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Managing Perioperative DMARDs with Arthroplasty

Jack Cush, MD

Postoperative complications with arthroplasty may be related to chronic inflammation and immunosuppressive therapy. Yet a recent retrospective study total ankle arthroplasty in end-stage RA patients shows that early postoperative wound complications are unaffected by the continued use of their preoperative medications including DMARDs.

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Partial vs Total Knee Replacement: Is One Superior?

Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little bit better. Final results of the landmark TOPKAT study indicated that rates of the most clinically important outcomes were nearly equal between the two procedures, according to David Beard, DPhil, GDPhys, MCSP, MSc, of the University of Oxford in England, and colleagues. These similarities included Oxford Knee Score (OKS) values both at year 10 and cumulatively during the entire follow-up period, as well as reoperations and revisions.

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Vitamin D and Lupus Outcomes (11.21.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Organ Involvement with Behçet’s

Jack Cush, MD

A review of patient data from the International AutoInflammatory Disease Alliance (AIDA) Network registry identifying those with mucocutaneous Behçet’s disease (BD) may progres to major organ involvement (MOI)m especially at later stages.

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APEX Study: Inhibition of structural damage progression with Guselkumab in Psoriatic Arthritis

Jack Cush, MD

Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active psoriatic arthritis (PsA) and shown to have both clinical and radiographic benefits at weeks 24 and 48.

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CorEvitas observational registry of 3,696 w/ psoriatic arthritis (no hx of CV eents), followed for mean 3.7 yrs, showed that Dactylitis and enthesitis did not predict future CV events. But Dactylitis and enthesitis and Synovitis were all significantly interrelated. Cureus 17(11): https://t.co/kPgGKliUUs
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Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes. https://t.co/raruHn5Txx https://t.co/bp1rWyWS7y

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Partial vs Total Knee Replacement: Is One Superior? Patients with osteoarthritis (OA) primarily affecting only one knee joint compartment did just as well with partial knee replacement (PKR) as with total arthroplasty after 10 years in a randomized trial -- and maybe a little https://t.co/abER7mS3QR
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Retrospective analysis of 2614 FM pts in the Italian Fibromyalgia Registry underscores the seasonal changes in FM pain, w/ signif. differences in FM assessment tools WPI p=0.042 & FASmod p=0.037); these changes were only seen in female patients, not males https://t.co/LqXnTgGIMB https://t.co/ihw1yJqKLC

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Vitamin D and Lupus Outcomes (11.21.2025) Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow. https://t.co/M2e4kMi5H7 https://t.co/wEcAjWJSk7

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Colchicine prevents total joint arthroplasty (TJA). Study of 31,478 colchicine initiators, followed 4.5 yrs. W/ an overall 12% lower risk of TJA (HR 0.88 95% CI 0.81 to 0.96), and a 23% lower risk of TJA in those with knee/hip OA (HR 0.77) https://t.co/1JsZd8K0sI

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Retrospective study of 39 pts w/ MDA5 + DM-ILD Rx w baricitinib. 31 (79.5%) had improvement in Gottron’s, heliotrope, dyspnea, HRCT score, ferritin, LDH, steroid dose & 6 mo survival (87% vs. 70%, p = 0.047). https://t.co/8whN2I1hXh https://t.co/voSVzPQWUI

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A New Disease Activity Score for Antiphospholipid Syndrome? APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/eouynDPLUX
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

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PROSPERO meta-analysis shows an effect of diet on #RA risk. 8 independent studies (n=270,121) showed a reduced risk of incident RA with Anti-inflammatory (OR 0.56; 0.31–0.99), Mediterranean (OR 0.88; 0.78–0.99), and HEI (OR 0.60; 0.25–1.47), but not DASH diets https://t.co/qf4kTVyJ0m
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Retrospective cohort study adult RA patients shows that TRIPLE Positivity (RF + /ACPA + /ANA +) was consistently associated with higher disease activity at baseline and 12 months of follow-up and lower rates of sustained remission compared to RF + /ACPA + /ANA- https://t.co/l2TQDShFYi
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Rheumatology Supply and Demand (2009 - 2024) A retrospective review of US rheumatology manpower and training from 2009- ‘24 shows that US rheumatology training has become competitive, with an increasing surplus of applicants compared to available training positions. https://t.co/2yWZt8eeEJ
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25-Hydroxyvitamin D levels and Lupus Outcomes Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
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Seeking Musculoskeletal Care A report entitled The Burden of Musculoskeletal Diseases in the United States (BMUS) was published by the USBJD with input from rheumatology, orthopedic surgery, physical medicine and rehabilitation regarding musculoskeletal care. https://t.co/KGYHrQYADE
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ICYMI: Head-to-Head Clinical Trials https://t.co/LpvqQRP06b https://t.co/YkXYvUuJWx

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