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Are You a Super Rheum?

d Jack Cush, MD

Several weeks ago, at the Rheumatology Winter Clinical Symposia, an interesting debate between Drs. Orrin Troum and Marty Bergman hashed over the concept of whether rheumatologists should sub-specialize with a practice, research or career devoted to one disease ("Super Rheum"), or be "selective" about what disorders and diseases they would treat or just be a generalist. 

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Apremilast Equals MTX in Palmoplantar Psoriasis

d Jack Cush, MD

Palmoplantar psoriasis (PPP) is a therapeutically challenging variant of psoriasis; nonetheless, a prospective, randomized, active-controlled trial from India suggests that apremilast is effective and safe in patients with PPP.

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Potent Topical Corticosteroids and the Risk of Osteoporotic Fractures

d Jack Cush, MD

JAMA Dermatology has published a Danish national cohort study showing that potent topical corticosteroid use was associated with an increased risk of osteoporosis and major osteoporotic fractures with a dose-response association for cumulative use.

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MDA-5 Antibodies and Juvenile Dermatomyositis

d Jack Cush, MD

A multicentre, retrospective study examined MSA profiles (by immunoprecipitation) from 96 juvenile idiopathic inflammatory myopathies (JIIM) at nine pediatric rheumatology centres in Japan. MSA were found in 85 of 96 cases with over 90% of patients having one of the following three MSA

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Enthesitis Responses to Secukinumab in Spondylitis Patients

d Jack Cush, MD

Schett and colleagues studies the secukinumab (an IL-17 inhibitor) response in patients from 3 clinical trials with enthesitis and ankylosing spondylitis (AS) and demonstrated consistent efficacy with improved enthesitis scores at both peripheral and axial sites.

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Hydroxychloroquine studied vs Vitamin C (PBO) prophylaxis to households (n=671) exposed to COVID-19. 89% were COVD1-9 test neg at baseline. HCQ did not protect against progression to COVID (53 vs 45 events; adj HR, 1.10 [95% CI, 0.73 to 1.66]. A vit C Win! https://t.co/S5qjdIYaXq

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The Reflecting Rheum: Top Publications from 2020 Covering SpA and Still’s Disease Sponsored by Novartis Medical Affairs Listen to a panel of experts share their views on top spondyloarthritis and Still’s disease publications from 2020. View Now: https://t.co/rxTAwQNalx https://t.co/y8wnHSmBug

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Phase III RCT of apremilast showed no benefit in ankylosing spondylitis pts. 490 AS pts recv placebo or apremilast 20 mg or 30 mg bid 24 wks. The ASAS 20 was the same in all groups (PBO: 37%; 20 mg 35%; 30 mg 33). 2 yrs Xray changes were equal too. https://t.co/ILYtVMZp80

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Concise overview of Ehlers-Danlos syndrome from Medscape...FYI https://t.co/acHSoEhVVF

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News Feature: Enthesitis Responses to Secukinumab in Spondylitis Patients https://t.co/U7qfwwA2as https://t.co/lFa5LdfkIZ

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Epi study of Scleritis in the UK (1997-2018) shows incidence declined from 4.23 to 2.79/100K persons/yr. Scleritis pts have 2 fold incr risk of IMIDs- esp GPA, Behçets Sjögrens, ReA, RA, SLE, Crohns, SLE & AS (OR 51 to >3). https://t.co/FzaCLRvmEX https://t.co/98M5o66fpD

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Great full read NEJM review of Extrahepatic manifestations of Chronic HCV Infection; 1) mixed cryo vasculitis; 2)20-30% w/ HCV related Sicca (w/ SSA, SSB); 3) fatigue & FM; 4) AutoAbs: 70% RF+, <40% ANA+, 15% ACL Abs, 7% smooth muscle Abs https://t.co/YrIJbs8P8k

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Charcot (neuropathic) arthritis: often manifests as exaggerated bony hypertrophy w/o joint pain. Common causes(sites): diabetes (TMT ankle), tabes dorsalis/syphilis (hip or knee), syringomyelia (Shoulders, elbows) . Also CPPD, steroids, alcohol, amyloid https://t.co/SrYYrVjSq3

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BC Canada population study shows newly diagnosed #SLE patients (n=5,169) have a higher rate of 1st serious/sever infections (1.8-fold), and more total severe infections (2.1-fold) and infection-related mortality (1.6-fold) vs general population. https://t.co/acDk0WYSby

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Rinvoq (upadacitinib) was slated for a psoriatic arthritis indication this month, but now that has been pushed back ~90days, pending further FDA review of the benefit-risk profile for upadacitinib in psoriatic arthritis https://t.co/FeBOrNIbTo

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Have you listened to this week's podcast? We answer listener questions. https://t.co/LXW8uyFGNP

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News Feature: Comparison of Three Coronavirus Vaccines https://t.co/omxsA8W3nQ https://t.co/s7dc9NwMQo

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News Feature: Rheumatic Patients Are at Risk for COVID Death https://t.co/bhJG1vuVA4 https://t.co/VEN3nwSOPB

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REMDACTA trial of Actemra plus remdesivir failed to meet its primary endpoint of improved time to hospital discharge for patients with severe COVID-19 pneumonia (nor its key secondary endpoints) compared to remdesivir alone https://t.co/OyqpnwUVXU

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4 Days! RheumNow Live is a powerful, interactive meeting delivered by researchers, educators, & clinicians. Sign up to attend virtually or in-person today. CME credits available. https://t.co/LJ3qClHTKh

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