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DMARDs for Early Rheumatoid Arthritis Have Cardiovascular Benefits

RheumNow

Patients with RA have up to a three-fold increased risk of mortality versus the general population, largely due to an increased incidence of premature CVD, such as atherosclerosis and heart failure.

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RheumNow Podcast – Lupus Delights (9.18.20)

Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow.com:

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Comorbidities Impact Disease Activity in Spondyloarthritis

Jack Cush, MD

An analysis of a large population-based cohort of axial spondyloarthritis (axSpA) patients shows that comorbidities are common and are associated with higher disease activity and higher levels of functional impairment.

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ICYMI: HCQ May Help Prevent Fetal Heart Block

RheumNow

Hydroxychloroquine (HCQ) helped reduce recurrent maternal autoantibody-mediated congenital heart block (CHB) in fetuses, an open-label study suggested.

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Early Cardiovascular Benefits to DMARD Treatment in Rheumatoid Arthritis

Jack Cush, MD

ARD has published a report showing that patients with early rheumatoid arthritis have cardiovascular disease that is modifiable with conventional and aggressive therapy and that it did not matter if first line DMARD therapy was with a tumour necrosis factor-inhibitor or methotrexate.

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RheumNow Podcast – Rheum Lives Matter (8.28.20)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week. Of mice and men in cartilage, the efficacy of JAK inhibitors in patients who are having skin problems, nrAxSpa has its own diagnostic code, metformin, talking about Back Talk, plus so much more.

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Do NSAIDs Increase Cardiovascular Risk in Osteoarthritis?

Jack Cush, MD

A longitudinal study of administrative data from British Columbia shows that nonsteroidal antiinflammatory drugs (NSAIDs) use increases the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients.

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)

Jack Cush, MD

Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.

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Outcomes survey of 229 relapsing polychondritis patients shows that 59% had auricular-onset (AO) and 21% had respiratory -onset (RO), 20% w/ miscellaneous-onset (MO- eye MSK CNS). Poorer prognosis seen in RO & MO subgroups than AO subgroups https://t.co/rzVU42z3EA

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Danish matched (1:4) cohort study shows COVID-19 pts taking NSAIDs had no greater risk of mortality, hospitalization, ICU admission, mechanical ventilation, or renal replacement therapy; study included 9,236 COVID PCR-positive & 2.7% were on NSAIDs https://t.co/OuUbJ9FxiM

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Dr. John Cush RheumNow ( View Tweet)

ILD studied in 679 inflammatory idiopathic myositis (IIM) pts; 508 had ILD (found in 93% amyopathic DM, 74% DM & 55% PM). Prevalence of of ILD was higher with antisynthetase Ab + and MDA-5 Ab +. Mortality higher in MDA5+ASA--IM-ILD group (33% vs 12=17%) https://t.co/ATz3wYmFuf

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296 women with HTN during pregnancy (half/147 NSAID-exposed) - NSAID use was not associated with a significant change in BP (vs no NSAID) and there was no added need to start or increase BP meds in those on NSAIDS. https://t.co/g56xgQEPjr

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Dr. John Cush RheumNow ( View Tweet)

Study of 1,631 incident RA & 3283 controls shows respiratory disease assoc with risk of RA, irrespective of RF & CCP and mostly in nonsmokers. aOR increased for chronic upper (1.4), acute lower (2.4) & chronic lower (1.6) Resp Dz, stronger for ACPA/RF+ https://t.co/C1hA631PIW

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ATS Abstract: n=616 survey contrasts rheums (57%) & pulmonologists (43%) beliefs on RA associated ILD. Both preferred to use steroids, MMF, RTX for RA-ILD, but Rheums tend avoid ADA & LEF. Rheums (17%) & Pulms (24%) think MTX a risk factor https://t.co/W5gbu84FBv

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Dr. John Cush RheumNow ( View Tweet)

Forward study of 18,754 RA patients who experienced 1,801 CVD events and found CVD risk reduction with TNFi (HR 0.82 [95% CI 0.72-0.94]) and abatacept (HR 0.50 [95% CI 0.30-0.83]) compared to csDMARDs over & above MTX alone (use vs. non-use: HR 0.82) https://t.co/YVfKWjkvxU

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NJ study of 764 ICU COVID-19 pts, 210 (27%) received tocilizumab. TCZ treated patients had a lower death rate (49% vs 61%) (HR 0·64, 95% CI 0·47–0·87; p=0·004). Similar results seen in those requiring mechanical vent. or CRP >15 mg/dL https://t.co/idZTDunG1a

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Dr. John Cush RheumNow ( View Tweet)

NY Times article about a "guy and aching legs". 48 yrs old w/ myalgias, wt loss, SOB, sinusitis, high inflammatory markers, pulmonary infiltrates, microscopic hematuria, red & swollen ears; but no fever/chills. You're a rheumatologist, you know the Dx. https://t.co/fbrRMNA5u4 https://t.co/JFOcM0MBxB

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Study of 52 Takayasus arteritis patients (age 31 yrs; 6yrs F/U): 15 (29%) had severe severe ischemic events (13/15 at or before Dx): 5 CVA, 5 ACS, 1 ischemic cardiomyopathy, 4 limb ischemia. Dz outcomes & damage scores were similar with and without SIE. https://t.co/Qhzks0gJz6

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Ann Int Med reports that the use of ACE inhbitors or ARB use is not associated with more severe COVID-19 disease (High-certainty evidence), and these meds are not associated w/ pos. SARS-CoV-2 tests- based on observational studies w/ 23565 COVID-19 adults https://t.co/px0rMH1Pjz

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Dr. John Cush RheumNow ( View Tweet)

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