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Linger on the Fingers (9.6.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.

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CAR-T Like Effects with Bispecific Teclistamab

MedPage Today

A new chapter may have begun in the exciting story of "immune reset" therapy for difficult-to-treat autoimmune diseases, with a patient with severe refractory lupus obtaining drug-free remission after treatment with an antibody product normally used in multiple myeloma.

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Does Rheumatoid Factor Influence Anti-TNF Responses in RA?

Jack Cush, MD

Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated with adalimumab had a blunted response in the face of high RF titers.

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Sustained Hydroxychloroquine and Cardiovascular Outcomes

Jack Cush, MD

A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects agains cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).

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Running with Data (8.30.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

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IV Methylprednisolone in Giant Cell Arteritis

Jack Cush, MD

A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP) in early GCA.

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Birth Control Use in Lupus

MedPage Today

Published guidelines on lupus management urge that female patients plan and prepare carefully for pregnancy, and use contraceptives when it's not intended -- but these recommendations are only rarely followed, a registry study suggested.

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ACR Backs FDA Rule Change on Interchangeable Biosimilars

ACR

The American College of Rheumatology submitted comments to the U.S. Food & Drug Administration supporting their recent proposal to update the approval process for biosimilars’ interchangeability status by repealing the requirement for switching studies while also encouraging the FDA to continue monitoring the downstream effects of this policy to ensure transparency for patients and prescribing providers.

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Sustained Hydroxychloroquine and Cardiovascular Outcomes A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects against cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE). https://t.co/xqB2tyzzYQ https://t.co/dlFjbgbsep

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Dr. John Cush RheumNow ( View Tweet)
Dactylitis is seen in 50% of PsA patients. Dactylitis is frequently associated with more severe PsA phenotype, often representing the initial feature of the disease. Many agents are effective but no b/tsDMARD is distinguished as being superior in dactylitis.… https://t.co/NKOXReiZYd https://t.co/Ake2fixZ40
Dr. John Cush RheumNow ( View Tweet)
Difficult to treat RA Approach https://t.co/2rmlv0kspP https://t.co/6yb5xj8jrn

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Dr. John Cush RheumNow ( View Tweet)
Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/s20wTKafR8 https://t.co/FPxc5VP4Xh
Dr. John Cush RheumNow ( View Tweet)
Claims analysis, shows <0.5% of IBD or RA pts developed an invasive fungal infx within 1 year of TNF therapy initiation (. Histoplasmosis was the most common IBD = 3.3 IFI/100PY RA = 2.8 IFF/100PY https://t.co/ER9YCxecJT https://t.co/T0UNgB4h6R

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Dr. John Cush RheumNow ( View Tweet)
Points to Consider when Managing Inflammatory Arthritis with Cancer https://t.co/qLMPwDNMiy https://t.co/sL87mp0gd4

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Dr. John Cush RheumNow ( View Tweet)
Retrospective observational study of 96 stable #SLE pts compared maintenance on HCQ vs belimumab. There were no significant differences in Flare rate (18% HCQ vs 8.3% BLM; p=0.47), damage index increase, SLEDAI, Pred dose or adverse events https://t.co/sVPMugSHn3 https://t.co/6bdel6Kvs9

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Dr. John Cush RheumNow ( View Tweet)
It takes >3-4 weeks of steroids (@ any dose >5 mg pred/d) to pose risk of adrenal insufficiency – Hence, Endocrine Society Guideline says short-term glucocorticoid therapy of <3-4 wks, irrespective of dose, DOES NOT require GC tapering https://t.co/o7tz1Am9pe https://t.co/CndfCYRApj

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Dr. John Cush RheumNow ( View Tweet)
IV Methylprednisolone in Giant Cell Arteritis A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP) in early GCA. https://t.co/5udYabU5z5 https://t.co/5FHhBnAX2j

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Dr. John Cush RheumNow ( View Tweet)
Antibiotics May Increase Inflammatory Arthritis Risk A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP) https://t.co/5CEewNqirM https://t.co/FSOFp4N6ks

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Dr. John Cush RheumNow ( View Tweet)
Cohort study shows GERD in 1539/1632 (94%) #SSc patients & 450/469 (96%) of SSc-ILD pts. GERD didnt influence ILD Dx or severity. But GERD Rx (PPI, H2RA) assoc w/ improved survival in those Scleroderma pts with ILD (p = 0.002) https://t.co/stQkpbmBCP https://t.co/e4BBz5c0av

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Dr. John Cush RheumNow ( View Tweet)
MDs: How long must you be on Pred 40 mg/d before you must slowly wean pred (vs stopping abruptly)?

Dr. John Cush RheumNow ( View Tweet)

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