All News
JAK Inhibitors in Difficult Still’s Disease
A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.
Read Article
The Great Unknowns (8.5.2022)
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.
Read Article
Plasmacytoid Dendritic Cell Inhibitor in Cutaneous Lupus
Litifilimab, a humanized monoclonal antibody against BDCA2, targets the BDCA2 receptor on plasmacytoid dendritic cells.
https://t.co/nmadPUhlyH https://t.co/4UbNPMtxIh
Links:
Dr. John Cush RheumNow ( View Tweet)
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/IqKdvRkcgZ https://t.co/cieXqJABTL
Links:
Dr. John Cush RheumNow ( View Tweet)
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/av6fVqASme https://t.co/utHJ9oiyRq
Links:
Dr. John Cush RheumNow ( View Tweet)
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/7bGJ0ZCJJl https://t.co/GtuXdHj3Og
Links:
Dr. John Cush RheumNow ( View Tweet)
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/UwDf3UkuZI https://t.co/5l4xE1LaxA https://t.co/PpwiKYUpdN
Dr. John Cush RheumNow ( View Tweet)
#RA disease activity drives risk of hospitalized infections (SIE). Study of 3,254 RA pts w/ 529 hospitalized infx. SIE seen 3.8/100 person Yrs in remission, 6.6/100PY w/ low Dz activity & 8/100PY w/ moderate Dz activity. HR was 1.60 w/ LDA and 1.83 w/ MDA https://t.co/i4bSsnRiHk https://t.co/kcN9ZvpSOn
Links:
Dr. John Cush RheumNow ( View Tweet)
PsA Females: more likely to have Peripheral arthritis, have more pain, fatigue, poor function, lower QOL and less likely to have xray damage (than men)
Males: more axial dz & severe psoriasis
PsA Women may need more psychosocial support & pain management https://t.co/ZYWYu1K3jW https://t.co/xZX913vGdX
Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Still's (or Not): an FUO Evaluation
A young man with fever up to 104F, has a complex history.
Is this Still's disease or not?
https://t.co/k47Kz3onCn https://t.co/UVMaaU1uPO
Links:
Dr. John Cush RheumNow ( View Tweet)
521 clinically suspect arthralgia (CSA) pts were assessed - Low educational attainment was associated with increased risk of developing inflammatory arthritis (HR = 2.35), independent of BMI & smoking https://t.co/h1bXDfxaQk https://t.co/g2ign0HDmj
Links:
Dr. John Cush RheumNow ( View Tweet)
Evusheld works & reduces COVID-19 by 77%; yet only 25% of available Rx has been used. Its FREE to the ~7000 immunocompromised pts who might benefit from it. Repeat doses (300 mg) every 6 mos! Time to jump on this! https://t.co/BSi7EtJytf https://t.co/GafjXXZ2ny
Links:
Dr. John Cush RheumNow ( View Tweet)
Durkan's Carpal Tunnel Compression Test is more sensitive (0.71) than Tinel's (0.47), Phalen's test (0.50) to detect #carpaltunnelsyndrome. - @rheumnow #RheumGR https://t.co/05U1a0HR2q
UTSWRheum UTSWRheum ( View Tweet)
Oral surveillance - tofacitinib vs TNFi in high risk pts: more infections, serious infection (SIEs) & non-serious infx with Tofa vs TNFi. SIE risk 17%-48% higher; SIE higher w/ high dose Tofa, esp in pts aged≥65. Usual risk factors - age, pred, comorbid. https://t.co/gjD8xqtfgp https://t.co/doMd4E9ClL
Links:
Dr. John Cush RheumNow ( View Tweet)
Private insurance claims data suggests that in the last 5 yrs Lyme disease has increased 19% (urban) to 60% (rural areas). Prevalence highest in June & July. Top 5 states - NJ, Maine, VT, Rhode Island, Conn. https://t.co/QHnhiWLOk3 https://t.co/7fYWQe0nBh https://t.co/GYKekF4Enf
Dr. John Cush RheumNow ( View Tweet)
Biosimilar availability is slow coming in US (only RTX, Inflx), but by 2030 these rheumatologic biologics should be available as biosimilars:
- rituximab
- infliximab
- adalimumab
- etanercept
- golimumab
- abatacept
- tocilizumab
- ustekinumab
- denosumab
https://t.co/Jjy9xrk4PA https://t.co/4Ht7HSngHQ
Links:
Dr. John Cush RheumNow ( View Tweet)
Supplemental Vitamin D Fails to Lower Fracture Risk
NEJM has published study results showing that vitamin D3 supplementation does not significantly lower fracture risk (vs. placebo) when used in generally healthy adults.
https://t.co/tY1VY3hpM2 https://t.co/22FcdnvAjL
Links:
Dr. John Cush RheumNow ( View Tweet)
Study of Erythrocyte MTX-polyglutamates (MTX-PG1-5) levels in Crohns patients shows that age, lower GFR and subcutaneous #MTX use all significantly increase RBC MTX-polyglutamate levels (all risk factors for MTX toxicity) https://t.co/469eMqbCBC https://t.co/8LoarfIyV4
Links:
Dr. John Cush RheumNow ( View Tweet)
Gout Flares Up Cardiac Risks
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.
https://t.co/HVmHZ0Pi7I https://t.co/XhdLTed5mr
Links:
Dr. John Cush RheumNow ( View Tweet)
The Approach to Difficult to Treat Rheumatoid Arthritis
Tan and Buch have reviewed the approach to D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.
https://t.co/CfCvgbl3VP https://t.co/OKzyY79shU
Links:
Dr. John Cush RheumNow ( View Tweet)