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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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TREAT EARLIER - Methotrexate in Clinically Suspect Arthralgia Patients
Lancet Rheumatology has published the results of the TREAT EARLIER trial, showing the prevention of rheumatoid arthritis may be enhanced by risk stratification, particularly in anti-citrullinated protein antibody (ACPA)-negative people with clinically suspect arthralgia.
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Moving Forward on RA Prevention Trials
Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess interventions that may alter disease development.
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Full read overview of ILD & its Clinical Course inRheumatoid Arthritis. Metanalysis of 22 reports shows 6-19% of RA have ILD on HRCT. Article discusses early onset, progression and the monitoring and management of RA-ILD https://t.co/mqexPcruni https://t.co/One7XYn4wX
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Analysis of 5 Nordic registries & 29,478 RA & 10,919 PsA pts initiating 1st bDMARD,s
(& 362,087 pop controls). Incident ILD was higher in RA (HR 9.7) & PsA (4.4). but MTX co-use (vs non-use) did not incr ILD in RA (HR 0.9; 0.7, 1.2) or PsA (HR 1.0) https://t.co/xY8COh85Bw https://t.co/weJGirfhDX
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Treatment of Rheumatoid Arthritis (RA) associated Interstitial lung disease #ILD
2023 ACR/Chest Guideline
#Rheumatology #MedTwitter https://t.co/hoW88BL2E2
Ask The Rheumatologist LastManStand85 ( View Tweet)
TREAT EARLIER - Methotrexate in Clinically Suspect Arthralgia Patients
Lancet Rheumatology has published the results of the TREAT EARLIER trial, showing the prevention of rheumatoid arthritis may be enhanced by risk stratification, particularly in anti-citrullinated protein… https://t.co/1NYgYtYKIr https://t.co/fMMy2DzSxN
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl
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Retrospective analysis of 63K Alopecia areata pts shows a higher risk of developing psychiatric (aHR 1.3) & autoimmune Dz (aHR 2.7), including SLE (aHR 5.7), atopic dermatitis (4.3), vitiligo (3.8), Sjogrens (3.7), Morphea (3.6), PsO (2.8), RA (1.8) https://t.co/gnEm9TsyoV https://t.co/XWA98sbRLp
Dr. John Cush RheumNow ( View Tweet)
IMPORTANT: Cost effectiveness analysis of the TREAT EARLIER RCT shows 88% probability that 1 yr of MTX in 236 pts w/ clinically suspect arthralgia was cost-effective. Results shows MTX Rx increased quality adjusted life years & reduced costs https://t.co/1BVxs77vo8 https://t.co/uQSQL5Eww9
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Cancer presenting as Inflammatory low back pain? 34 Cases presenting as SpA over 10 yrs often w/ higher ESR/CRP/LDH levels. CA included myeloma, leukemia, lymphoma, CA of breast/lung/prostate & bone tumors. https://t.co/YYKYx39tbD https://t.co/m9uCbJBsnU
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So You've Got RA and Want to Get Pregnant?
Dr. David Liew reviews abstract POS0436 presented at Eular 2024 in Vienna, Austria.
https://t.co/vG9l7kOReq https://t.co/xhumOCisOM
Dr. John Cush RheumNow ( View Tweet)
2612 BSRBR-RA Registry pts on tocilizumab - increasing Body weight was associated with reduced DAS28 response to SC tocilizumab. But the DAS28 difference was small, and did not change drug persistence https://t.co/eR7kmjRaEE https://t.co/vFKYC1I3pV
Dr. John Cush RheumNow ( View Tweet)
Retrospective Taiwan's Health claims: studied 6408 RA pts, half HCQ users vs non-users. No higher risk of osteoporosis in HCQ users vs non-users (aHR=0.99; 95% CI: 0.82–1.196). Why study this? HCQ may suppress both bone formation/resorption https://t.co/xShLXMElnH https://t.co/lkvihaYuAd
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1,717 Chinese rheumatologists (92% response) surveyed on Steroid use in RA. 60% admit to infrequent use of GC cotherapy. Bridging GC use was supported (35%), opposed (27%), but 38% were inconclusive & 67% said long-term low-dose GC use depends on the pt https://t.co/7qe1aRsZx8 https://t.co/D0RoYxPohY
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Animal model shows Aggregatibacter actinomycetemcomitans periodontitis can trigger macrophage/caspase-11/inflammasome activation leading to paw swelling in mice anti-collagen antibody-induced arthritis (CAIA) model https://t.co/f41r28g5yr https://t.co/61NeXgfzmB
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/uprHZbsqkR https://t.co/edjoN2vzc0
Dr. John Cush RheumNow ( View Tweet)
Moving Forward on RA Prevention Trials
Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess… https://t.co/ppmWa27tgd https://t.co/lQEtBNRZRm
Dr. John Cush RheumNow ( View Tweet)
In elderly onset rheumatoid arthritis, Treg cells are increased, but have decr suppressor activity. Maybe due to elevated Type I IFN with IFN-β suppressing old Tregs and increasing PD-1 expression. https://t.co/51ww481FkJ https://t.co/8EA1fENaFm
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Linger on the Fingers (9.6.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow. This week with a focus on fingers and better prescriptive follow through.
https://t.co/c9yvRjE9av https://t.co/mdN37AWHjX
Dr. John Cush RheumNow ( View Tweet)
