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Not All RA Drug Classes Are Created Equal

d MedPage Today

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.

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JAK Janus

JAK/STAT pathway in pyoderma gangrenosum: a new therapeutic highway?

d Aurelie Najm, MD, PhD

Pyoderma gangrenosum (PG) is rare, but often associated with different forms of arthritis, in particular rheumatoid arthritis and inflammatory bowel diseases. 

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Vaccination,vaccine

Flares Not Increased Following Recombinant Zoster Vaccine Injections

d Jack Cush, MD

Insurance claims analysis has shown that the use of the (CDC recommended) recombinant zoster vaccine (RZV) for prevention of herpes zoster was highly used in patients with immune-mediated inflammatory diseases and was safe, as higher rates of arthritis flares were not evident.

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covid coronavirus virus

Spondyloarthritis and COVID-19

d Robert Chao, MD

There are still questions surrounding COVID-19, and some common questions I receive from patients revolve around what to do with their current DMARDs or should they even start treatment during this pandemic. Two studies focused on this question. 

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hands pregnant

Improved Pregnancy Outcomes in SLE (2010–2020)

d Jack Cush, MD

A retrospective cohort study has shown that outcomes in pregnant systemic lupus erythematosus (SLE) patients has significantly improved in the last decade, but there still is a high risk of adverse pregnancy outcomes (APO).

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Australian Bureau of Statistics 2017–2018 shows relative risk of undergoing knee replacement for OA increased with increasing BMI (Class 1- 3 obese females 55–64 yrs had 4.7 to 17.3 fold risk of KR. Same for obese Males (OR 3.4 - 5.8) more KR https://t.co/vcPmRgbzUH https://t.co/FrfTC9LNnR

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Dr. John Cush RheumNow ( View Tweet)
31 systemic JIA pts: w/ systemic sxs (n=8), chronic arthritis (7), remission on meds (10) & remission off meds (6). High IL-18 levels & impaired IL-18 signaling in NK cells correlated with systemic Dz activity. High IL-18 impairs NK phosphorylation https://t.co/HlaQid7xGq https://t.co/0PbxC0pZtk

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Dr. John Cush RheumNow ( View Tweet)
Lit search on (Lyme) Borrelia burgdorferi sensu lato shows global Bb seroprevalence =14.5% (top 3: Central Europe 20.7%,Eastern Asia 15.9%, Western Europe 13.5%). Bb seropositivity assoc w/ ≥50 yrs, men & residence of rural area https://t.co/fvr845s5CC https://t.co/TLNumNuXnH

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Dr. John Cush RheumNow ( View Tweet)
Balance and falls studied in 228 #RA pts (24-85 yrs) followed x 1yr; 20% had at least one fall; risks included Age (OR 1.04), HAQ (OR 1.62), low FICSIT-4 score (OR 2.38) & 1-leg standing (OR  2.14). 1-leg stand is a good screening tool https://t.co/u9v8unC0gA https://t.co/oD0sgFxiQm

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Dr. John Cush RheumNow ( View Tweet)
Small study 34 biologic-naive RA pts starting abatacept. Remission achieved 47.1% of early and 23.5% established RA. Remission @ 6 mos predicted by Baseline LOWER IL-6 levels ≤ 8.4 pg/ml, (66.7%) and CD4+CD25+FoxP3+ cells ≥ 6% (83.3%) https://t.co/N93E9M4M15

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Dr. John Cush RheumNow ( View Tweet)

There are 494K PCPs in the USA, While up to 1/3 will "refill" DMARDs, only 6-9% are confident or knowledgeable in "initiating" DMARD therapy in #RA. GIGANTIC NEED FOR PCP education in MSK & Rheum Dz https://t.co/VjgWWDt3nX https://t.co/dTRXxsrzG5

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Dr. John Cush RheumNow ( View Tweet)

OA Initiative Study of 1212 knee OA pts (age 63 yrs), 73% walked for exercise. Walkers had signif. less New frequent knee pain (OR 0.6) & medial joint space narrowing (OR 0.8). Walking for exercise should be encouraged in knee OA pts. https://t.co/MLs9zutdRd

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Dr. John Cush RheumNow ( View Tweet)

Watch: Fatigue and Central Sensitization in Rheumatic Disease - We're sharing Philip Mease, MD presentation from the RheumNow Live 2022 meeting held in March. https://t.co/SFzsszL1aM https://t.co/DkxVPim9iU

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Dr. John Cush RheumNow ( View Tweet)
Learn how clinical research targeting immune pathways can help reduce the burden of #psoriaticarthritis symptoms, such as joint pain, stiffness, and swelling, as well as fatigue: https://t.co/ReBQVyYVka Sponsored by Janssen @JanssenUS https://t.co/fRb6kAj848

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Dr. John Cush RheumNow ( View Tweet)
Study of interferon (IFN) gene signature (IGS) finds IGS elevated in half of early RA pts; high IGS portends higher DAS28, fewer EULAR good resp & higher IFN-α; the latter assoc w/ epigentic changes, more lymphoctye activation. IFN-α as a biomarker? https://t.co/BHC98OR30A https://t.co/SRE7KVaoha

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Dr. John Cush RheumNow ( View Tweet)
Yesterday the FDA approved baricitinib (Olumiant) as the first systemic treatment for Alopecia Areata. Approval based on 2 DBRPCT Trial AA-1, AA-2) - 32% & 35% of pts on Bari 4 mg regrew scalp hair coverage by wk 36. https://t.co/SU74OxI2BC https://t.co/2wluug1fj4

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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)
JAKi not yet safe in pregnancy - theyre fetotoxic at high doses (animals). JAKi do cross placenta. ACR Guidelines: no position due to no data. 47 tofa Rheum & 15 UC maternal exposures - no signif probs. Paternal use of JAKi is ok. https://t.co/pom5KD0qt7 https://t.co/djYHZ5LdcE https://t.co/47lfyZC4H3

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Dr. John Cush RheumNow ( View Tweet)
Watch: The Microbiome in Spondyloarthritis Can microbes trigger SpA/PsA? https://t.co/KN7dMFU9qo https://t.co/k3M5QfwqGp

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Dr. John Cush RheumNow ( View Tweet)
Cluster study of 383 aPL+ pts showed 4 clusters: Cluster 1 (138): w/ SLE & non-criteria Sxs Cluster 2 (112): pts w/ CV risks Cluster 3 (83): females w/ OB morbidity (BEST outcome) Cluster 4 (50): lupus anticoagulant (+) (high freq of arterial thrombosis) https://t.co/HGRTceplsn https://t.co/ZDdwhCmj5r

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Dr. John Cush RheumNow ( View Tweet)

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