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Teaching You How to Think… (8.15.2025)
Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and aphorisms to live by.
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Biologic Switching in Psoriasis
A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay.
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CKD & Osteoporosis Rx Revisited (7.25.2025)
Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.
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NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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Systematic review of 47 studies covering 1.5 million cases found that Dx of Crohns, SLE, Type I DM positively associated w/ incr risk of pancreatic, esophageal, colon, liver, and hepatobiliary cancers. MS assoc w/ lower risk of pancreatic, esophageal, rectal, & colorectal CA https://t.co/g0N5eHhJYj
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Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh
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French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
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RA leads to ILD: but ILD does not lead to RA
New research sheds light on the link between rheumatoid arthritis (RA) and idiopathic pulmonary fibrosis (IPF). A team from Taizhou Hospital used advanced multi-omics methods to explore the causal relationship between these two https://t.co/QbY6GC0KBZ
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Retrospective study of FDG-PET scans at Int. Medicine tertiary hosp (2015-2020), included 260 adult IM pts - indications: infx 42%, inflammation 35%, suspected CA 17%. 80% were helpful; 40% Rx changed. 23% neg. results; 9% made the Dx; 43% PET superior to other imaging. Less https://t.co/2UG2npJgRg
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Danish childhood vaccination registry study (1997-2020) found among 1,224,176 children w/ vaccination before age 5, w/ aluminum containing vaccines against an DPT, poliovirus, Hib (DTaP-IPV/Hib), PCV, etc found no increased risk of autoimmune dz by 8 yrs of https://t.co/9IR6AmlIT9
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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors
Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer. https://t.co/i3FMOCbyNg
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New CDC report confirms a record number of Measles cases in the USA, now at 1,319 (in 39 states), the highest since 1992. National cases are more than 4.5 times higher than the entirety of last year, which had an estimated 285 cases reported. https://t.co/KkqQu9C4cO https://t.co/bND6hPDUNA
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RA Lung Disease Portends Poor Outcomes
A retrospective Harvard affiliates study shows that rheumatoid arthritis (RA) patients with lung disease have higher mortality, especially respiratory and infection-related mortality than those without lung disease (LD). https://t.co/13h2u26ecb
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Diminishing trend in serious infections assoc w/ TNFi use in inflammatory arthritis over the years. ICEBIO study 1387 Rx w/ 1st TNFi 2003–2018 (vs 6936 comparators. Over tme the SI rate dropped 52% (IRR 0.48; 0.25–0.94), but not for controls (Abx use stable) https://t.co/jDsKlCrd0p
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Osteoarthritis (OA) degenerative or inflammatory? 296 pts w/ Knee OA (age 63 yrs, 2/3 had poor oral hygien, K&L grade 2, pain >40). Periodontitis in 62.5% & signif assoc w/ Xray K&L grade 4 (OR 5.39), poor oral hygiene (OR 34), dental visits (OR 8.54), brushing time (OR 21.9) https://t.co/xXIr2qxtt4
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MTX lowers risk of serious infxn (SI) - UK Observational study of 17 472 newly Dx RA (2018–2023); 10K on MTX, 4,540 other csDMARDs; 13680 corticosteroids (GC). 1307 SI (3/100 PY) w/ reduced adj HR 0.72 (95% CI: 0.63–0.82). 311 SI-related mortality (IR 0.69;0.61–0.77) https://t.co/iuxAivtrYZ
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Short full read review of the history, safety and use of Corticosteroids in Respiratory Medicine (including use in community-acquired pneumonia (CAP), ARDS, septic shock, ILD, COPD/asthma, COVID-19, Cancer, Sarcoid & IPF. https://t.co/aKMAT8IhLm https://t.co/RopoNnYJ6Z
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Sulfasalazine as a preventative against Pneumocystis (PJP). 594 RA pts & 848 Rx episodes - 181 on SSZ, 667 controls. W/ 850 Pt-Yrs F/U, 21developed PCP, 3 died of PCP. SSZ significantly lowered PJP risk (p = 0.003, rate ratio = 0.05; 95% CI 0.00–0.34). https://t.co/PAgBaJGldR https://t.co/PuTxGXTeRS
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MTX lowers risk of serious infxn (SI) - UK Observational study of 17 472 newly Dx RA (2018–2023); 10K on MTX, 4,540 other csDMARDs; 13680 corticosteroids (GC). 1307 SI (3/100 PY) w/ reduced adj HR 0.72 (95% CI: 0.63–0.82). 311 SI-related mortality (IR 0.69;0.61–0.77) https://t.co/YhJV3vyAmB
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Sulfasalazine as a preventative against Pneumocystis (PJP). 594 RA pts & 848 Rx episodes - 181 on SSZ, 667 controls. W/ 850 Pt-Yrs F/U, 21developed PCP, 3 died of PCP. SSZ significantly lowered PJP risk (p = 0.003, rate ratio = 0.05; 95% CI 0.00–0.34). https://t.co/PAgBaJGldR https://t.co/VV3MvVEGal
Dr. John Cush RheumNow ( View Tweet)
