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No Extra Cancer Recurrence Risk with Biologics in RA

d MedPage Today

Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional disease-modifying anti-rheumatic drugs (DMARDs).

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Rheumatology: Believe It or Not (4/25/2025)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?

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Vitamin D for Prevention of Disease

d Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Stills,continuum

Unmet Needs in Still’s disease

d Jack Cush, MD

In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic pathways and possible biomarkers for diagnosis and response; (3) refractory disease and risk factors, and (4) treatment of SD and its complications.

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Better Responses with Chronotherapy for Baricitinib

d Jack Cush, MD

A nonrandomized, open-label, controlled trial has shown superior efficacy when baricitinib was given at night (instead of day); attesting to the benefits of chronotherapy - selective dosing meant to target the body's diurnal variations.

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Prevalence of ANCA Assoc Vasculitis (especially GPA) in Alaskan Natives (AN/AI) is high. GCA prevalence is lower than White populations, but higher than many others. AN/AI peoples w/ AAV & GCA may present at younger ages with more severe disease https://t.co/dhiu6sPGBk https://t.co/rNCo25HGcn

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Pairwise Network Metanalysis suggests that JAKi use may NOT be assoc w/ Gastrointestinal perforation (GIP), as suggested by the PI. 23 RCTs, (20,023 pts) followed for 24 wks. Incidence of JAKi GIP=0.19%. compared to csDMARDs this was not signif increased (RR 1.02; CI: 0.41-2.56). https://t.co/lLD9Tj6a9F
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Better Responses with Chronotherapy for Baricitinib A nonrandomized, open-label, controlled trial has shown superior efficacy when baricitinib was given at night (instead of day); attesting to the benefits of chronotherapy - selective dosing meant to target the body's diurnal https://t.co/pEJIsJq0wE
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84 RA pts on CZP+MTX w/sustained LDA (CDAI ≤10) ≥ 12 wks. 1/2 OL withdrawal of MTX & @ wk 36, LDA was maintained in 85% on CZP+MTX vs 84% on CZP alone (w latter group having signif less GI Sxs (2.4% vs. 15.8%, P = 0.034) https://t.co/jGlNlmkae4 https://t.co/6e0ySRrRD4

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IL-17 inhibitors increase risk of IBD. TriNetX database study of PsO & AS pts starting IL-17i vs apremilast. 13,216 matched pts per group, 142 developed IBD w/ IL-17i vs. 60 with apremilast (aHR = 2.50, 95% CI: 1.85–3.39). https://t.co/sSPqKsfbZ4 https://t.co/YCqDUzX9xq

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Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/29M0jePXHd
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Hip replacement outcomes are not linked to OA severity, instead pts muscle quality before THA best predicts recovery after surgery. Imaging of 10 pts undergoing THA showed poor muscle quality predicted post-op performance/movement after surgery https://t.co/io0UXQl6n2 https://t.co/cFM7Fg10Zm

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Piperacillin effectively treats Lyme disease at 100-times lower dose than doxycycline https://t.co/vbu78RbRys https://t.co/AqSkm7XtbB https://t.co/olTi8OWsQ6

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Retrospective study of 334 children with non-organic amplified MSK pain syndr(AMPS) plus back pain. Pts w/ localized AMPS were more likely to have a (+) straight leg raising test (P 0.01) & diffuse AMPS more likely to have allodynia & incongruent affect (reporting pain, but still https://t.co/unbub6VK0t
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A review of 18 guideline recommendations on DMARDs in pregnancy & reproductive health. There were recs. DMARDs & pre-conception (56%), lactation (67%), male fertility (33%), & use of csDMARDs (72%), bDMARDs(72%), tsDMARDs (28%); less recs for b/tsDMARD use https://t.co/tKGCXrbOuc
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Systematic review shows PTSD is strongly assoc w/ an increased risk of developing SLE. 7 studies (5 prospect cohort) and 11614 SLE pts - 1,325 (11.4%) had comorbid PTSD, mostly females. All showed + association of PTSD & SLE, 3 showing 2fold incr risk of SLE. No genetic https://t.co/Xjya0QNznQ
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Full read review of falls and fragility fractures in the elderly. https://t.co/WuQ6oIKTH0 https://t.co/fXnZFxaO28

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Retrospective EGPA study of mepolizumab Rx 45 pts Rx initially w/ 300 mg/4 weeks, 27% switched to 100 mg/4 wks after 26 mos & 50% maintained complete remission without GC. Other half had sinonasal Sxs Rx w/ increased MEP dose orlocal therapy. https://t.co/H8ftg136Ez https://t.co/CKchbGpq20

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Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/70sROoHusy
Dr. John Cush RheumNow ( View Tweet)
Hip replacement outcomes are not linked to OA severity, instead pts muscle quality before THA best predicts recovery after surgery. Imaging of 10 pts undergoing THA showed poor muscle quality predicted post-op performance/movement after surgery https://t.co/io0UXQl6n2 https://t.co/eI7u6BTPYx

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Dr. John Cush RheumNow ( View Tweet)
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