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The Approach to Difficult to Treat Rheumatoid Arthritis

d Jack Cush, MD

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.

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hip,fracture3

Supplemental Vitamin D Fails to Lower Fracture Risk

d Jack Cush, MD

NEJM has published study results showing that vitamin D3 supplementation does not significantly lower fracture risk (vs. placebo) when used in generally healthy adults.

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knee,pain3,target

Krill Oil Effective in Knee Osteoarthritis

d Jack Cush, MD

Krill oil supplements in knee osteoarthritis (OA) was shown to be superior to placebo in reducing knee pain, stiffness and function while increasing the omega-3 index.

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DLE discoid lupus

Plasmacytoid Dendritic Cell Inhibitor in Cutaneous Lupus

d Jack Cush, MD

Litifilimab, a humanized monoclonal antibody against BDCA2, targets the BDCA2 receptor on plasmacytoid dendritic cells. When administered to patients with cutaneous lupus erythematosus (CLE) was shown reducing disease activity in CLE patients.

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LBP.red_.jpg

Upadacitinib in non-radiographic Axial Spondyloarthritis

d Jack Cush, MD

The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of non-radiographic axial spondyloarthritis (nr-AxSpA), extending the efficacy of UPA beyond classic ankylosing spondylitis.

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Upadacitinib in non-radiographic Axial Spondyloarthritis The janus kinase inhibitor, upadacitinib, has been shown to significantly improve the signs and symptoms of nr-AxSpA, extending the efficacy of UPA beyond classic ankylosing spondylitis. https://t.co/BbvOSRxbXU https://t.co/z5QOaFKrxz

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In the RECOVERY trial - 8156 hospitalized COVID-19 patients; those on baricitinib had significantly fewer deaths (12% vs 14% PBO) but the size of benefit was somewhat smaller than that suggested by previous trials. (adjusted rate ratio 0·87) https://t.co/EW7xLc9TLC https://t.co/Ahr7bwAQmJ

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Risk of incident & recurrent H.Zoster higher after tofacitinib - Korean claims analysis of 11,720 seropos. RA pts Rx w/ bDMARD or tofacitinib (2011-19). 14% got HZ. Compared to other biologics (ABA), Tofa incr HZ (HR 2.5) & recurrence (HR 3.69) https://t.co/lDuqdtkIjR https://t.co/zJ3ArS3gGs

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"He who has a strong enough why; can bear almost any how" - Friedrich Nietzsche https://t.co/BOpO9MMijR
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib (Rinvoq) Approved by European Commission for use in adults with active Non-Radiographic Axial Spondyloarthritis - 15 mg qd p.o. Approval based on Phase 3 SELECT-AXIS 2 nr-axSpA trial published in Lancet https://t.co/n3Pci5GyoA https://t.co/4aoSOc7xHd

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QD Clinic- Still's (or Not): Fever, Joint pain & Itchy Eyes 30 yr. woman with high fevers, itchy eyes and Still's manifestations for 6 weeks. Still's or Not? https://t.co/kbzhCxYp7H https://t.co/FEUzdXxHoW

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Dr. John Cush RheumNow ( View Tweet)
Not Still’s – Now What? Your patient doesn't meet criteria for Still’s disease (AOSD or sJIA), now what should you do or consider? https://t.co/xPXZVzTXJr https://t.co/7hmhXFh6O3

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Approach to ILD in Myositis Syndromes Mehta et al have published a full read review of managing ILD in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk. https://t.co/MLBGL2ZqTk https://t.co/cdO2nHAK6h

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Rheumatic Causes for Fever of Unknown Origin Fever of unknown origin (FUO) represents a diagnostic challenge to many physicians and while cancer and infectious causes need to be excluded, rheumatic disorders are amongst the most common causes of FUO. https://t.co/2tlibH3SHO https://t.co/QsmkfeGEvb

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Dr. John Cush RheumNow ( View Tweet)
Physician Assistant Salaries -Amer Academy of Physician Assoc 2022 Report Critical care $122,832 Emer Med $121,480 Surgery $121,400 Cardiology $118,000 Heme/Onc $117,297 Rheumatology $113,000 ID $113,000 GI $113,000 Pulm $112,900 PCP $112,000 https://t.co/14SafbtTGm https://t.co/1yuPI5pAYE

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The FDA has extended its indications for ustekinumab (Stelara) for use in pediatric psoriatic arthritis aged 6 years and older. Pediatric PsA makes up 6% of all pediatric inflammatory arthritis pts. https://t.co/vTM4x53n7k https://t.co/aQcuMury2k

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FDA has approved a topical PDE4 inhibitor Roflumilast (Zoryve) a 0.3% cream for use in Plaque Psoriasis (Age 12 and Older) https://t.co/qDuCgUwmZV https://t.co/c0a7723A1X https://t.co/v5T66iKnvc

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THe microbiome differs between #AS (n 33) and AS-IBD(59) compared to IBD (105) patients. Study comparing feces & intesting Bx. Microbiome composition correlated with BASDAI and faecal calprotectin (FCP) levels. https://t.co/D4QCVVDK7G https://t.co/OJkeisycg0

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Review of Clinical Trial measures in systemic sclerosis: -RCTs focus on skin dz, ILD or Pulm HTN using mod. Rodnan skin (MRSS), 6-min walk -FVC is surrogate measure for SSc-ILD - Composites: CRISS, the EUSTAR-AI -Future: Skin mRNA biomarkersTHBS1 and COMP https://t.co/KPLiNTSSZA https://t.co/YgvWuMiU4i

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Heterozygous deficiency of Aggrecan (proteoglycan w/in cartilage) gene: manifests as inherited short stature, early-onset osteoarthritis, degenerative disc disease, osteochondritis dissecans, increasing joint pathology over time https://t.co/dQERowhrba https://t.co/q7a38FGEzb https://t.co/TPQmnGPoDw

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