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Psoriasis, arms, PsA

Abatacept After Ustekinumab Withdrawal in Active Plaque Psoriasis

d Jack Cush, MD

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.

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TNF Dose Reduction Succeeds in PsA, Axial Spondyloarthritis

d MedPage Today

Patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who were doing well on treatment with tumor necrosis factor (TNF) inhibitors were able to successfully taper the therapy when guided by disease activity, a retrospective cohort study found.

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Hepatitis B Reactivation with Rituximab and Abatacept

d Jack Cush, MD

Hepatitis B reactivation is an uncommon complication of biologic therapy use. Now, a serologic study of  rheumatoid arthritis patients shows that HBV reactivation is seen with rituximab, and less so with abatacept, especially in patients without hepatitis B antibody (HBsAb) positiv

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Start #MTX & escalate 5mg q2wk (usual) or 5mg q4wk (fast): open RCT 178 #RA pts - equal EULAR resp (28 v 23%), DAS28-CRP (-1.3 v -1.3) - same at wk8 & 24. No diff in MTX polygluts., cell #s, LFTs, D/C - but more GI sx w/ fast wk8 (40 vs 27%) https://t.co/MbuFoA5HFp

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of NSAIDs & opioids in Knee/Hip #OA - 192 RCTs (102829 pts). AE dropouts & adverse events were ZERO w/ topical NSAIDs; highest w/ opioids (83% & 90%). Pronounced Rx benefit more likely w/ oral & topical NSAIDs (99 & 93% probability) https://t.co/376uAzMcpH

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Dr. John Cush RheumNow ( View Tweet)

US Preventive ServTask Force has advised that adults >60 yrs should NOT take daily preventative aspirin without a no hx of MI/CVD risk (the GI risks outweigh CV benefit). If 40-59 yrs, discuss w/ their MD if ASA would be beneficial https://t.co/jfqnBjwLLn

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Dr. John Cush RheumNow ( View Tweet)

FDA Approves Avacopan for ANCA-Associated Vasculitis https://t.co/L7UwhYBaVY #RheumNow https://t.co/0cGN5eyfCl

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Dr. John Cush RheumNow ( View Tweet)
Triple DMARD Rx - MSH vs MLH (Lef). 136 active #RA pts given OL MTX/SSZ/HCQ vs MTX/HCQ/LEF. Equal efficacy (EULAR-Good) was seen at wk 12 (54% vs 59%) and wk 24 (65% vs 62%) - hence LEF substitution was noninferior. https://t.co/F5CGj0w7Bh

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Dr. John Cush RheumNow ( View Tweet)

RETRO - Taper or Not: You Decide A prospective, phase 3 trial of RA patients in sustained remission has shown more than half will flare if DMARD therapy is tapered or discontinued and that remission is best maintained by continued DMARD therapy. https://t.co/KDqGrujGMT https://t.co/8HqSS74PqL

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Dr. John Cush RheumNow ( View Tweet)
Anakinra appears to lower mortality risk (OR 0·32 vs historic controls) in hospitalized severe COVID-19 pneumonia (esp w/ hyperinflammation, CRP >100 mg/L). Metanalysis of nearly 2000 pts; better resp if given w/ dexamethasone (OR 0·23) https://t.co/7nFAkLgpGK

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Dr. John Cush RheumNow ( View Tweet)

Diagnositic Imaging comparison in 36 acute Gout vs CPPD pts: - Better: MSK US sensitivity/specificity for gout 92%/83% & 91%/92% for CPPD - Less: DECT sensitivity/specificity for gout 63%/92% & 55%/92% for acute CPPD https://t.co/Ee2MFb8qyl

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Dr. John Cush RheumNow ( View Tweet)

Low dose #methotrexate in primary cardiac prevention #CIRT. Trial had LESS decline in GFR in those with mild renal impairment than placebo. ?meaningful or a fluke. Either way MTX can be used safely in mild CRF! Just follow creatinine/GFR. #ClinicalPearl @RheumNow https://t.co/SyfsxZEeUH

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Janet Pope Janetbirdope ( View Tweet)

As a loud, fast talking man that has no idea what he’s talking about, I can vouch for this. https://t.co/0pjuzHhEBK

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Ethan Craig rheumecraig ( View Tweet)

The heterogeneous 🌍🌎🌏 world prevalence of systemic #lupus reflects heterogeneity in: ➡️ Ethnic mix ➡️ Genetic background ➡️ Age & sex ➡️ Year of the study ➡️ Socio-economic factors ➡️ Epidemiological methods ➡️ Environmental factors (?) Across populations https://t.co/QMJbJUf3vD
Laurent ARNAUD Lupusreference ( View Tweet)
Excited to share that the 2nd ed. Musculoskeletal Ultrasound in Rheumatology Review is the #1 new release in ultrasonography books on @amazon #ultrasound #RheumTwitter #meded #MedTwitter #POCUS #FOAMed https://t.co/b0ptm3MKid
Minna Kohler, MD, RhMSUS minnakohlermd ( View Tweet)
Upadacitinib was shown to be effective in two Phase 3 SELECT-AXIS trials. 1st trial: in bDMARD-IR AS pts the ASDAS resp was 44% vs 10% PBO at wk 14). 2nd trial: in nr-axSpA, the ASDAS response at wk 14: 42% vs 18% PBO. https://t.co/rnv9VVITeE

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Dr. John Cush RheumNow ( View Tweet)

Deucravacitinib (oral TYK2 inhibitor) in development, has been shown to be highly effective in psoriasis & PsA, but failed to meet its primary endpoints at wk 12 (remission) in Ulcerative Colitis in the phase 2 LATTICE-UC trial vs placebo https://t.co/ZGYuozFgOk

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Dr. John Cush RheumNow ( View Tweet)

Check out the most recent podcast where we “Ask Cush Anything” and discuss a dozen news items from the last week. https://t.co/Xb81eWEZ1q #RheumNow

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Dr. John Cush RheumNow ( View Tweet)

Clinical Associations with Myositis Antibodies Read the full post on #RheumNow https://t.co/tzPU1scc8x https://t.co/F537tPAQTU

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Dr. John Cush RheumNow ( View Tweet)
WHO's Strategic Advisory Group on immunisation has advised an addition COVID vaccination in those >60 years and the immunosuppressed (due to a higher risk of breakthrough infections) https://t.co/NcGr8EMDaO

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Dr. John Cush RheumNow ( View Tweet)

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