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In studies were glucocorticoids(GC) are used as initial bridging Rx, the odds of continuing GC 1 mo beyond expected end of GC bridging was 18% (decreasing to 7% from 6-18 mos). Initial higher doses & longer GC bridging assoc w/ higher cumulative GC doses https://t.co/6iyNVzxt1K https://t.co/TmecyFg2vB
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Dr. John Cush RheumNow ( View Tweet)
10 yr study of 390 RA pts, of whom 160 (41%) had MTX-related gastrointestinal intolerance (GIS); meaning they D/C MTX and had EGD - H. pylori was significantly higher inMTX GIS pts; such pts had 3 fold higher odds of Rx w/ biologics or JAKi's https://t.co/RvrUErHyWe https://t.co/ea8Kq42oqW
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Dr. John Cush RheumNow ( View Tweet)
THIS WEEKEND! Join us at RheumNow Live and hear from our keynote speaker, Miracle Larry.
Larry will share his story of surviving COVID-19 in March 2020 and becoming known as New York City's 'Miracle Larry.
https://t.co/WkB6RWZoDM https://t.co/ddBDXMR0tY
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Dr. John Cush RheumNow ( View Tweet)
Big Time Vasculitis
Dr. Jack Cush reviews articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers - does aggressive biologic treatment of psoriasis prevent future PsA?
https://t.co/hDClGPOYYO https://t.co/J2hsFZAGOr
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Dr. John Cush RheumNow ( View Tweet)
Annually acetaminophen is responsible for 112 000 US poison center calls, 59000 emergency department visits, and 38000 hospitalizations. Of more concern, it is the leading cause of acute liver failure in the US and other high-income countries https://t.co/5AtQAD1dKu https://t.co/ntZ8dD1srz
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Dr. John Cush RheumNow ( View Tweet)
Does Methotrexate Work in Alopecia Universalis?
Alopecia areata totalis (AT) and universalis (AU) are the most severe and difficult to treat forms of alopecia areata (AA).
https://t.co/Lvd7P6r85w https://t.co/hX3rz5fBKT
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Dr. John Cush RheumNow ( View Tweet)
NEJM Case: 44 yoF w/ 1wk hx of pustular rash, 1st on face, then legs. Also has ankle pain & odynophagia. PMHx oral ulcers. Exam: Aphthous ulcers & all labs were negative (ANA, ANCA, HIV, RPR, etc). Skin Bx= small-vessel vasculitis. What Dx? https://t.co/4Zw4xXxaAL https://t.co/GM3Yq70tWq
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Dr. John Cush RheumNow ( View Tweet)
GCA patients with AORTITIS proven by CTA or FDG-PET/CT have higher rates of relapse. Among 82 GCA pts, 78% positive on both CTA & PET. Relapse was seen in 70% in the CTA+/PET+ group & 29% in the CTA-/PET+ (p = 0.019). https://t.co/2zU9ueWkEZ https://t.co/aFn2xH6KmI
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Dr. John Cush RheumNow ( View Tweet)
Renal Involvement is Pivotal in ANCA-Associated Vasculitis
Researchers have identified four different trajectories of kidney function over time in AAV patients, with implications for personalized treatment, as well as future research.
https://t.co/JfIWmpkNiS https://t.co/72jRAVxj13
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Dr. John Cush RheumNow ( View Tweet)
Systemic sclerosis current therapy:
- early dcSSc: MMF, CTX, RTX, TCZ
- rapidly progressive dcSSc - ?Stem cell transpl?
- SSc-ILD: MMF>CTX, possibly nintedanib, perfinidone
- Raynauds w/ digital ulcers: CA channel block, PDE5 inhib, iloprost, Bosentan https://t.co/z4OzFklrcl https://t.co/bM01inV2QY
Dr. John Cush RheumNow ( View Tweet)
Long-Term Benefit of Rituximab in Systemic Sclerosis
A small cohort trial of rituximab (RTX) in 29 systemic sclerosis patients showed significantly improved skin sclerosis and lung function after a follow-up of 96 weeks.
https://t.co/qrtv9eK1Oz https://t.co/GdOyaCIPUA
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Dr. John Cush RheumNow ( View Tweet)
Serum beta-2 microglobulin (B2M) in 100 #SLE pts - strong correlations betw B2M & 24 hr urinary protein, BUN, creatinine, disease activity, & damage score (p < 0.001), & negatively correlated with GFR, C3, C4 (p < 0.001). B2M predicted lupus LN https://t.co/wXCs0WlIYv https://t.co/vZPWtnqIta
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 3 RCTs & 19 observational studies, showed hematopoietic stem cell transplantation . (HSCT) significantly improved skin thickness and lung function. While HSCT had more deaths than IV CTX, HSCT had higher 2 yr survival rate https://t.co/FMWFfmYPod https://t.co/SFjlj1yV0x
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis shows Takayasu's arteritis pts are at higher risk of adverse pregnancy outcomes. (27 studies, 825 pregs) showed more miscarriage (16%), hypertension (37%) and pre-eclampsia (14%) in TA patients (p < 0.01) https://t.co/stVx5jvPsj https://t.co/LaftdsHmSz
Dr. John Cush RheumNow ( View Tweet)
Does Methotrexate Work in Alopecia Universalis?
Alopecia areata totalis (AT) and universalis (AU) are the most severe and difficult to treat forms of alopecia areata (AA).
https://t.co/x8EjMekMBJ https://t.co/ntejSJcG5M
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Dr. John Cush RheumNow ( View Tweet)
CDC says EVERYONE should be tested for Hepatitis B al least once, w/ 3 lab - HBsAg, & Abs to hepatitis B surface Ag (anti-HBs), hep B core Ag (anti-HBc). At increased risk for HBV - persons in jail, +Hx of STDs, multiple sex partners or Hx of hepatitis C https://t.co/DRzAuhVJSJ https://t.co/9ma0I61xeD
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Dr. John Cush RheumNow ( View Tweet)
Population study from Japan shows that Aging is an independent contributor for seronegative RA in patients who are female, have a nonsmoking history, and a BMI < 25. https://t.co/WWRGczmc4K https://t.co/ZHRIHlxDIK
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Dr. John Cush RheumNow ( View Tweet)
1215 pts w/ refractory SJS/TEN (not responding to pulse steroids x 3d) compared subsequent plasmapheresis- vs IVIG treated patietns and shows similar mortality rates(18.3% vs 19.5%), but apheresis had more stays (45 vs 32 d) & cost ($34k vs $23k) https://t.co/QTnbPzf6Jd https://t.co/EgI2ueIhdz
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Dr. John Cush RheumNow ( View Tweet)
Registration is still open! Join us at RheumNow Live on 3/18 and 3/19. We have a great agenda lined up including a panel on Rheumatoid Arthritis: Revolutionary Advances in Therapy.
https://t.co/duAfKSDi1O https://t.co/JkbHa6b2Fg
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Dr. John Cush RheumNow ( View Tweet)
NEJM Case: 44 yoF w/ 1wk hx of pustular rash, 1st on face, then legs. Also has ankle pain & odynophagia. PMHx oral ulcers. Exam: Aphthous ulcers & all labs were negative (ANA, ANCA, HIV, RPR, etc). Skin Bx= small-vessel vasculitis. What Dx? https://t.co/gxjXRaRKzq https://t.co/OYmC4om6hi
Links:
Dr. John Cush RheumNow ( View Tweet)