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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 non-radiographic axial spondyloarthritis (nr-AxSpA), extending the efficacy of UPA beyond classic ankylosing spondylitis.
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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?
What you do or consider next can be addressed according to the stage of current disease: A) Hospitalized Febrile Disease, or B) Outpatient “Still’s” Disease.
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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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/vTM4x53n7k https://t.co/aQcuMury2k
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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/qDuCgUwmZV https://t.co/c0a7723A1X https://t.co/v5T66iKnvc
Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
Belimumab (Benlysta) has been FDA approved for use in pediatric patients with active lupus nephritis who are receiving standard lupus therapy. The approval in kids is for the IV formulation only; SC belimumab is for SLE and LN in adults https://t.co/TKyNDwIUQH https://t.co/6VaMOMfwYi
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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of cardiovascular effects of Colchicine: 21 RCTs (15,569 pts shows colchicine was superior to placebo reducing CV events; with lower risk recurrent pericarditis (RR 0.50), MACE (RR 0.67), & AFib recurrence (RR 0.68) https://t.co/hksDaCSj02 https://t.co/eGRVqZiBBx
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Dr. John Cush RheumNow ( View Tweet)
Nintedinib’s Durable Efficacy in Systemic Sclerosis
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.
https://t.co/5M92Yhpeo1 https://t.co/qZvwfLs1jx
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Dr. John Cush RheumNow ( View Tweet)
EMA in Europe has approved Rinvoq (upadacitinib 45 mg and 15 mg and 30 mg) for the treatment of adult patients with moderately to severely active ulcerative colitis who are DMARD-IR or biologic-IR. Based on 3 phase III trials. https://t.co/CbRQGzxJEr https://t.co/SlJNprUay3
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Dr. John Cush RheumNow ( View Tweet)
New podcast—Dr.Cush answers your questions!
https://t.co/cif6yo0tGi https://t.co/kia5J0OMf6
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Dr. John Cush RheumNow ( View Tweet)
Japanese SLE registry looked at infection risk with Prednisolone (PSL). Among 509 SLE pts (47 yrs); 77% used immunosuppressants & 52 had hospitalized infxns. Signif higher SIE w/ PSL 5.0–7.5 mg (aHR 6.8) & PSL 7.6-15 mg (aHR 7.6) vs 0-2.5 mg/d https://t.co/xZ5Yx4X1uw https://t.co/FSfsTENeUx
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Dr. John Cush RheumNow ( View Tweet)
Study of 245 active SLE pts followed x 2 yrs shows low disease activity (LLDAS) achieved in 63%. By multivariate analysis, negative predictors of LLDAS were nephritis, heme involvement & low C3/C4. Early LLDAS predicted future LLDAS-50 https://t.co/IQaDFRtrZy https://t.co/G6MdBOMftX
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Dr. John Cush RheumNow ( View Tweet)
TNR: Still's Now Journal Club - Pivotal Trials in SJIA & AOSD Approved Meds
This week's Stills disease Journal Club features expert panelists Drs. Olga Petryna, Daniel Lovell, Hermine Brunner and Jack Cush.
https://t.co/2TCtByJg4Q https://t.co/arqQUQJNNC
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Dr. John Cush RheumNow ( View Tweet)
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/JXcp2k6hJ1 https://t.co/5i97sKde8n
Links:
Dr. John Cush RheumNow ( View Tweet)
I had the chance to discuss intrinsic protection from Covid with my friend @ASlavitt
https://t.co/dI993XBoXr https://t.co/lidQnzgjJg
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Eric Topol EricTopol ( View Tweet)
Have the trends started to change in awards for more junior people in rheumatology? https://t.co/0UC9BvXfsY
Rheum Cat rheum_cat ( View Tweet)