Best of 2021: FDA Approves Anifrolumab in SLE

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AstraZeneca announced today that anifrolumab (Saphnelo or anifrolumab-fnia) was approved by the the Food and Drug Administration (FDA) for that treatment of adult patients with moderate to severe systemic lupus erythematosus (SLE) who are receiving standard therapy.  

Best of 2021: Potential Birth Defects with Hydroxychloroquine

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HCQ is one of the safest meds used in rheumatology, but new claims data suggests a small increase in the risk of malformations associated with first-trimester HCQ use. The March 2021 issue of the American Journal of Obstetrics and Gynecology studied the risk of major congenital malformations during the first trimester of pregnancy in women with rheumatic disease taking HCQ.

Best of 2021: Actemra FDA Approved for Systemic Sclerosis Interstitial Lung Disease

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Genentech announced March 4th that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adults S

Best of 2021: Rebuttals

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Since the COVID vaccine rollout, more people have been eligible to receive the vaccine. However, not everyone chooses to get one. I have heard many reasons (aka excuses) from my patients who are vaccine hesitant. 

Indications Awaiting (12.17.21)

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There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

CDC Panel Recommends mRNA COVID Vaccines Over J&J Vaccine

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The U.S.

Certain Cancers Increased with Autoimmune Diseases

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Rheumatologists are well aware that inflammation and immune dysregulation are prime contributors to cancer risk, but do oncologists carry the same impressions? A large study from JAMA Oncology shows that patients with immune-mediated diseases (IMD) have an overall increased risk of cancer, especially in organ-specific immune-mediated diseases. 

SGLT2 Inhibitors in Type 2 Diabetes Lowers Gout Risk

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A recent study of drugs used in type 2 diabetes (T2DM) shows that SGLT2 inhibitors have a lower risk for gout compared with those receiving DPP4 inhibitors.

Serious Adverse Events Associated with Tocilizumab in COVID-19 Patients

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Safety analysis of over 1000 adverse events associated with the use of tocilizumab in the treatment of COVID‐19 infection shows both rare expected and some unexpected AE.

Adherence to Medication - Predictive Factors in RA

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The numbers on treatment adherence is disappointingly low in RA, with a number of psychological, communication and logistical factors that outweigh the potentially negative influence of sociodemographic or clinical factors.

When to Stop Biologics in Systemic JIA?

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Systemic onset juvenile idiopathic arthritis (sJIA) is a dramatic onset inflammatory condition marked by spiking fevers, intermittent rash, polyarthritis and a host of other hyperinflammatory manifestations.

T2T Debate - A Prologue with Dr. Marty Bergman

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Drs. Jack Cush and Martin Bergman review the topic of treat-to-target (T2T) management in rheumatology.

Both will debate the pro's and con's of the T2T strategy at the upcoming RWCS meeting on Feb. 17, 2022.

Genes and Obesity Tied to Higher Gout Risk in Women

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Excess adiposity and genetic predisposition both contributed to risk of gout among U.S. women, with the risks being highest when both factors are present, a large prospective study found.

Pain is the Focus of the 2021 Nobel Prize in Medicine

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The 2021 Nobel Prize in Medicine and Physiology was jointly awarded to Drs.

Telehealth Diet and Exercise Benefits Knee Osteoarthritis

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Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight.  While both were beneficial, exercise had a greater effect than die

FDA Puts Boxed Warnings on JAK Inhibitors

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Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.

Telemedicine Upside Interview with Dr. Alvin Wells

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In spite of the transformative growth of telemedicine during the COVID-19 pandemic, rheumatologists use of telemedicine is waning, much like the use of masks. Dr. Jack Cush interviews telemedicine guru, Dr. Alvin Wells, on the current state of telemedicine and what the future holds for telehealth in rheumatology.

Rheumatoid Arthritis, Dementia and Cognitive Dysfunction

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Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies..

Cytokine Inhibitor Lung Disease in Still's Linked to HLA-DRB1 Alleles

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Pulmonary complications in the setting of Still's disease (juvenile and adult) has seldom but consistently been reported, including reports of pneumonitis, pulmonary hypertension and a severe or fatal lung disease, often associated with hypersensitivity to anticytokine therapy. A multicenter study reports that drug hypersensitivity and pulmonary reactions in Still's patients receiving IL-1 or IL-6 inhibitors is strongly associated with HLA-DRB1*15 haplotypes.

DORIS - Defining Remission in Lupus

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Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE.  A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016.