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steroid prednisone lab

Are You a High or Low Glucocorticoid Prescriber?

d Jack Cush, MD

A recent analysis shows thta glucocorticoids (GCs), usually recommended for short-term use in rheumatoid arthritis (RA), are variably used by rheumatologists, and that provider preference is a strong predictors of long-term glucocorticoid use.

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RheumNow Podcast – Quackademia (10.15.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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morbidity,covid,heart,lung,brain

2021 Update to EULAR Points on Immunomodulatory Use in COVID-19

d Jack Cush, MD

EULAR has updated its recommendations (points to consider - PtC) for rheumatologists managing patients during COVID-19; now with 2 overarching principles and 12 PtC.

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Still’s Disease Following COVID-19 Vaccination

d Jack Cush, MD

Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.

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Cancer Risk in Systemic Lupus Erythematosus

d Jack Cush, MD

Bernatsky and colleagues have shown cancer risk factors in incident systemic lupus erythematosus (SLE).

Researchers analyzed an SLE cohort of 1,668 patients, over an average of 9 years follow-up and found 65 cancers: 15 breast; 10 nonmelanoma skin; 7 lung; 6 hematologic; 6 prostate; 5 melanoma; 3 cervical; 3 renal; 2 each gastric, head and neck, and thyroid; and, 1 each rectal, sarcoma, thymoma, and uterine cancers.

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Among 2359 RA & PsA pts (3169 TNFi courses 1778/1391), serious infection (SIE) rates were higher in RA 4.17/100PY vs PsA 2.16/100PY. PsA had 41% lower SIE risk (HR 0.59, p=0.004) - Registry data from the NOR-DMARD study https://t.co/llH07TFHOI

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Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://t.co/blbOps9zVQ

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Comparative study of 46 AOSD, 9 MAS & 31 adult HLH pts, shows that serum IL-18 was signif higher in AOSD than HLH (closely correlates w/ ferritin, sIL-2R). IL-18, sIL-2R, ‘arthralgia or arthritis’ independently distinguished AOSD from HLH https://t.co/ZW6e78nEkh

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Smoking worsens adult-onset Still’s disease. 185 AOSD pts, found 45 smokers who had higher risk of pericarditis (36 vs 16%), pleuritis (33 vs 14%), abd pain (18% vs 6%), higher systemic score (6.4 vs 5.4 ), More MAS (29% vs 6%), lung disease (18% vs 13%) https://t.co/ZKKhw1EbnD

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Decline in the incidence of Behcets Dz? Between 2004 to 2017 Korea has seen BD decreased from 8.15/100K (2004) to 1.51/100K (2017), an 81.5% decrease, greater for women and middle-aged people, but no change survival or mortality https://t.co/tvZSSGMOH7

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Congratulations to a great rheumatologist, Dr. Rita Jain, newly appointed Executive Vice President, Chief Medical Officer for ChemoCentryx, who's new C5a inhibitor avacopan (Tavneos) was just FDA approved for ANCA-assoc vasculitis! https://t.co/udhjSFF1Q0

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Cancer Risk in Systemic Lupus Erythematosus https://t.co/1pzSJn62MS https://t.co/Mm1F4HCNFs

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A case of reactive arthritis following COVID-19 infection; manifest as dactylitis, psoriatic skin/nail lesions, painful oral & vaginal ulcers, subungual hyperkeratosis, but no oligoarthritis, or lumbar pain. https://t.co/nobMHGgKfZ

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A randomized controlled trial has shown that treatment of plaque psoriasis via costimulatory blockade ( CD28/B7) with abatacept did not prevent psoriasis relapse after withdrawal of ustekinumab. Read the full story on #RheumNow. https://t.co/8qgxYFW7EE https://t.co/8hi7JmR59a

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NICE issued a positive final appraisal recommending upadacitinib in previously treated moderate active rheumatoid arthritis (RA). This will expand UPA use to nearly 27,000 RA patients in the UK. Final pub date is Nov 10, 2021 https://t.co/A8OuzNlrAz

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Could Auranofin work in COVID-19 infection? it may do so by inhibiting IL-6 production, as auranofin inhibits TLR3/TLR4, STAT3/JAK1 and thioredoxin reductase that regulates NF-kB (later IL-6); and may inhibit viral replication too. https://t.co/efLG4tzpTZ

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Catastrophic Still's dz occurs early; compares 20 AOSD w/ organ failure vs 40 AOSD without. CAT-AOSD had shorter Dz duration, earlier Rx need; risks: younger; splenomegaly, liver, cardiac,lung involvement; ferritin level, no arthralgia https://t.co/8WIMd0JxZr

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498 axSpA (62%M: 38% F): Compared to men, women had higher Dz activity, joint counts, enthesitis scores (all P ≤ 0.01), more pain, worse fatigue and Functional scores; all P < 0.05), less full time work, More DMARDs/pred, Depression & FM https://t.co/kPY9YDpA9J

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Costs of #JIA are substantial, total costs up to 44,832 USD annually. Direct costs up to $32,446 USD, accounting for 55-98 % of total. $$$ mostly related to meds; cost go up 3 fold after biologic initiation. (JIA Indirect costs are underrepresented) https://t.co/rukJPWqD0y

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Are you registered on the #RheumNow site? With registration, you’ll receive new daily content first and can sign up for topic specific emails. https://t.co/riyAnrRHhX

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