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Rheumatoid Arthritis Nonadherence is Multifactorial

d Jack Cush, MD

The consequences of medication non-adherence (NA) in rheumatoid arthritis (RA) care are numerous and damaging.  A 6-month prospective cohort study of RA patients shows NA to vary according to drug type and be related to psychological, communicational, logistic, sociodemographic or clini

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Hand OA and Heroes in Rheumatology (2.11.2022)

d Jack Cush, MD

Interesting reports this week about dementia, who gets hand OA and a great list of women Heroes and Pillars of Rheumatology. Tune in as Dr. Jack Cush reviews the news and journal articles from this past week in RheumNow.com.

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Recommendations on Telemedicine in Rheumatology

d Jack Cush, MD

The integration of Telemedicine in to rheumatologic care was ignited by pandemic restrictions in early 2020 and since the advantages and disadvantages have been debated.

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Challenges in Lupus: -Mortality greatest in 1st yr -Dx Delays 6.4 yrs -Long-term complications increased 50 fold -Steroids worsen long-term outcomes -Health care costs increased 3 to 5 years prior to Dx -Mean delay in drug starts after Dx =177 days https://t.co/QUbsIQtcRa https://t.co/zAMUp99ecg

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Olumiant (baricitinib) studies in Lupus halted by Lilly due to mixed results in phase 3 trials. While the BRAVE-1 study showed 4-mg BARI meeting primary endpoint at 52 weeks; the Brave-II failed to do same & failed key secondary endpoints https://t.co/XBmo15UCYl

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Lupus international cohort study of 1460 HCQ pts showed that SLE flares were increased with dose reduction (aHRs 1.20;CI 1.04 to 1.38) and HCQ discontinuation (aHR 1.56; 1.31 to 1.86), higher with low educational levels after HCQ D/C https://t.co/fO4fBtrFYo

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Fatigue in Early RA registry - study of n = 1236 pts w/ Dz duration 11 mos. The prevalence rates of fatigue was 44% and severe fatigue 19% and was stable over 3 yrs. Greater fatigue in women, high pain, mental Dz, function; BUT NOT SJC or ESR https://t.co/hEgPbsAqYZ

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Taiwan study of 12,786 pre-dialysis advanced CKD patients with gout shows that use of febuxostat or allopurinol was assoc w/ a reduced sepsis/infection risk - most w/ FEB (HR, 0.68; 0.52–0.87), but no signif difference in MACE or CVA https://t.co/zp7JLwzah8

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Join Dr. Ronan Kavanagh for an incredible STEP Session at #RNL2022, where he will discuss The Jazz of Rheumatology. Register today! https://t.co/hMzdpN327q https://t.co/uHYC9VV1kp

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Round up of last week's QD Clinics: -Steroid Weaning -Diagnosing Neuropsychiatric Lupus - Not the Same Ol’ Lecture - Your Next Follow-up Visit is When? QD Clinic is sponsored by RheumNow Live https://t.co/9U1wcbIMs4 https://t.co/HjyyGtbe4r

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UK Biobank case control study of 15 871 pts with Gout and COVID. Gout associated with diagnosis of COVID-19 (OR 1·20; CI 1·11–1·29) but not with risk of COVID-19-related death in the cohort of patients diagnosed with COVID-19 (1·20, 0·96–1·51). https://t.co/dN5YnIqhzD

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Should we use colchicine in COVID-19? Mainly mixed results; not likely effective in sick hospitalized patients but may have utility in early infections https://t.co/wecWjSIbEG

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ICYMI: NEJM study of ~2000 persons showed that prior PCR proven SARS-CoV-2 infection was effective at preventing Symptomatic Reinfection against alpha variant (90.2%), beta ( 85.7%), delta (92%), but not omicron variant (56%). https://t.co/UkvDUH6alK

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ICYMI: Retrospective study of 179 antiphospholipid syndr pts, looked at noncriteria findings- their presence incr relapse rates (59% vs 34%;p=0.018) triple positivity & need for Rx. (cytopenias, APS nephropathy, livedo, CNS, Libman Sachs endocarditis) https://t.co/i7UItlDcHd

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ICYMI: Women Heroes in Rheum: - Barbara Ansell - JIA - Nanna Svartz-SSZ - Gertrude Elion - Nobel Prize for allopurinol, AZA - Tsai-Fan Yu - gout Rx - Mary Betty Stevens - lupus/vasculitis - Marian Ropes - 1st F ARA president - Fionula Brennan-TNFi & more https://t.co/0kxrXo5fr3 https://t.co/QfCDxkfYRi

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ICYMI: Approximately 61% of patients with rheumatoid arthritis or psoriatic arthritis who use methotrexate report side effects following weekly dosing, including fatigue and nausea, according to data published in Rheumatology and Therapy https://t.co/65OMw9A96h

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Data from 2 phase III studies of psoriatic arthritis using tofacitinib, adalimumab shows that a significant meaningful clinical response is achieved in 29-53 days -- why then are we not making go vs no-go decisions with modern biologics at 6-8 weeks? https://t.co/F56P9c3Rb5

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CARRA Registry looked at TNFi use in JIA and found a nearly 3 fold increased risk of psoriasis. 8225 pts w/ 3.9 yrs of F/U. 54% recv TNFi; the aHR of new onset of psoriasis after TNFi exposure was 2.93 (2.15 to 3.98). MTX had lower risk (HR 0.45) https://t.co/Z6qvlS26M9

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Osteoarthritis Initiative study looked at Hand OA. Among 3588 participants, 41% had hand OA by xray and 12.4 % by Sxs. Over 4 yrs, 27.3 % showed Xray OA progression. More in women (DIPs)>men (MCPs), but less in blacks https://t.co/WRZYcL7zFH

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Scandinavian study of cardiac abnl. in idiopathic inflammatory myopathies showed prolonged QTc abnormalities was more common in IIM pts (16%) & Anti-Mi2, anti-Pl-7, elevated CRP are associated with prolonged QTc (potential biomarkers?) https://t.co/vkEDaum9aY

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