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Washington Post: Case of Delayed Rheum Diagnosis
The Washington Post recently published a "medical mystery" case titled, "Medical Mysteries: A rolled ankle set this runner down a painful path", which tells the tale of how and why rheumatologists are often not consulted or are consulted too late.
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Top 10 Pharma R&D Budgets in 2023
Pharma budgets have undergone significant changes coming out of COVID. This year Merck & Co. has knocked Roche from previous years of leading in research and development (R&D) budgets and investments.
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Insights on Postinfectious ME/CFS
The medical community is challenged by myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS - its origins, pathogenesis outcomes and treatment. JAMA has reviewed a recent Nature paper wherein an NIH led team of multidisciplinary experts performed an inpatient study of postinfe
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Ides of March (3.15.2024)
Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.
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Biden signs executive order on womens health research ($200 million to NIH interdisc. women res), focus on:
- integrate Women’s Health Across Federal Research prgs
- fund Research on Women’s Midlife Health
- double funding Office Womens Health Research
https://t.co/NKtI5iFKeb https://t.co/G5T0YEdEkO
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Dr. John Cush RheumNow ( View Tweet)
Ides of March (3.15.2024)
Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.
https://t.co/s87j9fXQNA https://t.co/QNDXweNAvp
Dr. John Cush RheumNow ( View Tweet)
4873 gout pts w/ High SUA renally typed: UA overproduct. (ROA 9%); underexcreter (RUE 61%); combined (23%) or normal (7%)
ROL: older, lower SUA, tophi & DM
RUE: lower BMI, No DM
Combined: younger, HighBMI/SUA/eGFR & smoking
Normal: older, Low SUA/eGFR https://t.co/9u0Lujlkqf https://t.co/gVOvwd54Z1
Dr. John Cush RheumNow ( View Tweet)
UAB study shows the US adult rheumatology workforce grew clinically active adult rheumatology workforce grew 23% betw 2009-2020; including a 43% increase in women. Number of Rheums (5,667) grew 23% and APPs (379) grew 141%. https://t.co/sVPoNIUZUu https://t.co/4myGYaUtcd
Dr. John Cush RheumNow ( View Tweet)
US Trends in RA DMARD Use 2017-2021
A trend analysis of disease-modifying anti-rheumatic drugs (DMARDs) shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use.
https://t.co/vQmVyAjIaL https://t.co/tSJ4H5XtnU
Dr. John Cush RheumNow ( View Tweet)
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children
MIS-C is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.
https://t.co/PN2MPQxqSR https://t.co/eIzB4pjner
Dr. John Cush RheumNow ( View Tweet)
In RA, NO selective response with Seropositivity. Study of 28 eligible RCTs shows pts Rx w/ cs- or bDMARD that seropositivity did not predict better bDMARD response (ACR20 RRR ~1). Comparable resp in RF+ & RF- w/ TNFi or non-TNFi bDMARDs. https://t.co/AUWPgkzayt https://t.co/om9AYhNsQ9
Dr. John Cush RheumNow ( View Tweet)
9 Facts about Leflunomide
Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui.
https://t.co/X9lyrOs3D7 https://t.co/TGh2LnGdJ8
Dr. John Cush RheumNow ( View Tweet)
Retro study 109 oligoarticular JIA pts (~8 yrs) Rx w/ intraarticular steroids w/ 4.3 yrs F/U: 38% needed no Rx, 15.5% needed more IAS; 46% systemic Rx(MTX; 8 mos) &22% biologics(2.2 yrs later). @FUV 89% were inactive. Persistence predicted by ANA+ & B27+ https://t.co/5YLkYyA84l https://t.co/wClhEiKOIw
Dr. John Cush RheumNow ( View Tweet)
Japanese study of 672 autoimmune pts on TNFi & tocilizumab - 1.6% (n=9) developed non-tuberculous Mycobacteria (NTM) infx post biologics. 2 disseminated NTM, 2 died. NTM pts had higher mortality [(22% vs 2.6%) & took more steroid (17 vs 3 mg, P=0.004).https://t.co/fGGafrTeiL https://t.co/DkmiC2hVEA
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Dr. John Cush RheumNow ( View Tweet)
JAMA Review of DMARD Use in Rheumatoid Arthritis
JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs".
https://t.co/fpAigPpKzv https://t.co/GkbqW2BxpA
Dr. John Cush RheumNow ( View Tweet)
JAK-pot: 46913 Rx courses on JAKi, TNFi, other MOA. Rx D/Cs for AEs:
- TNFi = JAKi (HR 1.0)
- Other MOA > JAKi (HR 1.11)
- TNFi < tofacitinib (0.81)
- TNFi > baricitinib (1.15)
- TNFi < JAKi; if >65yrs w/ CV risk (0.79) https://t.co/jCtLG3SNvP https://t.co/FN5U5Z1M9M
Dr. John Cush RheumNow ( View Tweet)
Effective Treatments for Still's Disease
A systematic review of pharmacological treatments for adult-onset Still disease (AOSD) supports the efficacy of tocilizumab (TCZ), anakinra (ANK), and canakinumab (CNK).
https://t.co/r7RGD5WlvO https://t.co/Jfq7zPR0ci
Dr. John Cush RheumNow ( View Tweet)
JAK inhibitors maybe an option in refractory Juvenile Dermatomyositis. Metanalysis of 26 reports (195 pts) JDM Rx w/ JAKi (median 5 rys); most Rx w/ tofacitinib (57%), ruxolitinib(27%), baricitinib (15%), w/ Improvement in 90%, 69%, 93%, respectively. https://t.co/tfISYVtwUN https://t.co/zv88Vdy6c0
Dr. John Cush RheumNow ( View Tweet)
Again, a High Mortality with Depression and RA
Last week we reported on a Korean study showing a 66% elevated mortality risk in RA patients with depression. This week, a new report shows depression in RA increases the mortality risk by more than 5 fold.
https://t.co/C7Z7djny4S https://t.co/J9B6DUqcIC
Dr. John Cush RheumNow ( View Tweet)
Study 1189 males athletes sanctioned for doping with Androgenic anabolic steroids compared to 59 450 controls. Anabolic steroids signifi. increased the mortality risk (HR 2.81) from both unnatural (accidents) & natural causes (CVD, etc) https://t.co/XJr1oUw1gM https://t.co/YIQhdCXd2y
Dr. John Cush RheumNow ( View Tweet)
