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Methotrexate

Consensus Guidelines on Pediatric Methotrexate Use

Jack Cush, MD

Methotrexate (MTX) is commonly used in the treatment of pediatric inflammatory skin conditions, often for off-label indications. Consensus based recommendations were published to address 5 major subjects.

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Linger on the Fingers (9.6.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.

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antibiotics,pills,capsules

Antibiotics May Increase Inflammatory Arthritis Risk

Jack Cush, MD

A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP). 

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All in the Family (8.23.2024)

Jack Cush, MD

Dr. Jack Cush picks highlight reports from the past week on RheumNow.com, with reports on the challenge of lupus nephritis, perplexing skin issues, you don't know JAK (about Tyk) and the value of a good family history.

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hudsonpsoriasis.jpg

Studies on Psoriatic Arthritis Prevention

Jack Cush, MD

Psoriatic arthritis (PsA) is a sequelae to chronic skin psoriasis. Whether cutaneous psoriasis is the pre-clinical phase of what may become PsA is oft debated and has been inadequately researched, largely using claims data or retrospective data sets.

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Higher Cancer Rates (8.16.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

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CV,risk,MI,heart,cardiac

Less Mortality with GLP-1 Agonists in Rheumatic Patients

Jack Cush, MD

A recent article in PLOS ONE has shown that treatment of type 2 diabetes with glucagon-like peptide-1 receptor agonists (GLP-1-RAs) was associated with a significant lowering of risk of all-cause mortality and major adverse cardiovascular events in patients with immune-mediated inflammatory diseases and type 2 diabetes.

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PsA: Switch or Cycle, the Eternal Question Dr. Aurelie Najm reports on abstracts POS0278 and POS0266 presented at Eular 2024 in Vienna, Austria. https://t.co/xP65pw5zCw https://t.co/T0nBO3HMIP

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Dr. John Cush RheumNow ( View Tweet)
A low risk of Candida infections with ixekizumab (IXE); integrated analysis of 25; Candida infx rates - PsO:1.9/100 PY (N  6892); PsA 2.0/100 PY (N 1401); axSpA 1.2/100PY (N 932). Most occured only once, were mild/moderate & were oral or genital Candida https://t.co/ZkkPoSzPMW https://t.co/VysnaQ8rpi

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Dr. John Cush RheumNow ( View Tweet)
Dactylitis is seen in 50% of PsA patients. Dactylitis is frequently associated with more severe PsA phenotype, often representing the initial feature of the disease. Many agents are effective but no b/tsDMARD is distinguished as being superior in dactylitis.… https://t.co/NKOXReiZYd https://t.co/Ake2fixZ40
Dr. John Cush RheumNow ( View Tweet)
"Vanishing Fingers" Acro-osteolysis in a patient with Scleroderma and renal failure and bilateral hand pain. Causes of AO include Scleroderma, PsA, hypertrophic osteoarthropathy, skeletal dysplasias, frostbite, Hyperparathyroidism, genetic disorders https://t.co/UwXcw3r6LD https://t.co/bnGiY0i0ot

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Dr. John Cush RheumNow ( View Tweet)
Causes of Carpal Tunnel Syndr: obesity, repetitive wrist movements, pregnancy, RA, PsA. but also Sjögren's syndrome, Behcet's disease and systemic sclerosis (weaker) https://t.co/ssrs8UJEpX

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Dr. John Cush RheumNow ( View Tweet)

Studies on Psoriatic Arthritis Prevention PsA is a sequelae to chronic skin psoriasis. Whether cutaneous psoriasis is the pre-clinical phase of what may become PsA is oft debated and has been inadequately researched. https://t.co/5ESROnS6xk https://t.co/8Yte7JESZf

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Dr. John Cush RheumNow ( View Tweet)
Tyk2 inhibitor/Zasocitinib (TAK-279) effective in Psoriasis. Ph II RDBPCT of 259 pts w/ mod- severe plaque PsO showed 12 week PASI 75 success in 68% & 67% on 15 - 30 mg zasocitinib qd vs Placebo (18%). https://t.co/yyZwBYAP3H https://t.co/TvSSlEAKtR

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Dr. John Cush RheumNow ( View Tweet)
Biologic Rx may be less effective in psoriasis pts who are older, smokers, w/ Hi BMI & prior biologic use. Metanalysis of 40 studies, 21 438 PSO pts, and PASI90 responses. Decr Response w/ age (OR 0.99), Biologics (0.44), BMI 30+ (0.57), smoking (0.81) https://t.co/uhFFIwNKB7 https://t.co/LaznQ0M9UG

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Dr. John Cush RheumNow ( View Tweet)
#Injection of PIP Mid joint capsule but above midline to avoid collateral ligament #ClinicalPearl #MedTwitter #MedEd #RheumX #RheumEd #MedX https://t.co/N9dBHB0rsf

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Janet Pope Janetbirdope ( View Tweet)
Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/GV6WjsqZBH https://t.co/9l9qyJpg3I

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Dr. John Cush RheumNow ( View Tweet)
355 PsA (n=279) & psoriasis (76) pts studied. PsA pts had more comorbidity vs PsO (43% v 26%). >70% low exercise level. Exercise signif improved DAPSA, TJC/SJC, ESR, PASI. Hi Mediterranean diet decr ESR, PASI, but signif only for enthesitis (p 0.015) https://t.co/mdruLj9h5a https://t.co/NOiwXju0wm

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Dr. John Cush RheumNow ( View Tweet)
Oral microbiota study (w/ 16S rRNA sequencing) of 72 severe psoriasis vs 16 controls. PsA pts had incr in Aggregatibacter & decr Prevotella. PsO pts had incr in Capnocytandophaga, Campylobacter & Acetobacter, but decr Bacteroides & Muribaculaceae https://t.co/ol947Afupt https://t.co/OknMRtJ4oT

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Dr. John Cush RheumNow ( View Tweet)
Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/5chrS3sW8i https://t.co/twSv4Zs9r3

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Dr. John Cush RheumNow ( View Tweet)
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