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Adrenal Dysfunction after Steroids in PMR and GCA Patients
JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.
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PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis
The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA).
Mizoribine Effective in Lupus Nephritis
A randomized clinical trial has shown that oral mizoribine, a common immunosuppressant in Japan, was noninferior to intravenous cyclophosphamide (CTX) as induction therapy in patients with active lupus nephritis.
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#Thrombocytopenia is common in #antiphospholipid syndrome (APS), and is likely associated with more severe disease. Although the pathophysiology underlying thrombocytopenia in APS has yet to be definitively revealed, mechanisms that play a role (at least in subsets of patients) https://t.co/pUXmb1irbw
Alberto Giraldo alb_giraldo ( View Tweet)
Post hoc analysis of 5 ph III Belimumab RCTs (BLISS, etc, N=3086) on skin outcomes BILAG & SLEDAI-2K), BEL was superior to PBO (mcBILAG OR: 1.29; mcSLEDAI-2K OR: 1.37). Also if SLEDAI ≥10 & dsDNA+ pts. BEL prevented skin flares (HR 0.70) https://t.co/p1MVVf97Go https://t.co/qwWUyegpyi
Dr. John Cush RheumNow ( View Tweet)
Veterans Admin (VA) EHR study of #RA-associated ILD (n 1047), matched 237 RA-ILD pts who Rx w/ TNFi vs 237 Rx w/ non-TNF biologics (mean age 68y; 92% male). Death & Resp hospitalisation were similar (adj HR 1·21, 1·27), as was mortality (1·15), Resp mortality (1·38) https://t.co/03LV5B4FSV
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Adrenal Dysfunction after Steroids in PMR and GCA Patients
JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.
https://t.co/ZTaIQxs0ex https://t.co/LA5qji8Zj5
Dr. John Cush RheumNow ( View Tweet)
Systematic literature review of sleep Rx in Fibromyalgia - 47 RCTs, 11094 pts, found cognitive behavioral Tx (CBT) significantly benefitted insomnia, but not pain. Pregabalin & sodium oxybate had small effect, but Amitriptyline, milnacipran, & duloxetine showed no benefit for https://t.co/XG8cFlpQqq
Dr. John Cush RheumNow ( View Tweet)
Glucocorticoid Toxicity Index
Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids https://t.co/foTaoYrfDn
Dr. John Cush RheumNow ( View Tweet)
The FDA has approved guselkumab(Tremfya) for both subcutaneous (SC) and intravenous (IV) induction therapy treatment of adults with moderately to severely active Crohn’s disease (CD). It is the only IL-23 inhbitor available for SC and IV use in CD https://t.co/ekXRVOwNnS https://t.co/6zveRR5WjD
Dr. John Cush RheumNow ( View Tweet)
Systematic review of colchicine and pregnancy in #FMF pts included 25 studies. Miscarriage was not increased w/ colchicine in FMF (RR 0.87). Birth defects were similar to unexposed pts (range 0.6% to 4.0%). Colchicine showed no effects (men/women) on fertility. 1 study reported… https://t.co/axiH9jhEJr https://t.co/oBpew71fZw
Dr. John Cush RheumNow ( View Tweet)
Systematic literature review of sleep Rx in Fibromyalgia - 47 RCTs, 11094 pts, found cognitive behavioral Tx (CBT) significantly benefitted insomnia, but not pain. Pregabalin & sodium oxybate had small effect, but Amitriptyline, milnacipran, & duloxetine showed no benefit for… https://t.co/ReommvC5qO https://t.co/UnSM3HnWLV
Dr. John Cush RheumNow ( View Tweet)
Ontario study of 11 641 older psoriasis pts & hospitalized serious infx in those on b/tsDMARDs. IL-12, IL-23, and IL-17 inhibitors were assoc w/ 35% lower rates of SIE, while MTX, other older systemic meds, TNFi were not incr/decr. But JAK inhibitors had signif 3 fold incr in… https://t.co/ffFdHjme65 https://t.co/DkTsadUNx2
Dr. John Cush RheumNow ( View Tweet)
Glucocorticoid Toxicity Index
Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids… https://t.co/xR8D4Jpjfv https://t.co/LyfHrbneTO
Dr. John Cush RheumNow ( View Tweet)
Cardiovascular and Fracture Risk with Denosumab Versus Bisphosphonates in Dialysis Patients
Annals of Internal Medicine has published a Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk… https://t.co/kNqGNTrsAF https://t.co/xgCeaMDT1N
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Stelara Biosimilar Steqeyma Launches at 85% Discount https://t.co/2ZR7LMq1JT https://t.co/coHj1jh8JB
Dr. John Cush RheumNow ( View Tweet)
Alpha-gal syndrome (AGS) is a (Lone Star) tick-borne allergy to the galactose-α-1,3-galactose carbohydrate, found in mammalian meat/products; Sxs (hives, itching, swelling, and GI issues) present 2-8 hrs after meat & be life-threatening. Time to Dx has dropped considerably, w/… https://t.co/p1M9Qaf1jz https://t.co/jTJzq7YtVJ
Dr. John Cush RheumNow ( View Tweet)
Sobi announced it has submitted to FDA a supplemental (sBLA) for Gamifant (emapalumab-Izsg) for use in adult & kids w/ hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) in Still’s disease with an inadequate response glucocorticoids, or with recurrent… https://t.co/a3I1fzHLdl https://t.co/WTFAs5PLWF
Dr. John Cush RheumNow ( View Tweet)
With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/BMeYVaBmIy https://t.co/DpTqKhb1Sg
Dr. John Cush RheumNow ( View Tweet)
Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF
Dr. John Cush RheumNow ( View Tweet)
