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RheumNow Podcast – Coconspirators: RA and Lung Disease

Jack Cush, MD

Dr. Jack Cush reviews and discusses more than a dozen news and journal articles from the past week on RheumNow.com.

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Increased Risk of COPD in ACPA+ Pre-RA Patients

Jack Cush, MD

The lung and its pathology is uniquely tied to rheumatoid arthritis (RA) and its pathogenesis.  A new study shows that elevation of anti–citrullinated protein antibodies (ACPAs) before diagnosis of RA increases the risk of developing chronic obstructive pulmonary disease (COPD

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Implementing Smoking Cessation Programs

Jack Cush, MD

Rheumatologists are keen to the effects of smoking (increased arthritis risk, worse outcomes, blunted DMARD responses, added cardiopulmonary risks), but often do not have the resources or plan to encourage or implement smoking cessation from the rheumatology clinic. A new study details the success of a rheumatology staff‐driven protocol, Quit Connect, to increase the rate of electronic referrals to free, state‐run tobacco quit lines.

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Rituximab in Systemic Sclerosis?

Jack Cush, MD

No drug is FDA approved to manage the skin or joint complaints of systemic sclerosis (SSc); a recent metanalysis suggests that rituximab may improve skin score and disease activity indices (DAS, mRSS) while stabilizing organ involvement in SSc patients.

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RheumNow Podcast – Upadacitinib Wins in PsA (4.2.2021)

Jack Cush, MD

Dr Jack Cush reviews the news and Journal reports and takes "Back Talk" questions from viewers.

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Inflammatory Conditions Up the Risk of Premature Myocardial Infarction

Jack Cush, MD

The European Journal of Preventive Cardiology reports that younger patients with their first myocardial infarction before age 50 yrs have a higher risk of having a systemic inflammatory disease (SIDs) and higher rates all-cause mortality.

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RheumNow Podcast – Infection in ANCA-Associated Vasculitis (3.26.2021)

Jack Cush, MD

Dr. Jack Cush reviews the news, FDA Denials and journal articles from the past week on RheumNow.com.

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Rituximab vs. JAK inhibitors in Rheumatoid Lung Disease

Jack Cush, MD

There are no current FDA approved therapies for rheumatoid arthritis associated interstitial lung disease (RA-ILD) or bronchiectasis, but a recent retrospective cohort study showed equivalent outcomes when RA-ILD patients were treated with either rituximab or janus kinase inhibitors.

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News Feature: Increased Risk of COPD in ACPA+ Pre-RA Patients A new study shows that elevation of ACPAs before diagnosis of RA increases the risk of developing COPD and/or asthma. https://t.co/1F8fOxpaQ0 https://t.co/GaaGcF90YD

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Dual seropositivity with RF/ACPA autoantibody higher titers were strongly associated with prevalent RA-ILD (OR 2.90; developed in 3.7%). ILD more likely with high titer RF (HR 3.4) than high titer CCP (HR 1.9). https://t.co/ebvJjatQSw

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Dr. John Cush RheumNow ( View Tweet)

Serious problem! Pulmonologists uniformly believe that MTX causes and/or worsens ILD. MTX causes hypersensitivity pneumonitis, not ILD. RA, lupus DM, PSS cause ILD and they may need MTX to manage their disease. Do your own research, look at this paper to start. https://t.co/DHC5ikhCf6

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Dr. John Cush RheumNow ( View Tweet)

Don’t underestimate the utility of Vitamin D for VTE ppx in APS patients. Everyone should get some sun #RNL2021 Coverage from @doctorRBC #RheumNow

Dr. John Cush RheumNow ( View Tweet)

News Feature: Inflammatory Conditions Up the Risk of Premature Myocardial Infarction https://t.co/gbPpAYJGFg https://t.co/ValdJWGyxl

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Dr. John Cush RheumNow ( View Tweet)
Matched cohort Nurses’ Health Study looked at 283 pre‐RA pts (mean 9.7 years before RA Dx) and and 842 controls; 21% pre‐RA were ACPA+. ACPA+ was associated with increased risk of COPD (HR 3.04) that was not seen in ACPA- pts. https://t.co/HNB11eAiva

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Dr. John Cush RheumNow ( View Tweet)

News Feature: Hypertension Unaffected by Urate Lowering Therapy Does uric acid contribute to the risk of hypertension (HTN)? A recent cohort trial shows that allopurinol in young adults does not sufficiently lower blood pressure (BP). https://t.co/PAMkgCc2DS #RheumNow https://t.co/ar7OiWKVQj

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Dr. John Cush RheumNow ( View Tweet)
263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stablized their FVC, DLCO, CHest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/11vJCWOdSG https://t.co/yMF6imuFMV

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 32 studies shows most forms of arthritis assoc w/ incr risk of CVA (ischemic stroke: RR=1.53 or hemorrhagic stroke: RR=1.45), esp for RA (RR=1.38), AS (RR=1.49), PsA (RR=1.33), gout (RR=1.4) --risk higher with age <45 years (RR=1.46) https://t.co/YDiebrqtbi

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Dr. John Cush RheumNow ( View Tweet)

News Feature: Rituximab vs. JAK inhibitors in Rheumatoid Lung Disease https://t.co/2P0tdxvZD2 https://t.co/7gfE1CPSEx

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Dr. John Cush RheumNow ( View Tweet)
Leading the Rheumatoid Arthritis pod with discussions on pneumonia and RA and interstitial lung disease in RA. #RNL2021 https://t.co/psxMTHsOva
Dr. John Cush RheumNow ( View Tweet)
Top 4 arthritis types that significantly increase the risk of CVA: 1) RA (RR=1.38), 2) ankylosing spondylitis (RR=1.49), 3) psoriatic arthritis (RR=1.33) & gout (RR=1.4). With these, the risk was higher in younger (<45 yrs) (RR = 1.46), not older (>65) https://t.co/Snb6OrtZJH

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