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Early Antibiotic Use Increases JIA Risk

d Jack Cush, MD

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of juvenile idiopathic arthritis (JIA), although infections during fetal life or childhood did not increase risk of JIA.

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joint.tap_.septic.monarthritis.jpg

Post-Arthroscopic Increase in Septic Arthritis

d Jack Cush, MD

A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern.

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tylenol,acetaminophen,pills,tablets

Is Acetaminophen Potentially Hazardous in Pregnancy?

d Jack Cush, MD

A consensus report from a multinational group of 91 scientists, clinicians and public health professionals alarmed the medical world last week as they suggest the use of acetaminophen (paracetamol) during pregnancy may have hazardous developmental effects on the fetus.

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Biosimilar update: 31 FDA approved biosimilars, but only 60% made it to market. 2015 to 2019, drug spending grew 6.1%, biologic spending grew 14.6%; biologics are 43% of US drug spending. Most biologics at ~30% discount. https://t.co/4paYH8yVLQ

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Dr. John Cush RheumNow ( View Tweet)

MMWR shows the safety of a 3rd (booster) dose of the mRNA vaccine to be same as the 2nd dose AEs. V-safe data on 3rd dose (n=12,591) showed local or systemic effects (79% or 74%) to be same as 2nd dose (78% or 76%) https://t.co/LcD0ARlWJ2

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Dr. John Cush RheumNow ( View Tweet)

#RA patients had an an increased risk of mortality after CABG (HR 1.50; 1.28-1.77); and a higher risk of MI following CABG (HR 1.61; 1.28-2.04). A retrospective Finnish study comparing RA (n= 378) to nonRA patients (n = 7560) https://t.co/cGGsrLs1V2

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Dr. John Cush RheumNow ( View Tweet)

Tymlos (abaloparatide), for the postmenopausal osteoporosis, has a label update on the MOA, now reads as: "Once-daily...abaloparatide stimulates new bone formation on trabecular & cortical bone surfaces by stimulation of osteoblastic activity." https://t.co/AC9JvtmIdZ

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Dr. John Cush RheumNow ( View Tweet)

Case controlled study suggests that intraarticular steroid injections is associated with increased (HR 8.56; 3.29-22.3) risk of rapidly destructive hip disease (RDHD); at a rate of 5.4% (5.1 mos post injx) w/ JSN, osteolysis, fem head collapse https://t.co/grX5bO4495

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Dr. John Cush RheumNow ( View Tweet)

10 Signs You'd Make a Great Pathologist #PathTwitter #MedTwitter 1. You've been told that you "ask too many questions" at some point in your life.

Becca Brass, MD BeccaBrass ( View Tweet)

108 pts with autoimmune cytopenias (TTP, ITP, AIHA, etc) were given COVID vaccination showing low rate of post-vax flares. Signif HEME decreases in 7.4% of AIHA & ITP; mild decrease in 10% AIHA and 20% ITP, w/ no Rx change https://t.co/OaHILar57z

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Dr. John Cush RheumNow ( View Tweet)

Variance in Uric acid? 85 pts without gout & serial SUA measured. 72/85 had nl SUA, but 21% later had high SUA x1. If SUA < 6, much less like to have future hyperuricemia (7% vs 39%, p = 0.0037). 13 w/ high SUA, half later had nl SUA. https://t.co/w05ll3OMbJ

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Dr. John Cush RheumNow ( View Tweet)

Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib) https://t.co/MO4i5ngKkr

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Dr. John Cush RheumNow ( View Tweet)

Prospective study of 77 RA patients in remission --> vax w/ BNT162b2 (BioNTech-Pfizer) (w/ temp D/C of DMARDs per ACR) found a vaccine-related flare rate of 7/8% (6 pts) w/ 5/6 flares after 2nd dose (2.6 days), resolved w/in 2 wks https://t.co/YOL3YVArvG #RheumNow https://t.co/dxRWhu8CJX

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Dr. John Cush RheumNow ( View Tweet)
Can I get the INFLUENZA and COVID Vaccines together? The CDC says: "YES...both vaccines can be given at the same visit, people should follow the recommended schedule for either vaccine.... ideally get a flu vaccine by the end of October." https://t.co/T49zm6Cxyc

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Dr. John Cush RheumNow ( View Tweet)

Patients with rheumatoid arthritis (RA) who had a history of cancer did NOT have an increased risk of new or recurrent cancers if treated with biologic therapies, a meta-analysis found. #RheumNow https://t.co/jM9oiRzXUk https://t.co/XYnaalEfe2

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Dr. John Cush RheumNow ( View Tweet)
NEJM Image Challenge: A patient presented with painful and erythematous plaques on his hands and elbows. Lab examinations showed leukocytosis and thrombocytopenia. What is the diagnosis? https://t.co/kQrNuVmVXg https://t.co/4JGeExCcP7

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NEJM NEJM ( View Tweet)
Aortitis: Let’s review the differential for #aortitis including Non-Infectious and Infectious Causes! @febrilepodcast x @RheumOnePagers | created by @MithuRheum @swinndong #IDTwitter #RheumTwitter #FOAMed https://t.co/pR0iTls4PK
Rheum OnePagers RheumOnePagers ( View Tweet)
New study on #COVID19Vaccine in autoimmune cytopenias 🩸7.4% had clinically significant ⬇️ in counts 🩸 All successfully managed w/steroids & transfusion 🩸 Mild ⬇️ in 10% AIHA and 20% ITP ⭐️Vaccination safe with close monitoring⭐️ https://t.co/qGZe6LiPKz

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AmericanJournalofHematology AjHematology ( View Tweet)

Pooled analysis of the DISCOVER-1 and DISCOVER-2 trials have shown that guselkumab, an IL-23 inhibitor, was effective and safe in psoriatic arthritis (PsA) patients with axial involvement and imaging-confirmed sacroiliitis. #RheumNow https://t.co/yLCxyC1oLr https://t.co/Uloqx2phlh

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Dr. John Cush RheumNow ( View Tweet)

The #1 question I get from new consults: “How did I get arthritis?” Here is my list of 11 drugs (or drug classes) known to cause arthritis or rheumatic disorders (as an unintended consequence). #RheumNow https://t.co/GsV0Qj9ENr https://t.co/IrTkY5yFdY

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Dr. John Cush RheumNow ( View Tweet)
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