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Osteoarthritis Risky Business (4.18.2025)
Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com. Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.
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Predictors of Developing RA
A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing rheumatoid arthritis (RA).
EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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RA Prevention through Deep Immunophenotyping
Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA).
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ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain
The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.
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Obesity is a risk factor for not achieving remission in early #RA (ERA), independent of comorbidity. 1285 ERA RA pts; remission failure @6 mos = 64% w/ obese, 52% if overWt & 48% if NL wt. RR 1.33 w/ no change after adjusting for RF/CCP, education, EtOH, smoking, phys activity, https://t.co/341ba1rCSk
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Predictors of Developing RA
A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing RA. These studies underscore the influence of https://t.co/wpSHDfwCL7
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Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/nw8FfWyM8A
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AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/u8abvqNtnX
Dr. John Cush RheumNow ( View Tweet)
Systematic review of >90 studies on Pregnancy and RA risk indicates that parity, gravidity, infertility, pregnancy loss do not adversely affect RA development. But low birthweight was assoc w/ RA Dx/severity, and pre-eclampsia incr risk of subsequent RA Dx. https://t.co/jVa4tmSqvj
Dr. John Cush RheumNow ( View Tweet)
AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/EWwpvrduJz
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2nd Opinions in Rheumatology
https://t.co/R4CjJHEaL4 https://t.co/0quDwdANyU
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RA Prevention through Deep Immunophenotyping
Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for RA. They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to https://t.co/AEo0GOr7Kn
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KORAIL (Korean RA-ILD) prospective cohort study of CT and biomarkers showed 35% ILD progressed over 3 yrs. Higher baseline KL-6 (HR 1.37) & hSP-D (1.51) levels assoc w/ progression. Increasing KL-6 at 1 yr showed the greatest progression (∆KL-6: HR 2.0) https://t.co/efowyCp1qu https://t.co/JVd7sRKzVF
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Does DMARD Rx affect neurocognitive function in older pts? bDMARDs targeting TNF-α & IL-6 may mitigate neuroinflammation & preserve cognitive function. But, cognitive impact of csDMARDs (MTX) is complex, w/ conflicting reports on its role in vascular dementia. https://t.co/u3kSKHRvpI
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Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/Tx7LO59RbP
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NORD-STAR RCT: Rx -naïve pts w/ early #RA found triple (MSH) Rx w/ prn IA steroid injx was superior to MTX + Pred (w/ taper) - w/ better clinical outcomes, fewer withdrawals, fewer AEs, & less steroid use BUT slightly worse Xray outcomes https://t.co/YN6Om2xdIP https://t.co/a7G8WFZSK7
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Dr. John Cush RheumNow ( View Tweet)
JAK-pot Collaboration of 15 registries looked at MACE risk in RA pts and found NO incr CV risk during 1st 2 yrs of JAKi (vs TNFi) use. 51233 pts; 828 incident MACE; in 73008 Rx courses (16K JAKi, 35K TNFi, & 21K OMA bDMARDs). JAK adj IRR: 0.89;0.63 to 1.25 (vs TNFi); bDMARD-OMA https://t.co/MAZrGfCNrU
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French REGATE registry study examined RA pts (n 1496) & Safety of tocilizumab (exposure 3991 PYs). 63 (4.2%) developed 75 cancers (35 solid, 11 Heme, 3 melanomas, 26 NMSC). CA incidence rate (excluding NMSC) was 7.5 /1000 PY. Independ Risk factors for solid CA = age (HR=1.05), https://t.co/3q8HIPa6qf
Dr. John Cush RheumNow ( View Tweet)
Matched cohort study of 83,811 #RA pts showed RA had a 12% increased risk of avoidable hospitalizations (CHF, pulmonary edema; (IRR 1.12). Predictors of ACSC hosp. were age, Steroids, ambulatory comorbid Dxs. ambulatory care access & ^ primary care may reduce this risk. https://t.co/AxQVoXoxxx
Dr. John Cush RheumNow ( View Tweet)
