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Guselkumab, an IL-23 Inhibitor, Effective in Psoriatic Arthritis

Jack Cush, MD

The DISCOVER‐2 trial has shown that guselkumab, an interleukin‐23p19 was shown to be safe and effective in biologic‐naïve psoriatic arthritis (PsA) patients in a one year study.

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Romilkimab Effective in Early Diffuse Systemic Sclerosis

Jack Cush, MD

A phase II study of patients with early diffuse systemic sclerosis (SSc) has demonstrated improvement in SSc skin outcomes by targeting T cells and fibrosis with the bispecific monoclonal antibody romilkimab (RMK).

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Updated List of Drugs Inducing Lupus

Jack Cush, MD

Drugs inducing lupus may account for nearly 30% of all subacute cutaneous lupus erythematosus (CLE) and up to 15% of systemic lupus erythematosus (SLE) cases. Moreover there are over 100 drugs capable of inducing drug-induced lupus erythematosus.

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Comorbidities Impact Disease Activity in Spondyloarthritis

Jack Cush, MD

An analysis of a large population-based cohort of axial spondyloarthritis (axSpA) patients shows that comorbidities are common and are associated with higher disease activity and higher levels of functional impairment.

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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DLE discoid lupus

New Criteria for Discoid Lupus

Jack Cush, MD

JAMA Dermatology has proposed an initial validation of classification criteria for discoid lupus erythematosus (DLE), primarily for research purposes, but with clinical applicatility.

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Low Risk of COVID in Biologic Treated Rheum Patients

Jack Cush, MD

In an Annals of Rheumatic Disease report, Italian investigators performed consecutive testing for SARS-CoV-2 (IgM and IgG) between 25 March to 25 May 2020 and compared test results between rheumatic disease (RMD) patients and the general population. 

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Swedish population study of psoriasis pts Rx w/ secukinumab (848) or ustekinumab (1107) showed slightly more respiratory infx & UTI (HR 1.22), w/ no difference in hospital treated severe respiratory, UTI (HR 0.96) or candidiasis (HR 1.80) https://t.co/yIRubED6VX

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Dr. John Cush RheumNow ( View Tweet)

Meta-analysis shows smoking increases the risk of psoriasis (OR: 1.84) in the general population, but smoking the risk of PsA among psoriasis patients (OR: 0.70) but was equal to the general populatoin. https://t.co/4MkpkFQlqr

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up! Cardiovascular Risk in Psoriatic Disease, Higher COVID rates in young adults, Reimbursements for Rheumatologists and more. Watch here>> https://t.co/cBHTeUQhff or liste to podcast here> https://t.co/KBgmsoGRzU or on iTunes> https://t.co/FHJv01AAbC

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High-risk coronary plaques (LRNC) assessed by Coronary CT scores in 209 biologic naive Psoriasis pts. LNRC correlated w/ Framingham risk & Dz activity. After 1 year those on biologics had signif reduction in LRNC, but those not on biologics had no change https://t.co/8o74pjIs5n

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The EMAs Committee for Medicinal Products for Human Use (CHMP) has recommended baricitinib for approval in adults with moderate-to-severe atopic dermatitis who are candidates for systemic therapy https://t.co/goEacN1C8X

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Dr. John Cush RheumNow ( View Tweet)

Study of 211 SSc pts (70% with limited SSc) & during 120 (50-216) mos F/U, 105 (50%) had 1 or more skin ulcer (SU); 66% recurrent/persistent SUs. Being younger at Dx, articular involvement and telangiectasia were independently associated with SUs https://t.co/yLurnaft5X

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Dr. John Cush RheumNow ( View Tweet)

Successful treatment of refractory palmoplantar psoriasis in a psoriatic arthritis patient with the JAK inhibitor tofacitinib https://t.co/bdhppoUkmz

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Dr. John Cush RheumNow ( View Tweet)

Hong Kong study Myositis-specific autoantibodies in 201 pts with idiopathic inflammatory myopathies (IIM) shows MDA-5 (14%), TIFF-1γ (14%), Jo-(12.4%). MDA5 seen w/ DM, digital ulcers, amyopathy, ILD. TIF1γ was associ w/ refractory rash and cancer https://t.co/3E365F5SON

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Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #5: Its easier to see gouty Tophi and rheumatoid nodules than nail changes of PsA or subtle rashes. For Rashes and oral lesions its BEST to have the patient take multiple pix with the cell phone and send them in by EMR or Email.

Dr. John Cush RheumNow ( View Tweet)

Lenabasum (cannabinoid rcptr agonist) studied in Systemic Sclerosis - LEN (n=27) vs PBO (n=15). At wk 16 LEN had better responses by CRISS (skin) score (0.33, vs 0; P=0.07) w/ reduced gene expression for inflammation & fibrosis & improved skin histology https://t.co/oddSMvjnc9 https://t.co/HLFPNfigFD

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Dr. John Cush RheumNow ( View Tweet)
The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9

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Dr. John Cush RheumNow ( View Tweet)

Cross-sectional survey of 3200 PsA/Pso patients. 65% had both joint & skin involvement. Latter pts had worse QoL, work impairment, higher TJC (5.2) & SJC (4.8) (vs 2.0 & 1.5); more flares (35 vs. 23%, p < 0.001). Jts bigger burden (62%) vs skin (38%) https://t.co/mpmpF4LiLR

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 7 RCTs looked at melanoma risk comparing 34 029 biologic Tx vs 135 370 non-biologic conventional systemic Tx pts, showing no signif. increased risk in IBD (RR 1.20; 0.60-2.40), RA (pRR 1.20; 0.83-1.74), or psoriasis (HR 1.57; 0.61-4.09) https://t.co/PCOddiwKv0

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Dr. John Cush RheumNow ( View Tweet)

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