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Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.
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A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).
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Dr. John Stone has led the effort to develop the GTI - glucocorticoid toxicity index. In this review article he acknowledges the need and benefit of steroids, but details a novel means to identify and limit the untoward effects of glucorticoids (GC).
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2024 was a year of surprising new growth in technology, with the expansion of new therapeutic options for many patients and clinicians. While these many advances offer new hope, they are countered by disappointments and gapping unmet needs in rheumatology. Below is my top 10 list (in no particular order) of 2024 developments and desires that may change rheumatologic practices.
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Annals of Internal Medicine has published a Japanese administrative claims database study showing that, compared with oral bisphosphonates (BIS), denosumab (DEN) lowered fracture risk by 45%, but increased the risk for major adverse cardia
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Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
Dr. John Cush
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Sobi announced it has submitted to FDA a supplemental (sBLA) for Gamifant (emapalumab-Izsg) for use in adult & kids w/ hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) in Still’s disease with an inadequate response glucocorticoids, or with recurrent… https://t.co/a3I1fzHLdl https://t.co/WTFAs5PLWF
Dr. John Cush
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With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/BMeYVaBmIy https://t.co/DpTqKhb1Sg
Dr. John Cush
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Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/zcmo9mTRoS https://t.co/Q1lB0LvymF
Dr. John Cush
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Sobi announced it has submitted to FDA a supplemental (sBLA) for Gamifant (emapalumab-Izsg) for use in adult & kids w/ hemophagocytic lymphohistiocytosis (HLH)/macrophage activation syndrome (MAS) in Still’s disease with an inadequate response glucocorticoids, or with recurrent… https://t.co/PLpcD5jzxH https://t.co/0LUe9bXaYS
Dr. John Cush
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With GLP-1 agonists, is there a risk of aspiration during gen. anesthesia. Most advise against elective surgery/anesthesia unless the GLP-1 is held for 1-2 weeks. Based on MOA of delayed gastric emptying - 7/8 studies show Incr residual gastric contents in GLP-1, but none… https://t.co/U690OmeqJm https://t.co/Q6kyv9fyVJ
Dr. John Cush
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A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
Dr. John Cush
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Long-Term Use of NSAIDs Linked to Lower Dementia Risk
https://t.co/nlo2BodhLG https://t.co/TiE34zyvts
Dr. John Cush
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Are Combination Biologics Safe?
Real-life data from a French observational study suggests the overall risk of severe adverse events (SAE) with combotherapy does not seem to be increased (vs monotherapy), but certain combinations warrant caution.
https://t.co/IEIi6kQI4b https://t.co/KVSbqeMbyA
Dr. John Cush
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Hydroxychloro-King (3.7.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory actions from the past week on RheumNow.
https://t.co/83ZAyrrgg3 https://t.co/63cIdP559y
Dr. John Cush
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The European Commission (EC) has approved Celltrion’s Avtozma (CT-P47), a biosimilar referencing Roche’s RoActemra (tocilizumab). https://t.co/ukMDwtgUhw https://t.co/htDVWKbu3n
Dr. John Cush
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Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush
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DANBIO registry study - 21 982 Rx Starts, 96 475 PYs & 1423 cancers identified. Overall cancer risk w/in tocilizumab/sarilumab, abatacept or rituximab were not signif increased (HRs ranged from 0.7 to 1.1) compared with TNFi & with bDMARD-naïve real world RA pts… https://t.co/fPLFlWoQsw https://t.co/4KlGnjfNKm
Dr. John Cush
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BMS announced new data from Phase 3 POETYK PsA-2 trial - Sotyktu (deucravacitinib)vs apremilast vs PBO in PsA w/ higher ACR20 vs PBO at Week 16 (54% vs 39%). AEs led to discontinuation in 1.3% (PBO), 2.2% (Deuc) and 10.5% (apremilast). https://t.co/NAa2JigkZN https://t.co/mvaQXfjShd
Dr. John Cush
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Intraarticular Steroids in OA Lowers Need for Pain Meds
Is it possible that intra-articular corticosteroid injections for osteoarthritis might affect the use of opioids?
https://t.co/qkTN7CpuMZ https://t.co/npuT88Sj2m
