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Growing Cannabis Use in Arthritis Patients

d Jack Cush, MD

The National Databank for Rheumatic Diseases reports a significant increased in cannabis use amongst arthritis patients between 2014-2019, suggesting patients are more frequently engaged in self-management of pain and the unmet need for a pain relieving, opioid-sparing alternative.

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New-Onset IBD and IL-17 Inhibitors: What Is the Risk?

d MedPage Today

Patients with inflammatory/autoimmune diseases who initiated treatment with interleukin (IL)-17 inhibitors did not have a higher risk for the development of inflammatory bowel disease (IBD), but only after taking into account the severity of their underlying disease, French investigators reported

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FDA Approves IVIG in Dermatomyositis

d Jack Cush, MD

The U.S. Food and Drug Administration (FDA) has approved Octagam 10% [Immune Globulin Intravenous (Human)], as the first and only intravenous immunoglobulin (IVIg) formulation to be approved for adult dermatomyositis (DM).

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Canakinumab Fails to Improve COVID-19 Survival

d Jack Cush, MD

JAMA has published the findings of trial wherein the anti–interleukin-1β antibody canakinumab (CAN) failed to improve survival in patients hospitalized with severe COVID-19.

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ACR/Vasculitis Foundation Guideline for Giant Cell Arteritis and Takayasu Arteritis

d Jack Cush, MD

The ACR and the Vasculitis Foundation have published their evidence-based recommendations and expert guidance for the management of GCA and Takayasu arteritis. These recommendations address a variety of clinical questions and scenarios including diagnostic testing, imaging, treatments, and surgical interventions. Recommendations for GCA and TAK include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of glucocorticoids as initial therapy.

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In a study of 15123 RA pts >50 yrs; 1640 osteoporotic fractures occurred. Low-dose glucocorticoids (≤7.5 mg/D) was not associated with overall risk of OP Fx (adj HR 1.14) but was assoc w/ increased risk of vertebral Fx (adj HR 1.59, 1.11–2.29) https://t.co/ZJtYAAQ3KW

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Dr. John Cush RheumNow ( View Tweet)

EULAR guidelines rec starting prednisone dose in #PMR to be between 12.5-25mg/d. A cross sectional study of 138 pts (63M, 75F, age 73.4 yes) saw the mean starting dose to be 19.2±7.7 mg.  https://t.co/Yf3yqRRMCK

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Dr. John Cush RheumNow ( View Tweet)

US life expectancy dropped by 1.5 years in 2020, driven by the pandemic. https://t.co/89i333vmPv

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Dr. John Cush RheumNow ( View Tweet)

#VaccinationCovid DOES induce #SARS_CoV_2-specific #antibodies in #Rituximab-treated patients, after peripheral B-cells have at least partially repopulated! In addition, T cell responses (independent of B cell status) may also exert protective effects! https://t.co/E1FErHJtd3

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Daniel Aletaha DanielAletaha ( View Tweet)

Canakinumab Fails to Improve COVID-19 Survival https://t.co/ngThAgfHTq JAMA has published the findings of trial wherein the anti–interleukin-1β antibody canakinumab (CAN) failed to improve survival patients hospitalized with severe COVID-19. https://t.co/pUBmt85jAC

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 39 studies, 15,673 pts with nail psoriasis = 100% improvement of the Nail Psoriasis Severity Index, ixekizumab was best @ 24 wks (OR 2.98; 95% CI, 1.74-5.10), followed by TNF inhibitor (infliximab, adalimumab). https://t.co/VnhbMPYEV7

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Dr. John Cush RheumNow ( View Tweet)

Drugs capable of inducing drug-associated ANCA vasculitis - mirabegron (Myrbetriq), sofosbuvir (Sovaldi, antiviral), nintedanib (Ofev), hydralazine, propylthiouracil, thiamazole, minocycline, carbimazole, allopurinol, influenza vax.... https://t.co/KhK2w10hs5

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FDA delays in the analysis of Pfizers/Xeljanz Oral Surveillance Safety study has put off potential approvals for other JAKs (Lillys Oluminant in Eczema & Abbvies Rinvoq for Eczema, Psoriatic arthritis, Ank Spondylitis). The wait continues.. https://t.co/3pRp2Vnuhw

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Dr. John Cush RheumNow ( View Tweet)

ICYMI: 263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stabilized their FVC, DLCO, Chest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/1dGufcsRpC

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National Inpatient study (2000-2014) shows increased risk of vertebral compression fractures (VCF) in Ankylosing spondylitis (2.7%), compared to RA 0.77% & gen population 0.35%. VCF Hosp increased over time in AS, but decr in RA pts https://t.co/ugV44XJf8a

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Dr. John Cush RheumNow ( View Tweet)

152 Israeli pts w/ Breakthrough COVID infx >7d after 2nd Pfizer vax; all hospitalized, 38 w/ Poor outcome & 22% (34/152) died. All were older, most males, w/ comorbidities, 40% immunocompromised; high risk w/ RTX & low anti-spike IgG titers https://t.co/x1Uuyo7qim

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Dr. John Cush RheumNow ( View Tweet)

Study of 33 RCTs, 4544 pts Rx w/ either IL-17 or TNF inhibitors finds lower risk of UVEITIS with anti-TNF mAb (vs PBO OR = 0.46; vs IL-17i OR = 0.34. IL-17 inhibitors are not protective against uveitis https://t.co/AIxgI2qhq9

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Dr. John Cush RheumNow ( View Tweet)

Study of 647 RA pts wanting to get pregnant finds only 3.9% SSA+ & 1.1% SSB+ (higher in RF+ pts); ~1/2 had SSA titre of >240 units/mL - but No cases of neonatal lupus or heart block seen. In a French register, SSA related CHB was 1.5% https://t.co/FmZzPpmB7D

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Dr. John Cush RheumNow ( View Tweet)

Can you refuse to see unvaccinated pts? NY Times letter reviews options for “vaccine hesitant” or “vaccine refusing” 1. Ask if vaccinated 2. Offer telehealth 3. Require masks & distancing 4. Minimize contact betw vax & no-vax pts 5. Address pt concerns https://t.co/LEJLDMIDyF https://t.co/stoUpzzK02

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Dr. John Cush RheumNow ( View Tweet)
Botanical extract, Chrysanthemum zawadskii var. latilobum (GCWB) studied in 112 w/ mild-mod. knee OA. Randomized, double-blind, placebo-controlled study finds GCQB signif better than placebo in WOMAC total & function scores https://t.co/xyKlrL2CG7

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Dr. John Cush RheumNow ( View Tweet)

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