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Osteoporosis in Older Men

Jack Cush, MD

JAMA has publish an invited commentary on Screening for Osteoporosis (OP) in Older Men. They point out that a simple screening strategy for older men based on previous fracture history and bone density screening at age 70 or 75 years is a reasonable means of screening for OP in older men.

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Methotrexate intolerance in rheumatoid arthritis

Jack Cush, MD

Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week. 

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Prenatal acetaminophen linked to increased autism and ADHD

EurekAlert!

Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD), in children.

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Antibiotics are not linked to Autoimmune disease in kids

EurekAlert!

The global incidence of autoimmune diseases among children has increased over the past few decades.

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Safety of Combination Targeted Therapies in Psoriatic Arthritis

MedPage Today

Treating psoriatic arthritis (PsA) patients with more than one targeted therapy appears to be just fine, with no increased risk of serious infections, insurance claims data indicate.

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Rheums Speak: Future of Rheumatoid Arthritis

Jack Cush, MD

The third survey in this series addressed clinician views on future trends (AI), future therapies and lessons learned.

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Uncertainty with immunosuppressive for idiopathic inflammatory myopathies

Jack Cush, MD

A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for the idiopathic inflammatory myopathies (IIM). Overall there has been little progress since the previous Cochrane review (2012) that found little or no evidence to guide treatment.

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TNF Inhibitors in Takayasu's Arteritis

Jack Cush, MD

A large, retrospective, multicenter study demonstrated the efficacy of intravenous infliximab and  subcutaneous adalimumab in patients with Takayasu arteritis.

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Methotrexate intolerance in rheumatoid arthritis Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week. https://t.co/aizooTPNTe https://t.co/FZ52bwHBfq

Links:

Dr. John Cush RheumNow ( View Tweet)
Prenatal acetaminophen linked to increased autism and ADHD Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and ADHD, in https://t.co/Zpo9dymPPf
Dr. John Cush RheumNow ( View Tweet)
While the live-attenuated vaccine, Ixchiq, was pulled for safety concerns, there is another chikungunya vax still on the marked - a virus-like particle vaccine, Vimkunya. Travelers or the elderly at higher risk of chikungunya exposure should consider getting vaccinated

Dr. John Cush RheumNow ( View Tweet)

Rapid rituximab infusions are safe & efficient. Metanalysis of 7 RCTs, 538 pts w/ autoimmune/rheumatic dz, showed infusions(RTX 1000 mg) of 90-120 min (w/ premedication) had low risk (3-15%) of mild (Grades 1, 2) infusion Rxns; only 6 Grade 3 Rxns https://t.co/uVKuhhc80F https://t.co/NIMMhgIRzH

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Dr. John Cush RheumNow ( View Tweet)
TriNetX database study shows Beta blocker use assoc w/ more hip replacements (THA). 23K propensity matched pts (mean age 69) on or off BB compared. After 3 yrs BB use was assoc w/ higher risk of THA (HR 1.49; 1.4–1.59), esp w/ alpha-BBs (HR 1.64) https://t.co/W6ocMYI653 https://t.co/EiQ4WH94cD

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Dr. John Cush RheumNow ( View Tweet)
New IDSA recommendation: In hospitalized on systemic steroids w/ severe, critical, progressing COVID-19, when baricitinib or tocilizumab are not available, IDSA guideline panel suggests infliximab. https://t.co/ZCkkZXUDpi https://t.co/gbgkvj5R8Y

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Dr. John Cush RheumNow ( View Tweet)
ChildCAPTURE & BioCAPTURE registry studies of 117 pediatric & 243 young adult Psoriasis pts on biologics (753.4 Pt-Yrs) shows no sex differences in clinical responses, but shows females have more adverse events than males (both cohorts) https://t.co/5at9vCqwIO https://t.co/ScJkIH9G31

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Dr. John Cush RheumNow ( View Tweet)
Uncertainty with immunosuppressive for idiopathic inflammatory myopathies A current Cochrane review suggests a continued unmet need regarding the status and utility of targeted immunosuppressant and immunomodulatory treatments for IIM. https://t.co/evkwbX6U9j https://t.co/2s0Z9Y9Umm

Links:

Dr. John Cush RheumNow ( View Tweet)
Guidance on aromatase inhibitor-associated bone loss with hormone-sensitive breast cancer An updated joint position statement on the management of aromatase inhibitor-associated bone loss (AIBL) addresses the heightened fracture risk in women undergoing endocrine therapy for https://t.co/ZkvToBBGdB
Dr. John Cush RheumNow ( View Tweet)
Anifrolumab appears effective & safe in refractory Cutaneous LE. OL Study of 15 CLE, on HCQ, topical steroids, failed multiple DMARDs. All Rx w/ ANIF 300 mg IV q4wks. ALL improved, CLASI-A decr from 16 to 1 (p<0.001); CLASI-D decreased from 5 to 4 (p<0.001). DBPCT needed! https://t.co/umEYz0XDyt
Dr. John Cush RheumNow ( View Tweet)
Advances in Still's disease Rx: - using IL-1 or IL-6 inhibitors 1st line - New FDA approval of emapalumab (IFNg) for MAS - unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N

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Dr. John Cush RheumNow ( View Tweet)
JAKne? Study of 2183 IBD pts on JAK inhib, 272 developed acne. Crude prevalence: 16% upadacitinib, 4% tofacitinib, 2% filgotinib (dose-dependent w/ UPA & Tofa). JAKne in pts 30–50 yrs; mild-moderate severity; in 1st 3 mos. Higher risk w/ prior hx acne vulgaris (OR 4.9) https://t.co/G29CvZ6aux
Dr. John Cush RheumNow ( View Tweet)
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