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Safety and Tolerability of Subcutaneous Methotrexate

d Jack Cush, MD

A large, single-rheumatology center analysis of oral and subcutaneous (SC) methotrexate (MTX) use in daily clinical practice suggests that SC MTX has fewer drug discontinuations and is better tolerated compared to other DMARD therapies.

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RheumNow Podcast – Saphnelo (Anifrolumab) Approved for Lupus (8.6.2021)

d Jack Cush, MD

It was a banner week at the FDA; a new drug approval you should know about; a lot of information about pregnancy and safety; and an interesting case plus a question from one of our readers submitted via Back Talk. This and more in this week's podcast. Let's dive in.

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Lumbar Spine Decompression Alone is Superior to Decompression with Fusion

d Jack Cush, MD

The NEJM has published a multicenter study wherein patients with surgical lumbar spinal stenosis and degenerative spondylolisthesis were found to fair equally well (noninferior if treated with decompression surgery alone compared to decompression with instrumented fusion.

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Pfizer has another JAK inhibitor - ritlecitinib - shown to be effective (vs PBO) in alopecia areata in the Phase 2b/3 ALLEGRO trial. Ritlecitinib is also being studied in vitiligo, rheumatoid arthritis, Crohn’s & ulcerative colitis. https://t.co/ccx0eRXuTS https://t.co/fApTP7WaYU

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IL-6 Inhibitor Safety Issues-Download now! https://t.co/rjId76sJ64 https://t.co/QwBJNmrzBf

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In a head to head trial Upadacitinib was superior to Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis. 24wk DBRCT, 924 pts given either UPA 30/d vsDUP 300 EOW. ESI75 response@wk16, UPA 71% vs DUP 61% https://t.co/5cOoosKyao

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Dr. John Cush RheumNow ( View Tweet)

New podcast available for download! https://t.co/5K8ejJ4jj2 https://t.co/Va66dLGrXO

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Skin Involvement with HMGCR Necrotizing Myositis The Journal of Autoimmunity reports that anti-HMRCR antibody positive, necrotizing myositis patients frequently have cutaneous lesions, more so than previously reported. https://t.co/RR07dYIJSr https://t.co/MiaIqvMPaB

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: D-penicillamine Adverse events reported to FDA (1970-2020): dystonia (OR 20.52), drug hypersensitivity (OR 5.42), pancytopenia (OR 10.2), joint swelling (OR 9.07), Renal (OR 6.68), dysphagia (OR 5.05), CHF (OR 4.04), edema (OR: 3.77) https://t.co/8lmYiJo2Tz

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ICYMI: CRESS – A New Composite Measure for Primary Sjögren's Syndrome https://t.co/7tvjBvP3g4

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ICYMI: JRheum review: 40–50% of psoriasis pts have psoriatic nail disease NP). NP is an important predictor of enthesitis, which is associated with the early stages of PsA https://t.co/sEuih3CSgX

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Dr. John Cush RheumNow ( View Tweet)

It was a banner week at the FDA; a new drug approval you should know about; a lot of information about pregnancy & safety; and an interesting case plus a question from one of our readers submitted. This and more in this week's podcast. Let's dive in. https://t.co/5K8ejJ4jj2 https://t.co/pqCsvYuI96

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Dr. John Cush RheumNow ( View Tweet)
Veterans study gout prevalence rose from 4.2% to 5.8%, 2005 to 2014. 2014, 4.0% of all inpatient/outpatient encounters & 1.3% of hospitalizations were gout related. ULT use remained stable with 46% of gout patients receiving ULT https://t.co/Lmf2mmMddW

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Dr. John Cush RheumNow ( View Tweet)

Skin Involvement with HMGCR Necrotizing Myositis The Journal of Autoimmunity reports that anti-HMRCR antibody positive, necrotizing myositis patients frequently have cutaneous lesions, more so than previously reported. https://t.co/RR07dYIJSr https://t.co/f4WdkRZWpM

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Dr. John Cush RheumNow ( View Tweet)
Rheumatic Flares Uncommon After COVID Vax https://t.co/fuyC50K5UF Post-vaccination disease flares were uncommon among patients with rheumatic and musculoskeletal diseases who were inoculated against COVID-19, researchers found. https://t.co/jp0ZoRqnla

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Study of 708 newly Dx rotator cuff disorder shows that 6 sessions of Progressive exercise was not superior to a 1 physiotherapist session in improving shoulder pain and function. Subacromial corticosteroid injection provided no long-term benefits https://t.co/Flqv286MVV

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Study of 1821 pregnant women with autoimmune disorder. 74% used acetaminophen during pregnancy (HA, pain, injury). The highest (5th quintile use thru wk 20) acetaminophen had a modest risk (HR 1.62) of preeclampsia vs none https://t.co/DXxaSkTZs7

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Clinical characteristics and outcomes of COVID-19 breakthrough infections among vaccinated patients with systemic autoimmune rheumatic diseases https://t.co/xftj12BgzX #medRxiv

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medRxiv medrxivpreprint ( View Tweet)

The Israeli data for increased mRNA-vaccination breakthrough infections and "waning immunity" is finally available https://t.co/9j73Q7L7Nn h/t @Aiims1742 Overall 2X risk, no statistical significant difference between age groups, but trend of increase w/ age https://t.co/D4IpFm6Ydl

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Eric Topol EricTopol ( View Tweet)
D-penicillamine Adverse events reported to FDA (1970-2020): dystonia (OR 20.52), drug hypersensitivity (OR 5.42), pancytopenia (OR 10.2), joint swelling (OR 9.07), Renal (OR 6.68), dysphagia (OR 5.05), CHF (OR 4.04), edema (OR: 3.77) https://t.co/8lmYiJo2Tz

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Dr. John Cush RheumNow ( View Tweet)

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