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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.
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Linger on the Fingers (9.6.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.
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Sustained Hydroxychloroquine and Cardiovascular Outcomes
A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects agains cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).
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Higher Cancer Rates (8.16.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.
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Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl
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Dr. John Cush RheumNow ( View Tweet)
Pipeline drugs and trials intended for Interstitial Lung Disease - including studies with nintedinib, Efzofitimod, BI 1015550, AD-214, Abatacept, ATYR1923, Pirfenidone inhalation, RO-0220912, Lung stem cells...Riociguat, Treprostinil and more https://t.co/fpMjjubPVx https://t.co/ketFP0N9jk
Dr. John Cush RheumNow ( View Tweet)
Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/uprHZbsqkR https://t.co/edjoN2vzc0
Dr. John Cush RheumNow ( View Tweet)
Sustained Hydroxychloroquine and Cardiovascular Outcomes
A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects against cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).
https://t.co/xqB2tyzzYQ https://t.co/dlFjbgbsep
Dr. John Cush RheumNow ( View Tweet)
Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/s20wTKafR8 https://t.co/FPxc5VP4Xh
Dr. John Cush RheumNow ( View Tweet)
Study of 4370 RA pts (26534 PYs) saw 362 MACE (CV) events. RA activity & inflammatory markers assoc w/ MACE risk in bDMARD non-users (not those on bDMARDs). 515 bDMARD vs 3855 non-users (n=3855). Each DAS28-CRP unit incr MACE risk (HR 1.21)https://t.co/lRaHxTHzqe https://t.co/usEiJctVYk
Dr. John Cush RheumNow ( View Tweet)
Scleroderma skin findings in pts w/ skin of colour (SOC) - Raynauds was common but SOC pts had fewer hallmark Sxs: telangiectasias, calcinosis, digital swelling (complicating Dx). SOC had more severe pulmonary Dz & increased mortality, Atypical skin findings… https://t.co/8XkelxqvYE https://t.co/JOw8OSNjzw
Dr. John Cush RheumNow ( View Tweet)
Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M
Dr. John Cush RheumNow ( View Tweet)
Lipids and Inflammation in Rheumatoid Arthritis
In the realm of chronic inflammation, lipid abnormalities are well-recognized as pivotal contributors to the progression and clinical manifestations of atherosclerosis. Particularly in rheumatoid arthritis (RA), a systemic… https://t.co/zHKbBHlap8 https://t.co/KRIg1KYmcC
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 12 studies shows that being edentulous (or having < 20 teeth) was associated w/ higher risk (HR 1.66; 1.32–2.09) critical confounders also confirmed that tooth loss as a risk factor for Cardiovascular mortality (HR=1.52, 95% CI: 1.28–1.80) https://t.co/PStGlxmCC3 https://t.co/ZDzaytj9dY
Dr. John Cush RheumNow ( View Tweet)
Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease
A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD.
https://t.co/J9FCdkId8H https://t.co/uJylDP3IIp
Dr. John Cush RheumNow ( View Tweet)
Anti-Inflammatory Diet yields a lower risk of Dementia. UK Biobank study shows patients w/ type 2 diabetes, heart disease, or stroke who were on an anti-inflammatory diet had a 31% lower risk for dementia vs. a pro-inflammatory diet https://t.co/OjHq3BBOfd https://t.co/tG9vO59IEc
Dr. John Cush RheumNow ( View Tweet)
Less Mortality with GLP-1 Agonists in Rheumatic Patients
A recent study in PLOS ONE found that treating type 2 diabetes with GLP-1-RAs lowered the risk of mortality and cardiovascular events in patients with IMIDs and type 2 diabetes.
https://t.co/MzCG7WvrDS https://t.co/0RPIfOO0s7
Dr. John Cush RheumNow ( View Tweet)
Mass General Brigham Study 172 RA-ILD pts w/ 6.5 yrs F/U (age 62 yrs): noted (4%) lung transplants & 44 (26%) ILD-related deaths. FVC rapidly declining pts (14%) had aOR 19x lung transplant & aOR 2.8 ILD-related death. Slow decline in 54%, no decline 32% https://t.co/fKDnJIu9a7 https://t.co/ondzN4WZ1F
Dr. John Cush RheumNow ( View Tweet)
Lit review of ILD in anti-synthetase syndrome finds no conclusive evidence of effective treatment. 10 studies, 514 pts (68% female); Hi Res CT positive in 87% w/ 49% having NSIP pattern. 48% Jo-1+, 28% Ro52+. Low improvements w/ RTX (12%), CYC (17%). https://t.co/B7R0xQrUyw https://t.co/2hMzO8hyiV
Dr. John Cush RheumNow ( View Tweet)
