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GCA temporal artery

Update on Polymyalgia Rheumatica and Giant Cell Arteritis

d Jack Cush, MD

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has approved tocilizumab as a first-line glucocorticoid-sparing agent. 

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Diagnostic Accuracy of Symptoms, Signs and Labs in GCA

d Jack Cush, MD

A systematic review and meta-analysis of 68 diagnostic cohort studies (14 037 patients) suggests that no one feature is more impactful that the combination of symptoms, signs, and laboratory tests to diagnose the presence giant cell arteritis (GCA).

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Selective Biologic Responses in Seropositive RA

d Jack Cush, MD

The Journal of Rheuatology reports a pooled analysis of patients from 16 observational RA registries that examined the association between seropositivity (RF or ACPA) with biologic DMARDs responses; they showed better clinical responses when seropositive RA patients receive abatacept (ABA) o

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RheumNow Podcast – The Bad News That’s Fit to Print (8.21.20)

d Jack Cush, MD

Dr Jack Cush reviews the news and journal reports from the past week on RheumNow: filgotinib rejection, delays in diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX.

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Canakinumab Tapering in Still's Disease

d Jack Cush, MD

You can reduce - but not stop - canakinumab therapy in patients who are in complete clinical remission in children with systemic juvenile idiopathic arthritis.

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Are Women in Rheumatology Closing the Gap?

d Jack Cush, MD

"Fierce, Formidable and Phenomenal" was the tag line used to introduce Vice-Presidential candidate, Kamala Harris. Her introduction followed a review of the increasing role of women in voting, society and politics in America. Has the same been realized by women in academic medicine and rheumatology? 

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Fibromyalgia & Exercise? Systematic review of 50 trials, shows that, compared to usual care, exercise had moderate effect on fatigue, small effect on sleep and meditative exercise programs were the most effective for improving sleep quality. https://t.co/iloD8rMx64

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Dr. John Cush RheumNow ( View Tweet)

Responses to switching TNFi in SpA go down w/ the 2nd TNFi. 1st TNFi @ 3 mos ASAS CII 51%; 2nd TNFi 41%; BASDAI @6 mo, 1st 46%, 2nd TNFi 33%. Compared to primary failure, pts w/ 2nd failure (OR 7.3 ) or toxicity (OR 9.1) had better ASDAS-I https://t.co/jMCUfBtxmY https://t.co/PBkQNOwVRQ

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Dr. John Cush RheumNow ( View Tweet)
Telemedicine: What's Changed and What Needs to be Addressed? An update on legislative changes, uncertainties, and the care gap post COVID https://t.co/HRAsEP7IL6 https://t.co/X6PL0W4tI7

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Dr. John Cush RheumNow ( View Tweet)
Gilead/Galapagos gets a setback for filgotinib, its JAK1 inhib, that was poised to be the next approved RA drug by FDA. Instead the FDA issued a complete response letter; citing concerns over sperm studies (MANTA, MANTA-RAy) & 200 mg dose. Delay till 2021? https://t.co/H0rLjOMXq8 https://t.co/vb4FDUUVoS

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Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast - The Bad News That's Fit to Print (8.21.20) Dr Jack Cush reviews this week highlights filgotinib rejection, delays in Diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX https://t.co/1oZtU14VOB https://t.co/rcWlbYVKYn

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Dr. John Cush RheumNow ( View Tweet)
The FDA approves Novartis'anti-CD20 mAb, Kesimpta (ofatumumab) for the treatment of relapsing forms of multiple sclerosis (MS). https://t.co/2DgA4Modds

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast The Bad News That's Fit to Print - highlights filgotinib rejection, Dx delays, metformin in COVID, Abx & IBD, UPA beats MTX. Watch here> https://t.co/PV6b2wcanD or listen to the podcast on iTunes> https://t.co/FHJv01AAbC or SoundCloud> https://t.co/1oZtU14VOB

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Dr. John Cush RheumNow ( View Tweet)

ATS Abstract: n=616 survey contrasts rheums (57%) & pulmonologists (43%) beliefs on RA associated ILD. Both preferred to use steroids, MMF, RTX for RA-ILD, but Rheums tend avoid ADA & LEF. Rheums (17%) & Pulms (24%) think MTX a risk factor https://t.co/W5gbu84FBv

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of total elbow arthroplasty in RA - 38 studies, 2,118 TEAs w/ mean F/U of 819 mos - the implant failure & complication rates were 16% & 24%. Aseptic loosening was most common failure (9.5%). Higher failures in younger pts & unlinked design https://t.co/Pq2N1Kku60

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Dr. John Cush RheumNow ( View Tweet)

To date, the FDA has currently authorized 218 tests under EUAs; these include 176 molecular tests, 39 antibody tests, and 3 antigen tests.

U.S. FDA US_FDA ( View Tweet)

@RheumNow its time we stopped “seroneg RA” which are many diseases, like ANCA pos Vasculitis we should have ACPA pos RA and others - how many viral arthritides in our country “doing great” on SZP, PLAQ, or low dose MTX and reluctant to stop? #RA #Seronegative

Peter Nash drpnash ( View Tweet)

Mayo clinic: Theres a delay in diagnosing Seronegative RA - 1st joint swelling to diagnosis of RA was 187 days for seroneg vs 11 days for seropositive patients (P<.001). Seronegative RA less likely to achieve remission (28% vs 50% at 5 years) (P=.007) https://t.co/Hgewjmt1CL

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Dr. John Cush RheumNow ( View Tweet)

Study of 2 Canadian centers finds amongst 2095 patients taking biologics for #Psoriasis, 23 (1.1%) stopped their biologic for "COVID-19 related concerns". 5/23 restarted biologic for PSO flares. This included TNFi, inhibitors of IL17, IL12/23, IL23 https://t.co/gjSX4P0LMK

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Dr. John Cush RheumNow ( View Tweet)

COVID-19 child case count now over 400,000 https://t.co/bRYvZ5AoYt https://t.co/JhEbvncUbr

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Dr. John Cush RheumNow ( View Tweet)

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