View Tweet)
FDA Approves Infliximab Biosimilar for Subcutaneous Use
Another infliximab biosimilar has been FDA approved, but this new version of Inflectra can be given subcutaneously for patients with inflammatory bowel disease.
https://t.co/oTGm16k6Uo https://t.co/tSysmriP7q https://t.co/TIZc8rxwxM
Dr. John Cush RheumNow ( View Tweet)
JAMA Review of Knee Pain:
- 5% PCP visits for knee pain:
- Knee #OA: 654 mill worldwide, mostly >45 yrs age
- Patellofemoral OA: < 40 yrs age; Sx: ant knee pain w/ squat
- Meniscal tears: 12% adults < 40 yrs; dx by McMurray test & joint line tenderness
https://t.co/AKVFXjY0D8 https://t.co/GpBxA2rdLP
Dr. John Cush RheumNow ( View Tweet)
JAKi Safety and Efficacy in bDMARD-IR Patients with RA: Results Through 5 Years
Now in the RheumNow poster hall: Long-term extension outcomes from SELECT-BEYOND through 5 years in bDMARD-IR patients with RA. Sponsored by AbbVie US Medical Affairs. https://t.co/07PrYidnt9 https://t.co/qWM9N68hZ1
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Check out the latest therapeutic update for axSpA in this video series dedicated to creating a better understanding of treatment goals.https://t.co/8zFMwt5Q7g https://t.co/tc9txlCgw8
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PMR Mythbusters: PMR Gets 100% Better Within 72 hours
https://t.co/S7PWlNoQez https://t.co/CN469rzGVl
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Cardiovascular and VTE Risk w/JAKi Treatment of Skin Disorders
A JAMA systematic review and meta-analysis has shown the use of JAKi in immune-mediated inflammatory skin diseases was not associated w/ increased risk of all-cause mortality, MACE, or VTE.
https://t.co/XYAeLnFvHr https://t.co/tGRNEUEZj9
Dr. John Cush RheumNow ( View Tweet)