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Teaching You How to Think… (8.15.2025)
Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and aphorisms to live by.
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Biologic Switching in Psoriasis
A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay.
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Rheums Speak: Changing Rheumatology Practices & Choices
RheumNow surveyed clinicians worldwide on how their rheumatology practice, treatment decisions, and career outlooks have changed over the past 20 years. 242 respondents (68% from the USA) shared their perspectives on the changing landscape of rheumatoid arthritis care, practice patterns, and professional development.
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Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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Smoking and the Global Burden of Rheumatoid Arthritis
Detailed analysis of the Global Burden of Disease (GBD) 2021 database shows that tobacco and smoking is one of the most significant environmental risk factors for Rheumatoid Arthritis (RA) over the last 20 years.
Biologic Switching in Psoriasis
A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay.
https://t.co/QEv5jx9AIo https://t.co/06keUfXwRT
Dr. John Cush RheumNow ( View Tweet)
There's a transient (1 yr) increase in New Abx Rx among 399 PsA pts after starting a TNF inhibitor. Pre-TNFi, PsA pts were more likely to recv Abx vs controls (1.26 vs. 0.60/yr; p<0.001). Post TNFi Abx use incr to 1.64/yr (p<0.001) but returned to baseline thereafter. https://t.co/LHXn5d7oC9
Dr. John Cush RheumNow ( View Tweet)
Prospective study 1,237 pregnant women (APS excluded) - finding LA-RVVT, anti-β2GPI IgG, predicted preeclampsia & intrauterine fetal death (IUFDR) and were were in identifying obstetric antiphospholipid syndrome (APS) https://t.co/5zKpR9NTcw https://t.co/6HXID7gtwR
Links:
Dr. John Cush RheumNow ( View Tweet)
Venous thromboembolism (VTE) risk goes up w/ age, obesity, estrogens; BUT a UK primary care database shows VTE risk signif higher in RA (n 23K) vs matched controls (n 94K): adj HR 1.46. Absolute VTE risk higher w/ age & BMI, but VTE higher in younger v older; normal vs. Hi BMI: https://t.co/htI2YqiF0c
Dr. John Cush RheumNow ( View Tweet)
French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
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/nz8F2lBwe5
Dr. John Cush RheumNow ( View Tweet)
Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
https://t.co/Hx1aAdiTOy https://t.co/gwyDweXIbS
Dr. John Cush RheumNow ( View Tweet)
Mid East/N African Survey on #SpA referrals.
- 190 Rheum responded (68% consultants, 53% tertiary,95% urban)
- 89% reported delay in axSpA presenting (most: Ortho, FP, internists)
- 2/3 Dx challenges
- > 60^ Pt non-adherence (side effects or Sx improvement) https://t.co/6jBdOqp2gM
Dr. John Cush RheumNow ( View Tweet)
Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/0BW4StS15N
Dr. John Cush RheumNow ( View Tweet)
Large metanalysis of TNFi use in immune-mediated inflammatory diseases (45 studies, 150K pts) shows no increased risk of de novo heart failure (HF), and no significant risk of HF worsening w/ TNFis. https://t.co/9sRVsMZ1kv https://t.co/igCdcQMVK3
Dr. John Cush RheumNow ( View Tweet)
Smoking and the Global Burden of Rheumatoid Arthritis
Detailed analysis of the Global Burden of Disease (GBD) 2021 database shows that tobacco and smoking is one of the most significant environmental risk factors for RA over the last 20 years.
https://t.co/4IDf1ZTl7w https://t.co/oM0bNXIw28
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 63 pts w/ Cryoglobulinemia (essential mixed [EM], CTD-related) vasculitis (CryoVas) in remission post RTX induction. W/ 58 mos F/U Relapse rates were 23%, 42%, 71% (@ 1yr, 2yrs, 5yrs). Relapse risk w/ purpura [HR 2.2] & prior CryoVas flare (HR 1.9). https://t.co/6zGgSN8Wfe
Dr. John Cush RheumNow ( View Tweet)
COVID Vaccine study in rheum pts on JAKi (n 22) or TNFi (n 16) Showing 50% response in JAKi and 81% w/ TNFi Rx. Pt PBMCs were stim by SAR-CoV2 spike proteins & CD4+ T cells IFNγ production as Pos. response. Do JAKi impair COVID-19 Vax responses? https://t.co/dZAktwrytf https://t.co/mjkBfcGcfD
Dr. John Cush RheumNow ( View Tweet)
Full read overview of Immune Checkpoint Inhibitors and their downside - immune related Adverse Events https://t.co/h1AzFaGVMz https://t.co/s75UdhE1HK
Dr. John Cush RheumNow ( View Tweet)
Japans IORRA study of 10,613 RA pts (2007-21) - 915 deaths from cancer (28%), lung Dz (22%), CV Dz (16%). Protective Rx were MTX and bDMARDs, while even low-dose glucocorticoids showed increased mortality risk. https://t.co/lV5WmC5l1X https://t.co/QncyqXSRE9
Dr. John Cush RheumNow ( View Tweet)
