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World Changers (3.14.2025)
Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).
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Increased Mortality In Arthritis Patients with COPD
EurekAlert!
People with chronic obstructive pulmonary disease (COPD) and arthritis have a higher risk of death than people with arthritis who do not have COPD, according to a new study.
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Are Combination Biologics Safe?
Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
Hydroxychloro-King (3.7.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory actions from the past week on RheumNow.com
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Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
EurekAlert!
People with Crohn’s disease and related joint inflammation linked to immune system dysfunction have distinct gut bacteria or microbiota, with the bacterium Mediterraneibacter gnavus being a potential biomarker, according to new study by Weill Cornell Medicine researchers.
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Available the first time: https://t.co/4UQlqwujiR 2025 On Demand!
On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else.
Non-CME, practical, and finally here.… https://t.co/qZb8OKjPpw https://t.co/Exr8u6QkNc
Links:
Dr. John Cush RheumNow ( View Tweet)
Retrospective review of 781#RA pts; 78 Dx w/ILD (77 subclinical, most UIP on HRCT). w/ mean 10 yrs F/U, death rate was 1.5 vs. 7.1 per 100PY (without v with ILD) SMR equal betw RA & gen pop. but 2x higher in RA w/ ILD. Mortality higher w/ ILD (HR~3), age and low BMI… https://t.co/Vj0acewmK8 https://t.co/N1wHTjMfTr
Dr. John Cush RheumNow ( View Tweet)
Study of sarcopenia in 138 young adults with inflammatory arthritis (IA) found sarcopenia in ~47% of IA- Signif different between JIA, SpA, & RA. W/ multivariable analysis, predictors of sarcopenia included BMI (OR 0.84), BMD (OR 0.01), vit D (OR 0.96) & HAQ (OR 14.5)… https://t.co/JHKwF8icj1 https://t.co/ph3pVIYuXx
Dr. John Cush RheumNow ( View Tweet)
A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
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/IEIi6kQI4b https://t.co/KVSbqeMbyA
Dr. John Cush RheumNow ( View Tweet)
Congratulations to Dr. Mehmet Hocaoglu (University of Pittsburgh) on being awarded a 2024 Rheumatoid Arthritis Research Program grant to investigate the unique and shared risk factors between patients with preclinical rheumatoid arthritis and patients with RA.… https://t.co/eF4yb3Hxsj https://t.co/MLNWKFiCiU
Dr. John Cush RheumNow ( View Tweet)
Meta-analysis shows the combination therapy bDMARD with MTX in #PsA pts yields better bDMARDs drug survival, especially with TNFi. 20 observational studies, 30,634 PsA pts. Insufficient data for non-TNFi bDMARDs. But adding MTX to bDMARDs had better TNFi survival (HR=0.79… https://t.co/3Y2cOzt3TQ https://t.co/6f8yiwMqAa
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush RheumNow ( View Tweet)
DANBIO registry study - 21 982 Rx Starts, 96 475 PYs & 1423 cancers identified. Overall cancer risk w/in tocilizumab/sarilumab, abatacept or rituximab were not signif increased (HRs ranged from 0.7 to 1.1) compared with TNFi & with bDMARD-naïve real world RA pts… https://t.co/fPLFlWoQsw https://t.co/4KlGnjfNKm
Dr. John Cush RheumNow ( View Tweet)
BMS announced new data from Phase 3 POETYK PsA-2 trial - Sotyktu (deucravacitinib)vs apremilast vs PBO in PsA w/ higher ACR20 vs PBO at Week 16 (54% vs 39%). AEs led to discontinuation in 1.3% (PBO), 2.2% (Deuc) and 10.5% (apremilast). https://t.co/NAa2JigkZN https://t.co/mvaQXfjShd
Dr. John Cush RheumNow ( View Tweet)
Polypharmacy (>=5Rx) studied in 81 RA & 30 SLE pts. Polypharmacy incr at 2 yrs ~44% to ~73%. Med adherence >85%. Polypharmacy NOT assoc w/ Dz activity in SLE, but in RA did correlate w/ better DAS28CRP score at one year https://t.co/Jw05DIrBym https://t.co/pLIoDvPj8i
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 376 studies, 347 468 pts w/ chronic pain (mean 51yrs; 70%F) finds ~40% had clinically significant depression and anxiety (more common in Women, younger people, pts w nociplastic pain). Depression common in FM (54%) & OA/RA (~28%). https://t.co/s1tcgC3y7k https://t.co/NCxkOA82jD
Dr. John Cush RheumNow ( View Tweet)
Available the first time: https://t.co/4UQlqwujiR 2025 On Demand!
On Demand gives you access to all lectures, Q & A panels, and STEP talks, and all speaker slides and handouts — all packed with insights you won’t find anywhere else.
Non-CME, practical, and finally here.… https://t.co/MHFUWb3az1 https://t.co/cqzZG40Xp5
Links:
Dr. John Cush RheumNow ( View Tweet)
Risk of Cancer on JAKi in RA (12 463 vs 38 345 controls). No incr risk of CA w/ exposure to JAKi (adj OR 1.04), TNFi (0.98), other bDMARDs (0.98). But JAKi was assoc w/ signif more lung CA (1.40; esp in males 2.12) & less breast CA (0.62) in women https://t.co/fr3VjPhJve https://t.co/zNehdWBbeI
Dr. John Cush RheumNow ( View Tweet)
