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ACR’s Run at Goliath (PCPs) (5.31.2024)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and articles from this past week on RheumNow.com. The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?

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ACR Website to Support Primary Care Practitioners

ACR

The American College of Rheumatology recently launched Rheumatology for Primary Care, a new resource for primary care physicians (PCP) and advanced practice providers (APP) offering them expanded support and guid

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The Window of Opportunity (5.24.2024)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?

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MGUS,SPEP,Gamma

No Link Between Autoimmune Diseases and Monoclonal Gammopathy of Undetermined Significance

Jack Cush, MD

Annals of Internal Medicine reports a study of more than 75,000 persons screened for monoclonal gammopathy of undetermined significance (MGUS) and found no association between autoimmune rheumatic disease (AIRD) and MGUS.

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"Don't You Know Who I am?" (5.17.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?

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Risk Factors for Hydroxychloroquine Retinopathy

Jack Cush, MD

A long-term hydroxychloroquine users study found that 2.7% developed retinopathy, and identified risk factors as  increasing age, female sex, chronic kidney disease stage 3+ and tamoxifen use.

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Do you have a rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/qvVEUoNYi5 https://t.co/duw6jg5xpp

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NHANES study of 2500 #RA pts, found a significant correlation between an inflammatory diet (meas by DII score) and inflammatory indices like systemic immune-inflamm Index (SII) & neutrophil-lymphocyte ratio (NLR) https://t.co/sWXZRrG6hV https://t.co/9IcLDF1Jlo

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Dr. John Cush RheumNow ( View Tweet)
NON-treatment of 18,318 VA pts (RA, SpA, PsA) = 41% not Rx DMARDs w/in 12 mos of Dx. Signif higher odds if Black (HR 1.13), Hispanic (1.14), Charlson Comorbidity ≥2 (1.15), opiate use (1.09). DMARD use ^ if married, w/ erosions, female MD, Rheum Dx https://t.co/TaYC27oIOz https://t.co/qjfAGI5L5g

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FAERS retrospective, safety study of JAKi use in 75K RA pts (52K Tofa; 21K Upa, 2.2K Bari vs bDMARDs) found JAKi had incr risk of VTE (adj ROR=2.11), CVA (ROR=1.25), IHD (1.23), edema(1.22), & tachyarrhythmias (1.15) https://t.co/Bvds4C66Nq https://t.co/Xmu8g35MXR

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Dr. John Cush RheumNow ( View Tweet)
MarketScan Claims & Medicaid study of incident AS, PsA, or RA (2010–2017) that Opioid use was highly prevalent in AS (36%), PsA (30%), & RA (44%) in the year prior to Dx & during the 1st Yr. Is this PCP or Rheumatologist mismanagement? https://t.co/YsCOLZUCfS https://t.co/b33uNg6Ucx

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Insurance claims data studied 7580 newly Dx RA (2018-2020) - 1998 tofacitinib vs 5582 adalimumab. After propensity matching, dyslipidemia was signif. higher w/ TOFA (HR 1.25), BUT no differences in MACE (HR 0.995) or all-cause mortality (HR, 1.4; NS) https://t.co/ZJ7uHWTycS https://t.co/A6tSm4RipS

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Dr. John Cush RheumNow ( View Tweet)
Retrospective 170 RA pts Rx w/ IFX, ADA, & CZP shows CZP levels didnt differ w/ low or HI RF; but high basel RF linked to lower IFX & ADA drug levels, W/O DAS28 differences, but more IFX/ADA D/C w/ Hi baseline RF levels (80% vs. 75% vs. 33% CZP, p=0.002) https://t.co/OVUcKAgJ5a https://t.co/kzWd8jHXs3

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Dr. John Cush RheumNow ( View Tweet)
K Kuhn et al: Altered tryptophan catabolism by microbiome may contribute to inflammatory arthritis. Tryptophan increases indole leading to ncreases in serum IL-6, TNF, and IL-1β; splenic RORγt+CD4+ T cells, & IL-23 and IL-17 production https://t.co/i9le12QZm2 https://t.co/akeXxWnQ9o

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Dr. John Cush RheumNow ( View Tweet)
Substitute Measures of Inflammation (many dervied from the CBC) https://t.co/b2AuVERJQn https://t.co/QXZ8GthsMW

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Dr. John Cush RheumNow ( View Tweet)
Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush RheumNow ( View Tweet)
In animal models, IL-22 may have protective effects against pulm fibrosis. Study of 66 new #RA pts (1/2 w/ ILD) & 14 controls. Serum IL-22 was signif lower in RA-ILD; and was inversely correlated with the severity of RA-ILD https://t.co/Rmr5N2JznH https://t.co/OZ1ZrgGXC3

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Dr. John Cush RheumNow ( View Tweet)
Long term F/U of T2T in BeST (early RA 153) & IMPROVED (UA 282) pts 12 & 20 yrs after, the majority of RA & UA pts were in DAS remission (91% LDAS, 68% remission), & w/ limited functional disability (mean HAQ 0.6-0.8). Xray progression was mild https://t.co/J9AfSPhWoK https://t.co/SrVJywF2JI

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Dr. John Cush RheumNow ( View Tweet)
Complex Autoantibody Patterns in RA https://t.co/CHzUOUM2xD https://t.co/4fE7iLMwxM

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Dr. John Cush RheumNow ( View Tweet)
Long term F/U of T2T in BeST (early RA 153) & IMPROVED (UA 282) pts 12 & 20 yrs after, the majority of RA & UA pts were in DAS remission (91% LDAS, 68% remission), & w/ limited functional disability (mean HAQ 0.6-0.8). Xray progression was mild https://t.co/vcL8Mnv0Ty https://t.co/lPVbNipFng

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Dr. John Cush RheumNow ( View Tweet)
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