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U.S. overdose deaths far outpace other countries. In 2023 US drug overdoses >100,000 for 3rd year — a >50% jump since 2019. 2022 rate=324/1 million. High rates attributed to fentanyl, polysubstance use, counterfeit pills, variance in state policies on harm reduction… https://t.co/oHtiMytdtR https://t.co/DLFPYEkdRC
Dr. John Cush RheumNow ( View Tweet)
Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
Dr. John Cush RheumNow ( View Tweet)
Marketscan claims data study assessed fall risk in 57 086 older adult starting gabapentin vs duloxetine & found gabapentin was not associated with increase in falls. At 6-mos, gabapentin had lower risk of falls (HR 0.52; 0.43 to 0.64]. https://t.co/agrdzkxNdL https://t.co/Te981iDMZU
Dr. John Cush RheumNow ( View Tweet)
Prevalence of Autoimmune Diseases in the United States
An epidemiologic assessment of the prevalence of autoimmune diseases in the United States (US) finds that nearly 5% of the population has an autoimmune disorder, twice as many in women compared to men.… https://t.co/L5BusRvcFP https://t.co/JTw8CXf1Tq
Dr. John Cush RheumNow ( View Tweet)
Spanish registry ARTESER, looked at GCA outcomes from 2013 to 2019. In 1200 GCA pts ~ 2 yrs F/U, The 5-Yr mortality 37.9/1000 pt/yrs; higher in males vs females (59 vs 29 p<0.001), but was same as gen population . Incr mortality w/ age & male sex. HA & Hgb were protective… https://t.co/idnuUL9Kog https://t.co/2MsOxuTtCd
Dr. John Cush RheumNow ( View Tweet)
Rheumatologist Survey: Active Lupus on pred + DMARD w/ (more than skin/Joint) organ & serologic activity- whats your preferred "add-on" drug?
Dr. John Cush RheumNow ( View Tweet)
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV
Dr. John Cush RheumNow ( View Tweet)
Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/s5v3XD8QmC https://t.co/iP5yFWkQwb
Dr. John Cush RheumNow ( View Tweet)
Online survey of 1,531 in 2019 showed that rural women have greater psychological and physical burdens than their suburban/urban women - with more mood swings, muscle and joint pain, vaginal dryness and urinary problems . https://t.co/TlaEEENdzp https://t.co/TTtyWK5urZ
Dr. John Cush RheumNow ( View Tweet)
Algorithm for the treatment of calcinosis #calcinosis @RheumNow #ACR24 https://t.co/NZhP7Enzrp https://t.co/1mO8waM5DI
Links:
Dr. John Cush RheumNow ( View Tweet)
Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women
https://t.co/rFOW4OpZS7 https://t.co/A0EN8b9KYB
Dr. John Cush RheumNow ( View Tweet)
Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/FKZyNU1s06 https://t.co/w5q0hOesEH
Dr. John Cush RheumNow ( View Tweet)
What is Osteoarthritis? A downloadable patient education page from JAMA. https://t.co/PfoimFgxRp https://t.co/WVQbofTzGC
Dr. John Cush RheumNow ( View Tweet)
FDA has approved Eli Lilly’s GLP-1 drug Zepbound [tirzepatide] to treat moderate to severe obstructive sleep apnea in adults with obesity in combination with increased physical activity and a reduced-calorie diet.” https://t.co/rYiM6JzmDX https://t.co/hO6CgH9pVs
Dr. John Cush RheumNow ( View Tweet)
"If you want an argument, put two rheumatologists in a room and ask them about steroid tapers. Add a third and you'll have a fight"
-P. Merkel at UPA plenary session
#ACR24 @RheumNow
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/f7OwxAggaf… https://t.co/PUuwo0MLso https://t.co/JBzokT9icx
Dr. John Cush RheumNow ( View Tweet)
54K Peptic Ulcers Annually (12.13.2024)
https://t.co/18FiQx1YQA https://t.co/32UZi9XafS
Dr. John Cush RheumNow ( View Tweet)
Vaccine Responses:The DMARD Counts
Dr. David Liew reviews abstracts 0247, 0248, 1988, 1009, reporting from Melbourne, Australia for the 2024 ACR Convergence meeting.
https://t.co/0qDGRkT64B https://t.co/dO9EvhD1NE
Dr. John Cush RheumNow ( View Tweet)
How do you manage skin in Sscl?
-RNA pol III + high risk for skin progression.
-Limited+ low risk + stable Sscl no need for immunesuppresors.
-Look for EF in pts with generalized morphea.
-Ttnt of skin depending on other organ involvements.
-If no Raynaud’s/hands spared think of… https://t.co/DZzhShKzS8 https://t.co/J9Qg1Lk2Wl
Dr. John Cush RheumNow ( View Tweet)
Sarcoidosis is biopsy supported not proven”
-Dx is clinical with broad ddx.
-Assess organ involvement in all pts.
-Whole body PET can help assess disease activity (not in CNS disease)
-MR brain with pituitary cuts helpful in CNS sarcoid.
#ACR24 @ACRheum @RheumNow… https://t.co/Ka1cHtFOqj
Dr. John Cush RheumNow ( View Tweet)
