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Gout Flare and Treatment Studies Lacking in Severe Chronic Kidney Disease

d Jack Cush, MD

Gout is a common comorbidity amongst those with chronic kidney disease (CKD), with the added challenge of choosing best therapies in the setting of declining renal function.  A systematic literature review notes significant deficiencies regarding the efficacy and safety outcom

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Early Diastolic Dysfunction in Premenopausal Women with RA

d Jack Cush, MD

A two-dimensional/Doppler echocardiography of rheumatoid arthritis (RA) detected premature, clinically quiescent diastolic function.

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Starting Febuxostat During an Acute Gout Flare

d Jack Cush, MD

A randomized controlled trial in gout patients has shown that starting febuxostat during an acute gout flare was without ill-effects and did not prolong the gouty attack.

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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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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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Finnish Pop study 939 #RA pts shows highest healthcare costs linked to high Dz activity & comorbidity. Clusters: C1) young w/ low costs & activity, C2) chronic pain, disability, fatigue, C3) high cost/dz activity, less pain, C4)comorbidities w/ $$$ https://t.co/Azc35zyA9J

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RA DMARD use gleened from 86 rheumatologists recording Rx choices/reasons on next 12 pts. Total: 1027 RA pts, 621 already on b/ or tsDMARD (68% TNFi, 21% JAKi). ~Half who switched given another TNFi . Reasons: LOE, dz worsening https://t.co/zpjSO25wsh

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EULAR has received reports of tocilizumab shortage in several countries, including Germany, Portugal, Belgium, and Scandinavia. The UK and France are aware tocilizumab concerns, but have not yet reported actual shortages https://t.co/7QpjZTXXAK

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A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern. Read more… https://t.co/n82PpZ7a96 https://t.co/j3gzZ9g0QV

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Dr. John Cush RheumNow ( View Tweet)
DEA has warned of an increase in illegal counterfeit pills containing fentanyl & methamphetamine. These often look Rx opioids (Oxycontin, Percocet, Vicodin), Xanax or Adderall. DEA seized >9.5 million fake pills (more than last 2 yrs) https://t.co/Y0gJ4XrV1a

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Study Finds U.S. Generic and Biosimilar Savings Totaled a Record $338 Billion in 2020 https://t.co/hPR0nGd6jp

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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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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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#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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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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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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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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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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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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