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50 active RA pts RCT Rx w. either low dose IL-2(n=26), IL-2+TCZ (9) or control (15). All improved clinically by DAS28-ESR, but IL-2 Rx pts had signif proliferation of Tregs, w. decr inTh1, Th2, & Th17 cells. TREG #s correlated w/ ESR drop (r=0.54) https://t.co/1tF63FuXzx https://t.co/M5TWsa6zI4
Dr. John Cush RheumNow ( View Tweet)
Single center retrospective 173 pts w/ CTD-ILD - 34% Sjogren’s, 30 RA, 25 systemic sclerosis, 6 UCTD, 3% idiopathic inflam myositis, 1,2% MCTD, 0.6% SLE. NSIP most common (60%) inSS & SSc; UIP more common in RA. 6 died, mostly infection https://t.co/IL2tnVDtoQ https://t.co/Ada49Qv5XL
Dr. John Cush RheumNow ( View Tweet)
Chikungunya arthritis Metanalysis & good full-read review - 8 studies showing chronic arthritis (CCA) in minority of infected;, polyarticular, looks like RA, few seropositive, few w/ erosions on imaging. CCA may be progressive w/ irreversible damage https://t.co/Da7bKtM6oC https://t.co/OGBbIiGAc5
Dr. John Cush RheumNow ( View Tweet)
CPPD in seronegative RA? Among 364 RA patients - 73% seropositive & 26% seronegative (n=96). Amongst latter, 18 pt (18.9%) met CPPD-disease criteria. CPPD+ pts were more likely to be older & have Hx of acute episodic arthritis https://t.co/XO0J6Adaa0 https://t.co/3ouUCPshoh
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Practice Metrics Use by Rheumatologists in RA. 54% of Rheums do "some" measure, Most used: HAQ 36%, RAPID3 27%, CDAI 18%, Vectra 13%. More than 35% do NOT measure
https://t.co/FOlyCSFF25 https://t.co/3S36tDlgcE
Dr. John Cush RheumNow ( View Tweet)
Canary in a Coal Mine (4.19.2024)
Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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RA-ILD at Higher Risk for Serious Infection and Death
A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.
https://t.co/cjmcNi0ZqL https://t.co/wUXNWNeyOa
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of hand/feet Xrays in early/suspected #RA due to low prevalence of erosions (4.4%) seldom leading to change in Dx (2pts; 0.3%) or prognosis change (0.4%). Seronegative had less erosions; Longer Sxs not assoc w/ erosions https://t.co/YCj04ZlQJq https://t.co/fHf6EvGOyc
Dr. John Cush RheumNow ( View Tweet)
RA-ILD at Higher Risk for Serious Infection and Death
A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.
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ICYMI: Top 5 Clinical Pearls in RA Management
https://t.co/zWRXzHTtIo https://t.co/rbitB9oWQG
Dr. John Cush RheumNow ( View Tweet)
Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
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Dr. John Cush RheumNow ( View Tweet)
Burnout or Retire (4.12.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?
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Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
Dr. John Cush RheumNow ( View Tweet)
World Congress on OP, OA & MSK Disorders
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EurekAlert!
Bone and musculoskeletal disease researchers and physicians from around the world will meet today in London, UK for the opening of the largest scientific event in the field, the World Congress on Osteoporosis, Osteoarthritis and Muscul
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In RA, previously affected Jts more likely to flare ("joint-specific memory") ?mediated by synovial resident memory T cells, predominantly CD8+ T cells, with a restricted TCR repertoire, responding to specific Ags by releasing chemokines & cytokines https://t.co/VfFZ03yZYL https://t.co/npX3TGDe5A
Dr. John Cush RheumNow ( View Tweet)
Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/tuIigaswDK https://t.co/DAh3lgRufA
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Dr. John Cush RheumNow ( View Tweet)
Expert Review
Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention
📰 https://t.co/JfkO8WpELc
#rheumatoidarthritis #prediction #prevention https://t.co/3xqHalhjCV
The Journal of Rheumatology jrheum ( View Tweet)
Expert Review
Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention
📰 https://t.co/JfkO8WpELc
#rheumatoidarthritis #prediction #prevention https://t.co/3xqHalhjCV
The Journal of Rheumatology jrheum ( View Tweet)
Staph. aureus bacteremia (SAB) is assoc w/ poor outcomes & Osteoarticular infection. Danish study of 18 274 SAB pt (367 w RA). 90d SAB risk in RA was 23% vs 12.5% in non-RA (HR 1.93). Higher w/ Jt implants (29%) & TNFi use (42%). 90d Mortality was 35% https://t.co/hjaPnTbE0E https://t.co/7t7omiUVYf
Dr. John Cush RheumNow ( View Tweet)
13 Risk Factors for RA-associated Interstitial Lung Disease (ILD)
ILD is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%.
https://t.co/x1YFv0ZlL9 https://t.co/XGeilz2tus
Dr. John Cush RheumNow ( View Tweet)