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Rituximab Induction and Maintenance in Older ANCA–Associated Vasculitis Patients

d Jack Cush, MD

A cohort study suggests that rituximab (RTX) use among patients 75 years and older with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is efficacious but also has a high risk of serious adverse events, likely related to associated steroid use and the advanced age of the po

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Viscosupplementation Ineffective in Knee Osteoarthritis

d Jack Cush, MD

The BMJ has published the results of a metanalysis showing strong conclusive evidence that viscosupplementation in knee osteoarthritis (kOA) has minimal effects on kOA pain, and also reveals strong evidence of an increased risk of serious adverse events. 

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Achilles,ankle,heel

Steroid Injection for Chronic Achilles Tendinopathy

d MedPage Today

Adding a corticosteroid shot to exercise therapy significantly improved symptoms of chronic Achilles tendinopathy, a 100-person randomized trial found.

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MTX + Pegloticase Combo FDA Approved

d Jack Cush, MD

Horizon has announced that the U.S. Food and Drug Administration (FDA) has approved the expanded labeling of pegloticase (Krystexxa) injection to be co-administered with methotrexate (MTX), to improve response rates in patients with uncontrolled gout.

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French registry of IBD due to IL-17 inhib revealed 32 pts- risk of new IBD was low & decreased 2016 to 2019, w/ good outcome in 24/31. IBD more common w/ AS (27) vs PsO (4), IBD onse after 4 (1.5–7.5) mos; all cases w/ secukinumab https://t.co/FJAvhmzPkc https://t.co/WSIut9mAEq

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Dr. John Cush RheumNow ( View Tweet)
10% of PsA is PsA Sine Psoriasis - how to differentiate from seroneg RA? PsA sine PsO pts have peripheral arthritis, no skin dz, but may have axial sxs, +Family Hx or nail psoriasis, dactylitis, enthesitis, DIP involvement. https://t.co/TijVEc9Uw7 https://t.co/W6C1CTYbA9

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Dr. John Cush RheumNow ( View Tweet)
About 1 in 7 systemic JIA are "refractory" to standard Rx. Could the definition be active systemic or arthritic disease, despite IL-1 or IL-6 inhibitors? It could also include pts developing MAS, ILD or amyloidosis. Still, there are many Rx options. https://t.co/VBeHhHEtqW https://t.co/67c5Emo337

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Dr. John Cush RheumNow ( View Tweet)
Outside of meetings/journals and Twitter where do you find info/education you need? @rheum_cat @anisha_dua @KDAO2011 @BolekBerqui @doctorRBC @DrBhana @melodychungmd @got_rheum @philipcrobinson @EBRheum @DamanLangguth @CCalabreseDO

Dr. Rachel Tate uptoTate ( View Tweet)

Watch: Comanagement of Psoriasis and Psoriatic Arthritis https://t.co/N06bioibtm https://t.co/ghb81zF7tV

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Dr. John Cush RheumNow ( View Tweet)
2021 GRAPPA Recommendations - Looking Back, Looking Forward https://t.co/JzRCnh43QJ https://t.co/164AdDZCWz

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Dr. John Cush RheumNow ( View Tweet)
MTX + Pegloticase Combo FDA Approved Horizon has announced that the FDA has approved the expanded labeling of pegloticase (Krystexxa) injection to be co-administered with methotrexate (MTX), to improve response rates in patients with uncontrolled gout. https://t.co/z5b8xxcrOD https://t.co/s6PynSgqNk

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Dr. John Cush RheumNow ( View Tweet)
#EULAR2022 POS0285 130K UK patients had incident gout bw 2004-2020 ⭐️Only 29% started on ULT w/in 12 mos ⭐️Target urate level only 14% in 2004, only to 17% in 2020 Updated EULAR guidelines in 2016: No statistical difference in ULT Rx or target attainment cc: @ericdeinmd https://t.co/nWUM90wRQr
Dr. John Cush RheumNow ( View Tweet)
N.Zealand adult registry of ~1million without CV disease, amongst whom 32K had gout. Having gout increased risk of CV events in women (adj HR 1.34;1.23-1.45) and men (1.18). CV risk in men was increased if not on ULT & not at target (~15%) https://t.co/AgHF45kY2c https://t.co/KzRvtMjS9p

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Dr. John Cush RheumNow ( View Tweet)
Study of 420 active #AS patients not responding to bDMARDs (TNFi, IL-17i) randomised to upadacitinib 15 mg/d or placebo. By wk14, UPA was superior by ASAS40 (45 vs 18%; p<0.0001)& other secondary endpoints (p<0.0001). https://t.co/nfOLlxgP5d https://t.co/fROMep8tbT

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Dr. John Cush RheumNow ( View Tweet)
JAMA full read on wt loss and type 2 diabetes. - Diet, physical activity, & behavioral therapy - high frequency counseling (≥16 sessions/6 mos) - Wt medications effective as adjuncts to diet etc - Rec surgery if BMI >40, unable to lose # or comorbidity https://t.co/lgbNVPr8tz https://t.co/bzmdOvnxC7

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Dr. John Cush RheumNow ( View Tweet)
GLORIA trial presented by Martin Boxers. 2 yr RCT, 5mg Pred vs. PBO shows DAS28 benefit (-0.37 to -0.62) &amp; -1.7 better X-ray (vs PBO) at 2yrs. BUT signif more harm (AE) RR 1.24; mostly infx. Is this a good trade off? Abst# OP0263 #EULAR2022 https://t.co/sjuOqDSjrM https://t.co/vniyDI77qE

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Dr. John Cush RheumNow ( View Tweet)
#AOSD cause is unknown, but matched case control study suggests signif link to Stressful life events (OR 2.56) & nonsignificant risk trending towards coal dust exposure (OR 3.0), allergy prior to onset (OR 2.67) & oral contraceptive use (OR 2.0) https://t.co/Saa4gEbzKS https://t.co/87RKgojmGZ

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Dr. John Cush RheumNow ( View Tweet)
Proposed investigations (findings) in the diagnosis of Stills disease: - CRP, ESR, Ferritin (high) - W/U for infection, cancer (negative) - Serologies (negative) - consider Imaging (CXR, CT, US, PET) https://t.co/l3yqAx6PA0 https://t.co/Sg7okwKHaw

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Dr. John Cush RheumNow ( View Tweet)
Guidelines for MAS complicating Systemic JIA: Dx is based on: - Fever in sJIA with ^ ferritin > 684, plus - Any 2 of these: elevated PLTs, AST, Triglycerides or low Fibrinogen https://t.co/aIEvxRYZca https://t.co/DYpLHxRCzI

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Dr. John Cush RheumNow ( View Tweet)
Cyclic GMP–AMP synthase (cGAS) engages stimulator of interferon genes (STING) to trigger inflammatory cytokines & type I interferons. cGAS–STING activation by genomic or mitochondrial self DNA implicated in autoinflammatory & autoimmune dz https://t.co/7CEFt9wLrl https://t.co/HpHhjJOATd

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Dr. John Cush RheumNow ( View Tweet)

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