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RheumNow Podcast – Rheumatology Burnout (1.29.2021)

d Jack Cush, MD

Dr. Jack Cush reviews this past week's journal articles and news features on RheumNow.com. Colchicine, vaccine rollout, risk of RA in endometriosis patients, tREACH trial, lupus nephritis news, rheumatology burnout and more.

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Calculating Serious Infection Risk in IMID Patients

d Jack Cush, MD

Predictive modeling of data derived from the DANBIO registry (of treated IMID patients) revealed a 4 fold increased risk of serious infection (SIE) in those starting biologic DMARD (bDMARD) treatment. From this large dataset, researchers developed a simple prediction model to estimate future infection risk that may inform shared decision-making in individual patients.

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High Placebo Responses in SLE Trials

d Jack Cush, MD

A systematic review by Urowitz and colleagues examined placebo responses in randomized controlled trials of non-renal, non-neuropsychiatric SLE patients showing unexpectedly high placebo responses; with more than one-third of the placebo-treated SLE patients responding by validated outcome measures.

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Lupus Nephritis Despite Low Level Proteinuria https://t.co/awxvsvwGTg https://t.co/e6DV6sfiN5

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Dr. John Cush RheumNow ( View Tweet)
2016 Deloitte report on top 10 healthcare innovations (Spot on!): 1 Next gen sequencing 2 3-D printing 3 AI 4 Immunotherapy 5 Point of care diagnostics 6 virtual reality 7 social media for Pts 8 Biosensors/trackers 9 Telehealth 10 Convenient care https://t.co/yWaqzM9pFC

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Dr. John Cush RheumNow ( View Tweet)

ACR Convergence 2020 Fireside Chats – Top presentations in nr-axSpA, AS, axial PsA Sponsored by Novartis Medical Affairs Unable to attend all the key sessions at #ACR20? Listen to the experts as they present their views on the top abstracts. https://t.co/r5Cf4WS63s https://t.co/NmDXrTPGXq

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Dr. John Cush RheumNow ( View Tweet)
Several studies have shown that Xray progression has lessened in recent yrs - presumeably from more aggressive Rx by Rheums! Still - Predictors of Xray long term damage = high ESR/CRP, baseline xray damage, -CCP/RF positivity https://t.co/2iaMiaquEV https://t.co/cgEP4QBvL4

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Dr. John Cush RheumNow ( View Tweet)

JAK Inhibitor Misses Endpoint in Safety Study. Now What? Pfizer announced results Wednesday from its FDA-mandated postmarketing safety study of tofacitinib (Xeljanz), and they don't bode well for the drug and possibly others in its class. https://t.co/EPVdAdPP37 https://t.co/Box5NaxsKV

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Dr. John Cush RheumNow ( View Tweet)
News: #COVID19 risk may be reduced with #biologics and #JAKinhibitors, but increased with #glucocorticoids, Italian researchers report in @ArthritisRes https://t.co/zIef2aNCns

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Medicine Matters rheumatology Rheum_Matters ( View Tweet)

SELECT-PsA2, UPA vs PLBO in refractory PsA, @ARD_BMJ Better ACR20 (57% vs 24% PLBO, NNT~3) and ACR50 (32% vs 5% PLBO, NNT~4). Decent PASI 90 (30% vs 6%, NNT~4) Similar adverse events to RA pop. Nice to have another option, esp in refractory dx! https://t.co/Zz2WYqswT2
Mike Putman EBRheum ( View Tweet)
My #rheumatology clinics now inundated with patient questions re: #CovidVaccine. I'm looking forward to new #CovidVaccine Guidance expected from the newly-convened #ACR Task Force, forthcoming on February 11th.

Jeffrey Curtis RADoctor ( View Tweet)

Is there such a thing as "Preclinical Lupus" - half to 2/3 of SLE pts had + serologies up to 9 yrs before the Dx @KDAO2011 @UTSWIMchief @UTSWIMchief https://t.co/ThpKjZEG2v

Dr. John Cush RheumNow ( View Tweet)
The new ACR/EULAR SLE Classification Criteria 2019 with weighted criteria - need to be ANA+ and have 10 points @UTSWIMchief @UTSWInternalMed https://t.co/TwyUbEOCg2
Dr. John Cush RheumNow ( View Tweet)
UT Southwestern Grand Rounds w/ Dr. Kathyrn Dao @KDAO2011 - lecturing on lupus. Showing that the population rate of ANA has increased over time - NHANES shows 44 million in the USA have +ANA! @UTSWInternalMed @UTSWIMchief https://t.co/qU5gzuAD9j
Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Dadgummit, Where's Waldo's COVID Vaccine? My rant on the COVID vaccine unavailability, and what we can - and can't - tell patients. https://t.co/VKrDgvuXqt https://t.co/zuNe8lEaR4

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Dr. John Cush RheumNow ( View Tweet)

Colchicine suppresses MSU & CA pyrophosphate crystal activation of Nod-Like Receptor Protein 3 (NLRP3) inflammasome, thereby suppressing caspase-1 activation and the subsequent release of IL-1β and IL-18. Great review by Pillinger et al https://t.co/n7MHtSviT5

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Dr. John Cush RheumNow ( View Tweet)

New download available--Televideo Joint Exam Checklist https://t.co/XnyCW2eak8 https://t.co/WMdkra6SYv

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Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Rhabdo or Not https://t.co/KmKPTaFOtr https://t.co/9AvOIOOmci

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Dr. John Cush RheumNow ( View Tweet)
Urate Lowering Therapy During Acute Gout Acute gout has its well-defined protocols, and most state that urate lowering therapy (ULT) should be continued; but does ULT affect outcomes in an acute gout attack? https://t.co/aDHpU1I2d2 https://t.co/QihJNhMW8L

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Dr. John Cush RheumNow ( View Tweet)
Among 335 AAV pts, 18% had venous thromboembolism (VTE). The incidence rate of AAV-related VTE was 2.4/100 PYs and was higher in the first 3 months post–AAV diagnosis (20.4/100 PY) and decreased over time. Age & BVAS were predictive of VTE.https://t.co/Arb2gk27B7

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Dr. John Cush RheumNow ( View Tweet)

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