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Best of 2022: Allopurinol Safety in CKD Patients
A study in the Annals of Internal Medicine reports chronic kidney disease (CKD) patients can be safely treated with allopurinol without an increased risk of mortality.
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FDG-PET Scan in RA? Study of 34 #RA pts shows PET uptake (SUV scores) measures were significantly correlated with the number of swollen joints, SDAID but not the CDAI, disease duration, seropositivity, or RA treatments. https://t.co/AkGhEiNqwt https://t.co/FkKh49KYyd
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Dr. John Cush RheumNow ( View Tweet)
10% of PsA is PsA Sine Psoriasis - how to differentiate from seroneg RA? PsA sine PsO pts have peripheral arthritis, no skin dz, but may have axial sxs, +Family Hx or nail psoriasis, dactylitis, enthesitis, DIP involvement. https://t.co/BeYOq8ysgW https://t.co/pLogz1HHTV
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IL-18 is a proinflammatory cytokine involved in innate & adaptive immune responses. IL-18 is a key mediator in autoinflammatory diseases, MAS, Still’s disease. Serum IL-18 levels may be useful in diagnosis and monitoring of disease activity https://t.co/1SXlODZcXc https://t.co/xtauaMMMos
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Dr. John Cush RheumNow ( View Tweet)
Does Methotrexate Use Lead to Melanoma?
A systematic review suggests that low-dose methotrexate (MTX) use is associated with an increased melanoma risk, but the absolute risk increase could be considered negligible.
https://t.co/dChsIsCAMt https://t.co/5PgjlunTmp
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Dr. John Cush RheumNow ( View Tweet)
Drugs causing Scleroderma (DASSc) - Anticancer rx made up 42% DASSc & 62.3% case reports. Included: taxane-based agents, bleomycin, vinblastine, imatinib, dacarbazine, pembrolizumab pemetrexed; also HRT romiplostim & eculizumab https://t.co/jPNIuaYdnJ https://t.co/efZG5kG2Yd
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Dr. John Cush RheumNow ( View Tweet)
2 open-label reports of JAK inhibitors in Systemic sclerosis (SSc) - 59 SSc pts: significant decr in mRSS in 88%. 28/29 w/ ILD had no progression. Overall responses better in treatment naïve SSc patients. 20% had side-effects. More studies needed https://t.co/zjxZtTFnlS https://t.co/XTwip2wv1n
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Dr. John Cush RheumNow ( View Tweet)
Rituximab Efficacy in Systemic Sclerosis
The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.
https://t.co/cqlVo104Y9 https://t.co/dYgBsj65BJ
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AVOID THE WEEKEND! Study of high-impact rheumatology journals (Rheumatology, J Rheum, & Seminars A&R) shows higher risk of "desk rejections" by editor (avoiding peer review) for manuscripts submitted Saturday (OR 1.23) or Sunday (OR 1.13) https://t.co/rWIkiYgh8Y https://t.co/kPSJmfWSUl
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Treatment of pyoderma gangrenosum is clinically empiric. Full read ref w/ Graded Rx Recommendations:
- 1st line: Steriods or Cyclosporin
- Consider biologics: TNFi, IL-1, IL-12/23, IL-17, IL-23
- Others: MTX, MMF, AZA, Dap, colchic, thalidomide, IVIG
https://t.co/z0XeT0ja45 https://t.co/fWAcryIDJR
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Dr. John Cush RheumNow ( View Tweet)
Women Heroes in Rheum:
- Barbara Ansell - JIA
- Nanna Svartz - SSZ
- Gertrude Elion - Nobel Prize for allopurinol, AZA
- Tsai-Fan Yu - gout Rx
- Mary Betty Stevens - lupus & vasculitis
- Marian Ropes - 1st F ARA president
- Fionula Brennan - TNFi
& more
https://t.co/FDRORJ7c1q https://t.co/ZebVagIyQA
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Dr. John Cush RheumNow ( View Tweet)
Best of 2022: Was this a Mistake? HCQ Dose Reductions per AAOS Guidelines
https://t.co/Swf5kq6VtG https://t.co/UTIaCFpAX6
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Dr. John Cush RheumNow ( View Tweet)
Good review of Diagnosis and Treatment of Pulmonary Sarcoidosis in JAMA.
- Lung progression (in only 10%) assoc w/ 12-18% 5yr mortality
- Sx Sarcoid w/ Lung: start Pred 20 to 40 mg/d for 2 -6 wks
- Steroid sparing w/ MTX, AZA or TNFi
https://t.co/aVnUXaj0sj https://t.co/JN142hlR6g
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Dr. John Cush RheumNow ( View Tweet)
Approximately 61% of patients with rheumatoid arthritis or psoriatic arthritis who use methotrexate report side effects following weekly dosing, including fatigue and nausea, according to data published in Rheumatology and Therapy https://t.co/k7hhdbIhW1 https://t.co/GiaihMGnWK
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Dr. John Cush RheumNow ( View Tweet)
Full read review of advances in bone biology leading to drug development (denosumab, romosuzumab, Burosumab), advances in Pagets and rickets and key regulatory molecules for bone remodeling, RANK, RANKL, OPG, & sclerostin https://t.co/1d6A6MsdbJ https://t.co/IuKEp1PQtr
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Dr. John Cush RheumNow ( View Tweet)
Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis
https://t.co/S7OR6zXTiw https://t.co/Mgy4IcoIZj
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Dr. John Cush RheumNow ( View Tweet)
JAMA - Update/Review of Hemochromatosis Dx and Rx.
- 5 gene defects in hepcidin. 95% HFE & the C282Y variant
- 90% are asymptomatic
- Suspicion w/ arthralgias, LFTs, hepatomegaly, cardiomyopathy, 1st degr relative
- Untreated, 9% risk of cirrhosis
https://t.co/LWbIbLITK9 https://t.co/xDpA16K0tm
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Dr. John Cush RheumNow ( View Tweet)
Hyaluronic Acid Knee Injections Equivalent to Placebo
In the United States, where over $300 million is spent annually on intraarticular hyaluronic acid injections, yet another study shows such therapy to be no better than placebo.
https://t.co/bBEwpId84L https://t.co/5msGqViTpz
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Dr. John Cush RheumNow ( View Tweet)
Drug-Induced Lupus from Proton Pump Inhibitors
A wide range of therapies have been implicated in causing drug-induced lupus erythematosus (DIL); now it appears that proton pump inhibitors (PPIs) can be added to the list of causative drugs.
https://t.co/Jp3oNUhP6c https://t.co/AcC4mM0nLM
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Dr. John Cush RheumNow ( View Tweet)
Effect of Intraarticular Steroid Shots on Knee OA Outcomes
In patients with osteoarthritis of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.
https://t.co/yqVHPmqzzi https://t.co/k8dMADHg7P
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Dr. John Cush RheumNow ( View Tweet)