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SAPHYR Trial: Sarilumab Wins in Relapsing Polymyalgia Rheumatica

d Jack Cush, MD

NEJM reported today that polymyalgia rheumatica (PMR) patients who fail to respond to standard doses of prednisone therapy, were significantly better when given the IL-6 inhibitor sarilumab (than placebo).

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FDG,PET,CT

Predictive FDG-PET in Newly Diagnosed GCA

d Jack Cush, MD

Annals of Internal Medicine reports that the use of 18F-fluorodeoxyglucose (FDG) PET imaging at the time of a giant cell arteritis (GCA) diagnosis may help estimate the risk for aortic aneurysm formation.

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First PMR panel

TNR: PMR Diagnosis and Monitoring

d Jack Cush, MD

Panelists Dr. Claire Owen, Stephen Paget, Anisha Dua and Jack Cush discuss diagnosis and monitoring in PMR during this week's Tuesday Night Rheumatology.

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Gout Flare Prophylaxis - Colchicine or NSAIDs? A new study suggests that colchicine, more so than non-steroidal anti-inflammatory drug (NSAID) prophylaxis, may increase the odds of adverse events, when initiating allopurinol for gout. https://t.co/MfVvBy0DsD https://t.co/jP5oiAHaBa

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Dr. John Cush RheumNow ( View Tweet)
Subclinical vasculitis in PMR For a long time #PMR has been an underinvestigated disease. This is changing with new possibilities to make a more accurate diagnosis with imaging as well as new therapies for treatment resistant disease. https://t.co/t0BRosgMWt https://t.co/bWZzRidqlm

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Dr. John Cush RheumNow ( View Tweet)
Subclinical GCA prevalence in newly Dx #PMR ranges from 23 to 29%; best by Vessel imaging or temporal artery Bx. #PMR & GCA share common genetic/pathogenic inflammatory mechanisms & an IL-6 signature; BUT there are differences; further research needed! https://t.co/MhuIs068NG https://t.co/1BeeP3RY0H

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Dr. John Cush RheumNow ( View Tweet)
GCA pts w/ prior #PMR Dx had 2 fold more Lg vessel dz & signif more vasculitic stenoses. Study of 311 GCA pts, 16% had prior PMR ~ 31 mos before. prior PMR had more LVV (51 vs 25%) & stenosis(18 vs 3%). Prior PMR incr LVV (OR 7.65) https://t.co/1kqtkPnPaz https://t.co/oVs084NfmV

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Dr. John Cush RheumNow ( View Tweet)
JAKi Safety & Efficacy in bDMARD-IR Patients with RA: Results Through 5 Years This poster shows 5-year outcomes from the SELECT-BEYOND study in bDMARD-IR patients with RA, including TNFi-IR subgroup outcomes. Sponsored by AbbVie US Medical Affairs https://t.co/BRsCMnOnFT . https://t.co/lxfPs12mHb

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Dr. John Cush RheumNow ( View Tweet)
Best quote from last nights Tues Night Rheumatology on #PMR , comes from Dr. Stephen Paget (#HSS) who said, "steroids to a new PMR patient are like spinach to Popeye" https://t.co/r7L1cUTJeT

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Dr. John Cush RheumNow ( View Tweet)

X-sectional case-cntrl study w/ UK Biobank looked @ comorbidity w #PMR (n=1036) & GCA (102) pts (98% W; age 63 yrs) - pts rated their health as poor. Comorbid Dx included-more hypothyroidism (OR 1.34), HRT use (1.26), HTN (1.21-1.86) & cataract (1.51-3.84) https://t.co/GxpzN5NWug https://t.co/8J0IRMLK5g

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Dr. John Cush RheumNow ( View Tweet)
New download on #PMR available now! https://t.co/C4fCUQ5j8e https://t.co/3Fm5xG8EM7

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Dr. John Cush RheumNow ( View Tweet)
Steroid Tapering in #PMR: What's the Gold Standard? Dr. Anisha Dua, Chicago, discusses the gold standard tapering of glucocorticoids in polymyalgia rheumatica. https://t.co/WyojhJQkN2 https://t.co/NarFqwNxEj

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Dr. John Cush RheumNow ( View Tweet)
Retrospective EHR study of 7,970 gout pts from Singapore finds ~28% are poorly controlled, with only 46% prescribed allopurinol (13% @doses ≥300). Poor control assoc w/ male gender (adj OR 1.66), Malay ethnicity (aOR 1.27), CHF (aOR, 1.64) https://t.co/M8dJFIbZEV https://t.co/aUnLgUmvXN

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Dr. John Cush RheumNow ( View Tweet)
Cardiovascular manifestations of monogenic periodic fever syndromes - includes: - Pericarditis (most common) - Cardiac Amyloidosis - Myocarditis - CV complications of inflammation and steroid - Premature atherosclerosis https://t.co/iLfbPq2nzn https://t.co/T7Vtx5q8Y1

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Dr. John Cush RheumNow ( View Tweet)
October is #PMR Month PMR has come a long way from being an occasional referral and often test question, to now being a hot area of drug development and investigation https://t.co/voVlxuRGZA https://t.co/NwEvws8cD3

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Dr. John Cush RheumNow ( View Tweet)
Diagnosis and Monitoring of PMR https://t.co/D3ml0ZZCpb

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Dr. John Cush RheumNow ( View Tweet)

Excited to join @RheumNow for Tuesday Night Rheumatology and contribute to Make Rheum for #PMR this October🤩 https://t.co/8HqAVPDLXS

Claire Owen  ( View Tweet)

RA QD Clinic - RA in Deep Remission If the patient is in Deep Remission - do you suggest DMARD or biologic weaning? https://t.co/ELV1MTNkrI https://t.co/9wiqvlZUEY

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Dr. John Cush RheumNow ( View Tweet)
1 in 3 of our pts are on steroids; nice ARD full read review of important papers on steroids 2022-23 written by Prof J Bijlsma, covering: Mechanisms of action CV AE Bone Effects Infections, COVID-19 Clin trials Benefit vs Harm Tapering GC Guidelines https://t.co/MAErgj8MGz https://t.co/JDnBUU3FLe

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 17 studies (n=862849 pts) looked at fall risk w/ #OA. OA Hip (OR 1.50 & knee (OR 1.55) assoc w/ signif incr risk recurrent falls, but not FX. Xray knee OA w/ incr risk of falls (OR 1.28); Xray hip OA decr risk recurrent falls (OR 0.70) https://t.co/7iD8CDA1L7 https://t.co/Cn8lUt07WG

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Dr. John Cush RheumNow ( View Tweet)
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