Article
Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.
All News
Article
Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.
Article
An analysis of the tofacitinib (Xeljanz) drug development program in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ulcerative colitis suggests a low level risk for venous (VTE) and arterial thromboembolism (ATE).
Article
A case-controlled study shows that methotrexate (MTX) use in rheumatoid arthritis (RA) is not associated with interstitial lung disease (ILD) according to a report in the European Respiratory Journal.
Article
The interleukin (IL)-1β inhibitor canakinumab (Ilaris) showed promise for preventing the need for hip or knee replacement among patients with osteoarthritis in an exploratory analysis of data from a randomized clinical trial, investigators reported.
Among patients enrolled in CANTOS, the pooled incidence rate for total hip replacement/total knee replacement was 0.31 events per 100 person-years for those receiving the monoclonal antibody every 3 months for up to 5 years compared with 0.54 per 100 for those given placebo, according to Paul M. Ridker, MD, of Harvard Medical School in Boston, and colleagues.
Article
Ridker and colleagues have shown that statins (3-hydroxy-3-methylglutaryl coenzyme-A (HMG Co-A) reductase inhibitors) are effective at treating hyperlipidaemia and lowering C-reactive protein levels; Aranaow and colleagues have shown that lovastatin, when given to rheumatoid arthritis (RA) patients with elevated CRP levels failed to significantly lower disease activity.
Article
A proof-of-concept study published in Annals of Rheumatic Disease suggests that colchicine significantly improves COVID-19 outcomes.
Efficacy and safety must be determined in controlled clinical trials.he outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties.
Dr. John Cush
Tweet
Study of 1,631 incident RA & 3283 controls shows respiratory disease assoc with risk of RA, irrespective of RF & CCP and mostly in nonsmokers. aOR increased for chronic upper (1.4), acute lower (2.4) & chronic lower (1.6) Resp Dz, stronger for ACPA/RF+ https://t.co/C1hA631PIW
Dr. John Cush
Tweet
ATS Abstract: n=616 survey contrasts rheums (57%) & pulmonologists (43%) beliefs on RA associated ILD. Both preferred to use steroids, MMF, RTX for RA-ILD, but Rheums tend avoid ADA & LEF. Rheums (17%) & Pulms (24%) think MTX a risk factor https://t.co/W5gbu84FBv
Dr. John Cush
Tweet
Forward study of 18,754 RA patients who experienced 1,801 CVD events and found CVD risk reduction with TNFi (HR 0.82 [95% CI 0.72-0.94]) and abatacept (HR 0.50 [95% CI 0.30-0.83]) compared to csDMARDs over & above MTX alone (use vs. non-use: HR 0.82) https://t.co/YVfKWjkvxU
Dr. John Cush
Tweet
NJ study of 764 ICU COVID-19 pts, 210 (27%) received tocilizumab. TCZ treated patients had a lower death rate (49% vs 61%) (HR 0·64, 95% CI 0·47–0·87; p=0·004). Similar results seen in those requiring mechanical vent. or CRP >15 mg/dL https://t.co/idZTDunG1a
Dr. John Cush
Tweet
NY Times article about a "guy and aching legs". 48 yrs old w/ myalgias, wt loss, SOB, sinusitis, high inflammatory markers, pulmonary infiltrates, microscopic hematuria, red & swollen ears; but no fever/chills. You're a rheumatologist, you know the Dx. https://t.co/fbrRMNA5u4 https://t.co/JFOcM0MBxB
Dr. John Cush
Tweet
Study of 52 Takayasus arteritis patients (age 31 yrs; 6yrs F/U): 15 (29%) had severe severe ischemic events (13/15 at or before Dx): 5 CVA, 5 ACS, 1 ischemic cardiomyopathy, 4 limb ischemia. Dz outcomes & damage scores were similar with and without SIE. https://t.co/Qhzks0gJz6
Dr. John Cush
Tweet
Ann Int Med reports that the use of ACE inhbitors or ARB use is not associated with more severe COVID-19 disease (High-certainty evidence), and these meds are not associated w/ pos. SARS-CoV-2 tests- based on observational studies w/ 23565 COVID-19 adults https://t.co/px0rMH1Pjz
Dr. John Cush
Tweet
RA is associated with a 24‐35% lower risk of type 2 diabetes. Claims data comparison of 449,327 RA, general non‐RA, hypertension, OA, or PsA patients finds a lower risk of T2DM in RA (7/1000PY) and highest w/ HTN (12.3/1000PY) https://t.co/uZn5qaImO9
Dr. John Cush
Tweet
Analysis of PPI use from the Nurses Health Study shows regular PPI use was associated with increased risk of RA in women, higher with a longer duration of PPI use. With 1.7 million PY F/U, Regular PPI users had a 44% higher RA risk (adjHR 1.44; 1.10–1.89) https://t.co/pmBf88zGKH
Eric Topol
Tweet
Important finding of marked lung fibrosis (scarring) after severe #COVID19 in 8 patients https://t.co/Akp6jVXmB9 @TheLancetInfDis
(first complete pathologic description of this finding) https://t.co/QCuri3olgs
Dr. John Cush
Tweet
The RheumNow Podcast is up - COVID-19 Responds to Steroids & TCZ, statin myopathy, Lung Dz in AOSD, TNFi & Liver, IL-23 in Psoriasis. Watch it here>> https://t.co/DrrFZSWmZa or listen to Podcast on iTunes>> https://t.co/FHJv01AAbC or on SoundCloud>> https://t.co/nSPI9lcaY9
Dr. John Cush
Tweet
Systematic review of 100 pts with statin-associated myopathy showed mean age 65 yrs, presenting w/ symmetric prox. muscle weakness, mean CK=6853 IU/l, all were HMG-CoA reductase Ab+ & >80% had necrotizing myopathy & required immunosuppressants https://t.co/BoNmOHPkGH
Dr. John Cush
Tweet
Retrospective cohort of 147 Adult-Onset Stills Dz pts finds 18 (12.3%) with lung dz (LD) at the diagnosis of AOSD. AOSD-LD were older, w/ more myalgia, LN, pleuritis, ab,dominal pain, more systemic Dz, higher ferritin and more mortality (%39 vs 10%). https://t.co/2phEFwi6n2
