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ANA+ consult (10.18.2024)

Jack Cush, MD

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

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Economic and Mental Health Burden of Rheumatoid Arthritis

EurekaAlert!

A University of Mississippi-led comprehensive study of a disorder that affects 4.27 million Americans nationwide is revealing just how significant its burdens are on patients' financial well-being and quality of life. Patients with rheumatoid arthritis pay an average of $3,383 more per year on health care expenditures than those without the disorder, according to the study published in ACR Open Rheumatology, the American College of Rheumatology’s journal. 

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Health Disparities in DMARD Use in RA

Jack Cush, MD

A UK study shows biological and targeted synthetic DMARD use in newly diagnosed rheumatoid arthritis varies markedly by ethnicity, age and setting - "one-size-fits-all approach" does not apply.

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Dot the "i", Cross the "t" (10.11.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.

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Mucosal Disruptions as Initiators of Rheumatoid Arthritis

Jack Cush, MD

Many have suggested that microbiome and mucosal disruptions are contributors to autoimmunity, especially rheumatoid arthritis (RA). This is partly represented in what is known as the "mucosal hypothesis" to RA. A current review article by Hollers, et al. addresses how distinct mucosal endotypes can serve as drivers or initiators of RA.

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Metanalysis of 40 papers, 486,465 RA pts & 3,928 incident ILD outcomes shows no signif risk of ILD w/ DMARD use; no ILD risk w/ TOFA or TNFi (Oral Surveillance n=2,911; OR 0.94). MTX use yielded a Lower ILD risk (OR 0.49; 0.32 to 0.76) vs no MTX use. https://t.co/Es8yyEiD8r https://t.co/qOYPkWNi9o

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ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/j54Vnsl50V https://t.co/jaPbigaqgS

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Early bird registration for RheumNow Live is now open! Join us Feb 8-9 in Dallas, TX. Join the Revolution in Rheumatology Education! https://t.co/ygjZRMVkOZ

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Health Disparities in DMARD Use in RA A UK study shows biological and targeted synthetic DMARD (b/tsDMARDs) use in newly diagnosed rheumatoid arthritis (RA) varies markedly by ethnicity, age and setting - "one-size-fits-all approach" does not apply. https://t.co/t7O99FM7fQ https://t.co/CtvfblpPUo

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Cardiovascular health (CVH) is critical in arthritis care. NHANES study 5919 arthritis pts finds 10-point incr, in CVH score yielded significantly lower all-cause mortality risk (adj HR 0.72; 0.67–0.79); best results with OA/DJD, more than inflammatory arthritis.… https://t.co/etBbH7bH1D https://t.co/1is2VlT5sl
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Eu Heart J - Cardiometabolic risk factors in RA Pregancy rose in last 15 yrs. RA-Preg at higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, venous thromboembolism during hospitalizations. https://t.co/7SnjWFluCf https://t.co/H93ELPZWWz

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Screening to Prevent Multimorbidity in Rheumatic Patients A population based screening program of patients with chronic inflammatory rheumatic diseases (IRD) demonstrates that systematic screening IRD patients for multimorbidity increased preventive interventions and reduced… https://t.co/qh0mkN8HgD https://t.co/ggz5bafCMt
Dr. John Cush RheumNow ( View Tweet)
ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/53bmkQ0qj0 https://t.co/8VUxqxnuGl

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Upadacitinib safety across in RA, PsA, AS, atopic dermatitis >15000 Pt-Yrs exposure. Rates (per 100PYs) of Hzoster (1.6–3.6), NMSC (0–0.8) & incr CPK (4.4–7.9) higher w/ UPA vs comparators (RA, PsA); Deaths (0–0.8), SIE (0–3.9), MACE (0–0.4), VTE (<0.1–0.4), CA, malignancies… https://t.co/OoJ5OX7JyL https://t.co/vaMVFmldEB
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Long Term Antibiotics Increase Risk of RA JAMA has published a population-based retrospective cohort study showing a possible association between the long-term use of antibiotics and the risk of rheumatoid arthritis (RA). https://t.co/U7lPvTSJWO https://t.co/MrUuP6crB7

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Leiden Early Arthritis Clinic study (2011-17) of 431 pts found when RA is Dx in <12 wks, treatment costs were lower in Seropositive & negative RA. If Dx after 12wks, costs 316% higher in seronegative and 19% higher is autoantibody-positive RA pts https://t.co/I8QqZxIChW. https://t.co/8CRpqRiscz

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A CATCH study of 2052 early RA (ERA) pts found high incidence of hypertension (26%) with the highest risk in older patients with traditional cardiovascular risk factors. Those without HTN, at enrolment, 24% developed HTN after median follow-upof 5 years. https://t.co/8MmU60MK8v https://t.co/LyxSssXKLo

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World renowned faculty delivering state of the art lectures. Early bird registration for RheumNow Live is now open! https://t.co/Yk8dKDdZie https://t.co/d14Mq2AxlI

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Mucosal Disruptions as Initiators of Rheumatoid Arthritis The microbiome and mucosal disruptions are believed to play a role in autoimmunity, particularly rheumatoid arthritis (RA). This is linked to the "mucosal hypothesis" of RA. A recent review by Hollers, et al. discusses… https://t.co/79khnkajMy https://t.co/UvZWwJ3ERg
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Appraisal of 2023 ACR RA-ILD guidelines (based on only 3 RCTs). Conditional Recs for MMF, AZA, RTX as 1st-line RA-ILD Rx. W/ RA-ILD progression, options include MMF, RTX, nintedanib, TCZ, CTX, & pirfenidone are conditionally recommended https://t.co/9M3XykPQIi https://t.co/S0TMCsVd4y

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