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PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis
The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA).
World Changers (3.14.2025)
Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).
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Increased Mortality In Arthritis Patients with COPD
EurekAlert!
People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study.
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Are Combination Biologics Safe?
Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
Single Center study of 112 RA pts from Morocco used machine learning (ML) logistic regression model & identified #Depression in 48% (HADS score >8) w/ 76.5% accuracy, 72.2% precision, 81.2% recall, and an area under the receiver operating characteristic curve (ROC AUC) of… https://t.co/LBvdVEzDGJ https://t.co/bYLqsFagbR
Dr. John Cush RheumNow ( View Tweet)
Japanese study of hip replacements (THA) - #RA pts undergoing THA at higher risk for dislocation and reoperation. Retrosp database study of THA - matching 3,951 RA vs 11,853 OA. w/ RA incr risk of dislocation (OR 2.8) & reoperation (OR: 2.25). No diff infx, Fx, VTE, death… https://t.co/Mz8niRlFaa https://t.co/mgcXTnw5Al
Dr. John Cush RheumNow ( View Tweet)
Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF
Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/aU8j4d6pei https://t.co/Ft99jwzPB3
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Available the first time: https://t.co/4UQlqwujiR 2025 On Demand!
On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else.
Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc
Links:
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Retrospective review of 781#RA pts; 78 Dx w/ILD (77 subclinical, most UIP on HRCT). w/ mean 10 yrs F/U, death rate was 1.5 vs. 7.1 per 100PY (without v with ILD) SMR equal betw RA & gen pop. but 2x higher in RA w/ ILD. Mortality higher w/ ILD (HR~3), age and low BMI… https://t.co/Vj0acewmK8 https://t.co/N1wHTjMfTr
Dr. John Cush RheumNow ( View Tweet)
Study of sarcopenia in 138 young adults with inflammatory arthritis (IA) found sarcopenia in ~47% of IA- Signif different between JIA, SpA, & RA. W/ multivariable analysis, predictors of sarcopenia included BMI (OR 0.84), BMD (OR 0.01), vit D (OR 0.96) & HAQ (OR 14.5)… https://t.co/JHKwF8icj1 https://t.co/ph3pVIYuXx
Dr. John Cush RheumNow ( View Tweet)
A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
Dr. John Cush RheumNow ( View Tweet)
Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA
Dr. John Cush RheumNow ( View Tweet)
Congratulations to Dr. Mehmet Hocaoglu (University of Pittsburgh) on being awarded a 2024 Rheumatoid Arthritis Research Program grant to investigate the unique and shared risk factors between patients with preclinical rheumatoid arthritis and patients with RA.… https://t.co/eF4yb3Hxsj https://t.co/MLNWKFiCiU
Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/3Y2cOzt3TQ https://t.co/6f8yiwMqAa
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush RheumNow ( View Tweet)
DANBIO registry study - 21 982 Rx Starts, 96 475 PYs & 1423 cancers identified. Overall cancer risk w/in tocilizumab/sarilumab, abatacept or rituximab were not signif increased (HRs ranged from 0.7 to 1.1) compared with TNFi & with bDMARD-naïve real world RA pts… https://t.co/fPLFlWoQsw https://t.co/4KlGnjfNKm
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BMS announced new data from Phase 3 POETYK PsA-2 trial - Sotyktu (deucravacitinib)vs apremilast vs PBO in PsA w/ higher ACR20 vs PBO at Week 16 (54% vs 39%). AEs led to discontinuation in 1.3% (PBO), 2.2% (Deuc) and 10.5% (apremilast). https://t.co/NAa2JigkZN https://t.co/mvaQXfjShd
Dr. John Cush RheumNow ( View Tweet)
Polypharmacy (>=5Rx) studied in 81 RA & 30 SLE pts. Polypharmacy incr at 2 yrs ~44% to ~73%. Med adherence >85%. Polypharmacy NOT assoc w/ Dz activity in SLE, but in RA did correlate w/ better DAS28CRP score at one year https://t.co/Jw05DIrBym https://t.co/pLIoDvPj8i
Dr. John Cush RheumNow ( View Tweet)
