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The Great Unknowns (8.5.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

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CV,risk,MI,heart,cardiac

Gout Flares Up Cardiac Risks

Jack Cush, MD

A large case-control study showed that gout patients who experienced a cardiovascular (CV) event were more likely to have had a recent (< 120 days) gout flare compared to those without CV events.

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Lungs ILD

Approach to ILD in Myositis Syndromes

Jack Cush, MD

Mehta et al have published a full read review of managing interstitial lung disease (ILD) in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk.

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Nintedinib’s Durable Efficacy in Systemic Sclerosis

MedPage Today

Patients with interstitial lung disease (ILD) related to systemic sclerosis continued to see less progression when treated with nintedanib (Ofev) in the pivotal 100-week SENSCIS trial, researchers said.

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2021,year

ICYMI: 2021 Rheumatology Year in Review

Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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What Worries You, Masters You (7.1.2022)

Jack Cush, MD

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.

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heart,cv,meds, events, CVD

HCQ for RA: Not a Great Idea?

MedPage Today

Hydroxychloroquine (HCQ) appeared less safe from a cardiovascular standpoint than methotrexate in older patients with rheumatoid arthritis (RA), analysis of Medicare data indicated.

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CV risk factors not equal when considering magnitude of risk

Janet Pope, MD, MPH, FRCPC

What can we learn from Oral Surveillance?



The Oral Surveillance trial has almost become a household word for rheumatologists.

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It's time to exonerate methotrexate in causing or exacerbating fibrotic interstitial lung disease in #RA patients https://t.co/AuEIWn8Pc4 https://t.co/razVTF6fFX

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Dr. John Cush RheumNow ( View Tweet)
450 axSpA pts followed 2868 Pt-yrs, 48% on TNFis. TNFi Rx pts had reduced CV risk (HR 0.30; 0.10–0.85), but no longer signif after adjustment for CRP, ESR (HR 0.37, 0.12–1.12, p = 0.077). Reduced CV risk, may not be specifically due to TNFi use https://t.co/mVHYn3PteL https://t.co/bgKWreBL8z

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Dr. John Cush RheumNow ( View Tweet)
CV risk factors not equal when considering magnitude of risk What can we learn from Oral Surveillance? The Oral Surveillance trial has almost become a household word for rheumatologists. https://t.co/LHZTVZh4AK https://t.co/2SlxrG7UpQ

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Dr. John Cush RheumNow ( View Tweet)
New biomarker for atherosclerosis, cardiovascular risk and disease activity in axSpA? Low Irisin associated with subclinical atherosclerosis, high CV risk and more severe disease activity in axSpA @RheumNow #EULAR2022 ABST#POS0327

Robert B Chao, MD doctorRBC ( View Tweet)

Redondo-Rodriguez et al. Abatacept in RA-ILD. Prospective study 38 patients. 73.6% improved/stablised with abatacept at median 17 month follow-up @RheumNow #EULAR2022 POS0654 https://t.co/D2du0hAXIy
Richard Conway RichardPAConway ( View Tweet)
Associations with RA-BR (n=57 cases) compared to RA-no lung disease controls (n=36) ⬆️⬆️⬆️RF level (OR 4.4) ⬆️⬆️ ACPA level (OR 3.5) ⬆️older age at RA onset (OR 1.37 per 10 years) ⬇️ BMI (OR 0.94 per kg/m2) (i.e., higher risk in underweight) 🚫 associations: sex, smoking pk-yrs

Jeffrey Sparks MD MMSc jeffsparks ( View Tweet)

Alsing et al. Dutch study. Persistent excess stroke risk in RA in biologic era. @RheumNow #EULAR2022 OP0277 https://t.co/oLmsrniKw6 https://t.co/2zDkuUzq0S

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Richard Conway RichardPAConway ( View Tweet)
Szekanecz et al. ORAL Surveillance. Geographic differences in MACE largely driven by history CVD and high baseline risk in North America and ROW. @RheumNow #EULAR2022 POS0110 https://t.co/cR6a7N2KP5
Richard Conway RichardPAConway ( View Tweet)
Was ORAL Surveillance really a surprise? Let's look post-hoc at all the other tofacitinib RCTs (ph 1-3b/4 +LTE) Cardiovascular risk-enriched pts were always in the same MACE ballpark with tofa ORAL Surveillance was worse, but clues were always there OP0264 #EULAR2022 @RheumNow https://t.co/rB5SwVX2oc
David Liew drdavidliew ( View Tweet)
#OP0251 #EULAR2022 Any data to support association of RA-ILD with poor #COVID outcomes? A study is US >500 pts (9% ILD) showed ILD as well as poor RA status (RF+ & erosion) increased risk. Detailed analysis inc Radiographic + PFT cd help stratify risk further @RheumNow https://t.co/E89dd38GQS
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
CTD associated ILD 🫁: lncRNA ENST00000604692 detected in PBMCs is associated with CTD-ILD and can distinguish SSc- ILD and RA-ILD vs. non ILD patients with AUC 0.79. As many lncRNA, unknown if biomarker only or has a pathogenic role. @RheumNow OP0114 #EULAR2022 https://t.co/sR4GmaMkXD
Aurelie Najm AurelieRheumo ( View Tweet)
Vadillo et al. Clinical course in IPAF (ping @leticiakawano ) . Most frequent females in 60s. Arthritis, raynauds most common features. Most NSIP. 50% PFT deterioration 16 months. UIP, baseline fibrosis, mod/high ANA titre assoc progression @RheumNow #EULAR2022 POS1427 https://t.co/qk9zK90Wuk
Richard Conway RichardPAConway ( View Tweet)
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