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Methotrexate Monitoring (5.13.2022)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.

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Rheum,resident,medpage

A Day in the Life: Consults with a Rheumatology Fellow

d MedPage Today

Join medical resident Siobhan Deshauer, MD, as she visits three hospitals for inpatient rheumatology.

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Methotrexate

Can You Reduce Frequency of Methotrexate Monitoring?

d Jack Cush, MD

Observational research presented at the British Society for Rheumatology meeting suggest that, based on the COVID-19 pandemic experience, reduced frequency of routine lab monitoring in patients receiving weekly methotrexate therapy for rheumatoid arthritis (RA) was not associated with an increase in adverse outcomes.

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Wiki Guidelines Approach to Pyogenic Osteomyelitis

d Jack Cush, MD

A crowd sourced, WikiGuidelines approach to clinical treatment guideline development for pyogenic osteomyelitis yielded 7 important clinical questions, 2 clear treatment recommendations and 5 topic reviews to inform future treatment or investigations.

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NEJM has published results of 2 phase 3 trials (BRAVE-AA1, BRAVE-AA2) demonstrating the efficacy of Baricitinib in aduls with severe alopecia areata - BARI was superior to placebo in hair regrowth by week 36 https://t.co/I88bvuU4cg https://t.co/4xNH0IZnGA

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Dr. John Cush RheumNow ( View Tweet)
Small RCT 39 pts with #PMR given tocilizumab or placebo. Steroid-free remission at wk 16 was 64% on tocilizumab (63.2%) and 12% placebo. Mean time to first relapse was shorter with PBO (82 vs 130days). 5 SAE PBO, 1 TCZ https://t.co/FJjDxm7wfQ https://t.co/EiuSGaXgeh

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Dr. John Cush RheumNow ( View Tweet)
Acne with JAK Inhibitors JAK inhibitors have become enormously popular and while their side effect profile has been delineated and reviewed, little mention is made of acne – an adverse event that may affect up to one-quarter of patients taking JAKi. https://t.co/ADzaBjgsAN https://t.co/Yydo47UGYl

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Dr. John Cush RheumNow ( View Tweet)
Welcome to the latest update from #SLEEducatorsNetwork, with Dr. Askanase, Director of the Lupus Center @Columbia who explains why a deeper understanding of SLE pathophysiology may help us better address its underlying mechanisms. Sponsored by GSK USMA. https://t.co/LFfZAFgMWE https://t.co/n8X45pInYQ

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Dr. John Cush RheumNow ( View Tweet)
Early results from the U-ENDURE, Phase 3 RCT of upadacitinib in adult Crohns disease. Pts responding to UPA 45 mg/d were given PBO or UPA (15 or 30 mg). 52 wk UPA achieved CDAI (37% & 48% vs 15% PBO)& endoscopic remission (28% & 40% vs 7%) https://t.co/eo2KtNOUW8 https://t.co/MKnTxVEkth

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2019 Gabapentin Rx=69 million; 7th most common Rx in USA. MMWR: 62,652 overdose deaths, 52% had Pos. gabapentin test. OD deaths w/ GAB involved usually involved illicitly manufactured fentanyls. GAB+Opioids=BAD COMBO! https://t.co/qQbPmwzAgJ

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EADV Dermatology Meeting presents data on the 2 year safety of Deucravacitinib, (TYK2 inhibitor); also showing DEUC is effective in scalp, nail, & palmoplantar PSO. Data from the phase 3 POETYK PSO-1 and PSO-2 trials https://t.co/cFz6XkpA69 https://t.co/ZNJzph6i5N https://t.co/QJZEhzqkY4

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Dr. John Cush RheumNow ( View Tweet)
Welcome to the latest update from #SLEEducatorsNetwork, with Dr. Askanase, Director of the Lupus Center @Columbia who explains why a deeper understanding of SLE pathophysiology may help us better address its underlying mechanisms. Sponsored by GSK USMA. https://t.co/spcdweO0pE https://t.co/0stEBPy6hc

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Dr. John Cush RheumNow ( View Tweet)
Save the date! Join us on May 17th for Tuesday Night Rheumatology on Spondyloarthritis Spectrum. This webinar will feature lecture highlights followed by live audience Q & A. https://t.co/s7r09y5KNG https://t.co/0KYRPwGHsV

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Dr. John Cush RheumNow ( View Tweet)
Bimekizumab's Favorable Safety Profile in Psoriasis A 2-year safety study of BMK, the dual IL-17A/F inhibitor, plaque psoriasis patients showed BMK, to be effective, well tolerated, w/ no new safety concerns other than a modest risk of oral candidiasis. https://t.co/84zS8VET6B https://t.co/aLvLmmTc93

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Dr. John Cush RheumNow ( View Tweet)
#ClinicalPearl Autoantibodies in #Sjogren’s Syndrome include CCP and anticentromere - think of overlaps with #rheumatoid arthritis or lcSSc limited cutaneous systemic sclerosis #scleroderma #CCR22 #CCR2022 ⁦@RheumNow⁩ https://t.co/vrdbv640B5
Janet Pope Janetbirdope ( View Tweet)
Risk factors for readmission among 132,400 #SLE hospitalizatiions included young SLE, AIHA (OR 1.86) GN (OR 1.41) pericarditis (OR 1.4), CHF(OR 1.38), Medicare (OR 1.2), Medicaid (OR 1.26). Most Readm Dxs were Sepsis, CHF, pneumonia https://t.co/Nr9bCGDaw0 https://t.co/THO6KT6dWV

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Systemic Sclerosis patients with Digital Ulcers used significantly more healthcare resources per year. Study of 104 SSc pts; w/ DU's had more severe disease, more tests, More HCP/Rheum visits, etc (p˂0.05) https://t.co/wWvrOye92c https://t.co/HsZfSrf5CV

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Dr. John Cush RheumNow ( View Tweet)
We had a great TNR this week. Playback now available in case you missed it. This webinar presented excerpts from these lectures along with Q & A Psoriatic Arthritis Guidelines Drug Targeting in PsA PsA Registries and Real World Data https://t.co/al17KLQm0j https://t.co/O4SvMU37Lg

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Dr. John Cush RheumNow ( View Tweet)
Early inflammatory arthritis pts (n=35,807; 86% White & 5,164 ethnic minority). Whites & minorities were equally seen by rheum <3 wks & started on Rx < 6wks, <inorities had less remission @3 mos (OR 0.79) or recv MTX 1st or steroids(0.68-0.63) https://t.co/rK7GLt5n1X https://t.co/uUwBBCnyGL

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Dr. John Cush RheumNow ( View Tweet)
Doctor Survey: how many Rheumatic/Autoimmune pts do you have on Evusheld (PrEP)?

Dr. John Cush RheumNow ( View Tweet)

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