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Undifferentiated Arthritis Does Not Follow an RA Course
Undifferentiated arthritis (UA) is common in medical practice and many advocate early use of DMARDs; yet a recent study shows that despite DMARD use, UA patients do not fair well with this approach.
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Tocilizumab Works Best in Non-Mechanical Ventilated COVID-19 Patients
JAMA has published a meta-analysis of 15 studies of hospitalized patients with COVID-19 treated with tocilizumab and corticosteroids, showing that a clinically meaningful mortality benefit from tocilizumab (and steroids) was best seen in those not requiring invasive mechanical ventilation (IMV).
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When Less (Drug) is More (Activity) (3.4.2022)
Dr Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
This podcast is sponsored by RheumNow.live. The great future of rheumatology education is at RNL 2022.
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COMPLETE-PsA Trial studied MTX vs MTX + leflunomide in 78 active untreated PsA pts. MTX+LEF was superior to MTX alone at wk 16 (PASDAS 3·1 vs 3·7; p=0·025). Combo group had more N/V (44% v 28%), ^ALT (31% vs 18%). https://t.co/Hc4rNrlQzP https://t.co/UPosZIc4C0
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Drug Survival Differences in RA, PsA, SpA and PsO
https://t.co/aBRhTbVmCM https://t.co/ZDGiKlowoV
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Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Arthritis and Eosinophilia
Considerations when eosinophilia is seen in RA patients.
QD Clinic is sponsored by https://t.co/4UQlqwujiR (March 19 & 20, 2022 in Las Colinas, Texas)
https://t.co/2FszCiTLgf https://t.co/07uZT2heW3
Dr. John Cush RheumNow ( View Tweet)
New Download Available!
Autoimmune Disease in the USA
https://t.co/KvsgBUY7mL https://t.co/PSTF7ma6G6
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Dr. John Cush RheumNow ( View Tweet)
2021 Top Articles from Arthritis & Rheumatology
https://t.co/nxKWrkdGX3 https://t.co/iZx5MOUyA7
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CORVITAS RA registry shows poor biologic responses in Severe obesity (BMI >35) & underweight (<18.5) w/ no diff between 2891 TNFi vs 3010 non-TNFi users. Severe obesity lower odds of LDA, MCID, CDAI ~10-20% UnderWt ~50-70% https://t.co/iMvlyo4UKx https://t.co/JTQ6aRVTpH
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ICYMI: Spondyloarthritis in Early Crohn's Disease
Analysis of a German Crohn's disease cohort finds that in patients with early CD, SpA was present in nearly one out of five patients and was associated with HLA-B27 positivity and a highly active CD.
https://t.co/ExAHSCw5v2 https://t.co/UDZHbg9ySY
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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Increased SLE Flares with HCQ Reduction
Concerns about the long-term safety of HCQ often results in dose reduction or drug discontinuation; study shows that, for those in remission, HCQ taper/discontinuation resulted in a higher rate of SLE flares.
https://t.co/l0Xh1oQzQA https://t.co/HyDbqKrEFp
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ICYMI: NEJM case - Whats the diagnosis? 31yoM w/ 10yr hx of clubbing, arthralgias, nailfold hyperpigmentation, Tender DIPs, toes; xrays showed bony proliferation. Labs and PET were normal. Rx w/ NSAIDs and improved w/ specific Rx? https://t.co/gJ922ToXe9 https://t.co/vyuxLA5SkL
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ICYMI: INBUILD Study of 170 pts with autoimmune related ILD showed nintedanib signifi. slowed the rate of FVC decline in FVC decline over 52 wks (NIN -75.9 mL/yr vs PBO -178.6 mL/yr). AE's (mostly diarrhea) leading to D/C was NIN 17.1% vs PBO 10.2% https://t.co/1h2recxnqn https://t.co/d930Xij3Zv
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ICYMI: FDA approved 2/28/22
IV (intravenous) Actemra for GCA: dose 6mg/kg q4 weeks (don't exceed 600 mg/dose)
https://t.co/QhIq6dHGSf
TheDaoIndex KDAO2011 ( View Tweet)
ICYMI: Psoriatic fingernail onycholysis and hyperkeratosis, rather than nail pitting, are significantly & independently assoc w/ PsA. Study of 1985 pts w/psoriasis, 11.5% were Dx w/ PsA. Only onycholysis (OR 2.34) and hyperkeratosis ) were assoc w/ PsA https://t.co/5K8L5WKQXs https://t.co/InDPhLrIUK
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Dr. John Cush RheumNow ( View Tweet)
Download this week’s podcast titled “When Less (Drug) is More (Activity) “
https://t.co/FESVNenri9 https://t.co/PVGGjkgcTV
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Dr. John Cush RheumNow ( View Tweet)
French GAZEL study of 20,625 pts showed a confirmed RA Dx was significantly assoc w/ increased CV risk (HR 3.03; 1.13–8.11) independent of usual CV risk factors. RF or ACPA (+) without RA was not associated with CV events https://t.co/DG8o5d9hHE https://t.co/5n9uDAhSrF
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When Labs and Exam are Discordant
A patient whose labs are way scary but her exam is not
QD Clinic is sponsored by https://t.co/4UQlqwujiR (March 19 & 20, 2022 in Las Colinas, Texas)
https://t.co/zUNcCn2CMi https://t.co/jsCGdwn5SH
Dr. John Cush RheumNow ( View Tweet)
Spondyloarthritis in Early Crohn's Disease
Analysis of a German Crohn's disease cohort finds that in patients with early CD, SpA was present in nearly one out of five patients and was associated with HLA-B27 positivity and a highly active CD.
https://t.co/q3w0hy0mzw https://t.co/P6EdggUxM8
Links:
Dr. John Cush RheumNow ( View Tweet)
An odd association - Swedish Registry analysis matched incident gout (1:5) w/ non-gout & looked for birth associations. Future gout risk was assoc w/ maternal diabetes ( https://t.co/Tsz72SeTC8 3.1), congenital malformation (OR 1.33), $ small gestational (OR 1.75) https://t.co/r9dGMzBopK
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Dr. John Cush RheumNow ( View Tweet)
