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Risk Option Decision

The art of talking about risks with our patients

d David Liew, FRACP

On the first day of EULAR 2024, I am debating Janet Pope.

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CATCH cohort study of 547 Early RA pts shows higher Tender > Swollen joint differences is assoc. w/ worse n patient-reported outcomes (PROs) in all domains (phys function, social , pain, sleep problems, fatigue, anxiety, depression) -- Isnt this FM ? https://t.co/4Bk8VGQNB6 https://t.co/K7kO5q990v

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Dr. John Cush RheumNow ( View Tweet)
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Humira Clobbers Biosimilars in Battle for Part D Coverage

d Medpage Today

Just about every Medicare Part D prescription drug plan on offer this year covers the original version of adalimumab (Humira), whereas only about half will pay for any of the several biosimilar versions currently approved, researchers found.

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Medicare & Optum claims data study of 2851 #RA pts w/ breast cancer (BC). In 3 mos before BC 27028% received bDMARDs. W/in 1st 3 yrs post-BC Dx 24-26% were receiving bDMARDs. 70% of RA pts on steroids without change w/ time https://t.co/51NcXv0xyc https://t.co/461NZiFvDO

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Dr. John Cush RheumNow ( View Tweet)
Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis A new study led has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events. https://t.co/VVKR2G91VQ https://t.co/ZZNLJpoyNA

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Dr. John Cush RheumNow ( View Tweet)
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Is Cannabis Safe? (6.7.2024)

d Jack Cush, MD

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis? A JAK inhibitor outperformed TNF blockers for substantially reducing RA symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found. https://t.co/7BhFSwb1Ns https://t.co/Hf31OPgE0M

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Dr. John Cush RheumNow ( View Tweet)
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Molecular Profile for Cardiovascular Risk in Rheumatoid Arthritis

d Jack Cush, MD

A new study led by the University of Córdoba, the Maimonides Institute for Biomedical Research and the Rheumatology Department at the Reina Sofía University Hospital in Córdoba has managed to establish, for the first time, the molecular profile of those patients with rheumatoid arthritis who have a higher risk of suffering cardiovascular events.

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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?

d Medpage Today

A Janus kinase (JAK) inhibitor outperformed tumor necrosis factor (TNF) blockers for substantially reducing rheumatoid arthritis (RA) symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.

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TriNetX US claims study of 7580 RA pts Rx w/ tofacitinib or adalimumab found Tofa signif. more likely to cause dyslipidemia (HR 1.250), but no difference betw TOFA & ADA in MACE (HR 0.995; 0.76–1.3) or all-cause mortality (HR 1.4; 0.89–2.2) https://t.co/83CGng2R9e https://t.co/QfD4ePuTER

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Dr. John Cush RheumNow ( View Tweet)
Save the date! We are covering #EULAR24! We'll be sharing recaps, videos, and more. https://t.co/NMWtHB94Pi https://t.co/ok43pnagFg

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Dr. John Cush RheumNow ( View Tweet)
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ACR’s Run at Goliath (PCPs) (5.31.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the journal reports and articles from this past week on RheumNow.com. The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?

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Do you have a rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/qvVEUoNYi5 https://t.co/duw6jg5xpp

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Dr. John Cush RheumNow ( View Tweet)
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ACR Website to Support Primary Care Practitioners

d ACR

The American College of Rheumatology recently launched Rheumatology for Primary Care, a new resource for primary care physicians (PCP) and advanced practice providers (APP) offering them expanded support and guid

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NHANES study of 2500 #RA pts, found a significant correlation between an inflammatory diet (meas by DII score) and inflammatory indices like systemic immune-inflamm Index (SII) & neutrophil-lymphocyte ratio (NLR) https://t.co/sWXZRrG6hV https://t.co/9IcLDF1Jlo

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Dr. John Cush RheumNow ( View Tweet)
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The Window of Opportunity (5.24.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?

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NON-treatment of 18,318 VA pts (RA, SpA, PsA) = 41% not Rx DMARDs w/in 12 mos of Dx. Signif higher odds if Black (HR 1.13), Hispanic (1.14), Charlson Comorbidity ≥2 (1.15), opiate use (1.09). DMARD use ^ if married, w/ erosions, female MD, Rheum Dx https://t.co/TaYC27oIOz https://t.co/qjfAGI5L5g

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Dr. John Cush RheumNow ( View Tweet)
FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq https://t.co/Xmu8g35MXR

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Dr. John Cush RheumNow ( View Tweet)
MarketScan Claims & Medicaid study of incident AS, PsA, or RA (2010–2017) that Opioid use was highly prevalent in AS (36%), PsA (30%), & RA (44%) in the year prior to Dx & during the 1st Yr. Is this PCP or Rheumatologist mismanagement? https://t.co/YsCOLZUCfS https://t.co/b33uNg6Ucx

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Dr. John Cush RheumNow ( View Tweet)
Insurance claims data studied 7580 newly Dx RA (2018-2020) - 1998 tofacitinib vs 5582 adalimumab. After propensity matching, dyslipidemia was signif. higher w/ TOFA (HR 1.25), BUT no differences in MACE (HR 0.995) or all-cause mortality (HR, 1.4; NS) https://t.co/ZJ7uHWTycS https://t.co/A6tSm4RipS

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Dr. John Cush RheumNow ( View Tweet)

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