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What is JAKne? (5.6.2022)
Dr. Jack Cush reviews the news, journal reports, FDA actions, new side effects and changing prevalence of Gout.
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Lack of Research Stymies Uptake of Medical Marijuana for Rheumatic Pain
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Creaky Joints
A new review article from CreakyJoints finds that there has been limited progress in understanding the potential of cannabis based therapies for the treatment of pain associated with rheumatic conditions in the past five years because of a lack of standardization of clinical research and barriers to conducting research due to existing federal and state regulations.
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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 JAK inhibitors (JAKi).
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"I think we can get rid of maintenance prednisone in nonrenal lupus" (but not in renal lupus)
"...prednisone contributes to some organ damage (but not renal)"
Organ damage is multifactorial -traditional risk factors, disease activity & steroids
- Dr. Michelle Petri #UTSWSLE2022 https://t.co/N9NMPgtPEn
Dr. John Cush RheumNow ( View Tweet)
"How awful is our current prednisone practice"
- Dr. Michele Petri #UTSWSLE2022 https://t.co/WGNx5yxF8x
Dr. John Cush RheumNow ( View Tweet)
From the Hopkins Lupus cohort - Just one month of Prednisone 40 mg/d yields a FOUR fold increase in avascular necrosis risk #UTSWSLE2022 https://t.co/RGP06PUIKH
Dr. John Cush RheumNow ( View Tweet)
DOCTORS: are you ready to attend big medical meetings ? @LCalabreseDO
Dr. John Cush RheumNow ( View Tweet)
Large Korean population study compares pts w/ palmoplantar psoriasis vs psoriasis and PPP pts have more risk for ankylosing spondylitis (aOR 1.37) & Graves dz (aOR 1.4) but lower risk for PsA (aOR 0.54), SLE (0.67); Sjögren (0.70); vitiligo (0.53) https://t.co/0fv2vnFBPf https://t.co/PJMagIeZ2F
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UT Southwestern Symposia on "Future of SLE". Summary of Disparities in SLE Care/Outcomes (from Dr. Candace Feldman - Harvard). #UTSWSLE2022 https://t.co/KQb9JV7uJU
Dr. John Cush RheumNow ( View Tweet)
Yet another examples of underrepresentation of minority groups in clinical trials! #UTSWSLE2022 https://t.co/TbhhdglJ6v
Dr. John Cush RheumNow ( View Tweet)
How do we solve/address the problem of Health Disparities in Lupus and Rheumatology? Dr. Ashira D Blazer, MD @ashira_md (HSS) approach:
Study
Listen
Educate
Partner
Diversity
#UTSWSLE2022 https://t.co/w3DX1w0chy
Dr. John Cush RheumNow ( View Tweet)
Danish case-control registry of 491,274 women shows Psoriasis assoc w/ increased risk of ectopic pregnancy (EP) (OR 1.34), highest in women w/ moderate-to-severe psoriasis (OR 2.77). EP risk was 2.5x higher for women w/ mod--severe PSO https://t.co/vUtNEMDOhr
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Trends in RA Disability, Despite Biologics
Disability claims in the U.S. related to RA were just as common in 2015 as in 1999, a gov't researcher found, against expectations that the advent of biologic therapy would have led to a steady decrease.
https://t.co/vyyjTbkLN2 https://t.co/D5Eo42P4cw
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Dr. John Cush RheumNow ( View Tweet)
Study of 17 homeless RA or PsA pts - less clinic access (80% vs 91%), more ED use (20 vs 5), less DMARDs (43% vs 100%), more steroids (29% vs 0%); 83% unable to work due to health. Greatest need - dental , PT, knee surgery, employment & housing https://t.co/VHnTR0MTkr https://t.co/JDZTELz2qB
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Dr. John Cush RheumNow ( View Tweet)
Gout affects >10 million (4%) in USA, but now w/ more ethnicity, with highest risk in Native Hawaiians (HR 2.21), followed by Black (1.34) and Japanese (1.14); but lower in Latinos (HR 0.78) compared to whites. https://t.co/lQiSx0ExAM https://t.co/bVx41mbquW
Dr. John Cush RheumNow ( View Tweet)
There is 1.4 million transgender persons in the US. ACP has published a guideline "Care of the Transgender Patient" addressing health disparities, certain cancers, substance abuse, mental health conditions, infections, and chronic diseases. https://t.co/AoBeOzv9YH https://t.co/jKabVELPxH
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Forbes review on how patients can save on the cost of prescription meds https://t.co/zbFMJdOI0W https://t.co/O2RQSrLwZY
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Dr. John Cush RheumNow ( View Tweet)
Large Korean population study compares pts w/ palmoplantar psoriasis vs psoriasis and PPP pts have more risk for ankylosing spondylitis (aOR 1.37) & Graves dz (aOR 1.4) but lower risk for PsA (aOR 0.54), SLE (0.67); Sjögren (0.70); vitiligo (0.53) https://t.co/zrlvJpOhqc https://t.co/rxrEVHuUgm
Links:
Dr. John Cush RheumNow ( View Tweet)
Insurance delays in starting TNF Inhibitors in kids w/ Juvenile Idiopathic Arthritis (91% on DMARDs) - prior authorization required in 98%; 26% of PA requests denied & required appeals, w/ 22% delays > 2+ wks, 25% took 30+ days to start TNFi https://t.co/1TGmM8qOHR https://t.co/EpbrNSbNBl
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Dr. John Cush RheumNow ( View Tweet)
An increasing incidence of RA is driven by increasing # of ACPA-negative RA (but not ACPA-positive RA), partly explained by an ageing population (thus making ACPA-negative RA more prevalent in coming years) https://t.co/AzbYyrOfUG
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Dr. John Cush RheumNow ( View Tweet)