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Lead with Lupus (8.2.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com - leading with lupus because everyone wants to know about lupus!

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NSAIDs Used Despite Contraindications

EurekAlert!

Osteoarthritis affects 600 million people worldwide, making it a leading cause of disability.

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Arthritis drugs may relieve long COVID lung symptoms

EurekAlert!

University of Virginia School of Medicine researchers have identified a potential treatment for the respiratory symptoms of long COVID after discovering an unknown cause of the condition inside the lungs.

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PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

Jack Cush, MD

A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance. 

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Biologics Prevent AA amyloidosis progression to ESRD

MedPage Today

One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.

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Patients with Financial Limits Struggle with Medication Adherence

Jack Cush, MD

Analysis of the National Health Interview Survey shows that nearly 1 in 5 patients with rheumatologic disease in the United States struggled economically, suffering from food insecurity and cost related medication (CRM) nonadherence.

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Full Read Overview of the safety of bDMARDs/tsDMARDS - contraindications, precautions, & boxed warnings for treatment of RA, PsA, SpA, JIA - safety checklist for a class of drugs you use and diseases you treat https://t.co/TIdCtJjF21 https://t.co/UE0nGbESDB

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Melatonin doesnt work! 172 pts w/ unilateral TKA for Rx in DBRPCT trial of qhs 5 mg melatonin vs. 125 mg vit C placebo for 6 weeks. No differences in PSQI or other sleep measures @6wks. Poor sleep assoc w/ worse pt function and pain. https://t.co/b1gfnyB7Qw https://t.co/nT589CItIF

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Guselkumab maintenance dose is 100 mg sc q8wks. GUIDE ph 3b trial treated 297 PSO super responders (PASI <3) w/ q8wk or extended q16wk GUS & demonstrated noninferiority of q16 wk dosing w/ disease control (91.9 vs 92.6%) https://t.co/31DPTmcVD2 https://t.co/qHMsyYCH4J

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NSAIDs Used Despite Contraindications https://t.co/elhnmB3N52 https://t.co/VgIqKvkfVJ

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Dr. John Cush RheumNow ( View Tweet)
TRUST: 10 Yr Japanese study of tacrolimus in 1355 SLE nephritis pts; half on TAC x 10yrs. TAC use assoc w/ signif reduction corticosteroid use (~16 mg/d @4wks to 7.2 mg/d @ 1Yr(P < 0.001). 9.7% w/ serious AEs. https://t.co/PsfCVZF4tk https://t.co/l3HkTRc4oC

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Dr. John Cush RheumNow ( View Tweet)
Literature review - Glucocorticoid use in elderly to be problematic. GC use may be assoc w/ remission, but GC increases AE rates, & there is difficulty w/ GC discontinuation. Goal: D/C GC early, but some may require for up to yrs to control Dz activity https://t.co/6liN0mubIv https://t.co/PiGKGSYrof

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Dr. John Cush RheumNow ( View Tweet)
In the UK, estimated cost of hardardous NSAID use is £31.43million (pounds) (£9.28m to £67.11m) over 10 yrs. High risk = Elderly >65y without gastroprotection, pts on anticoagulants; & Pts w/ heart failure, chronic kidney Dz , or Hx of peptic ulcer. https://t.co/bPXnQbQnNV https://t.co/aDLGHjLmhB

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Polypharmacy Doubled in 20 Years. Polypharmacy (5+ Rx last month) went from 24% in 2000 to > 40% in 2020 https://t.co/2czI4DxlVm https://t.co/VAZkbxKrJP

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NEW VIEWPOINT—Arthritis complicating inflammatory bowel disease—the future is now https://t.co/FyojGF6Pvx @DrLauraCoates #GITwitter https://t.co/kMewGTDQTc

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The Lancet Rheumatology TheLancetRheum ( View Tweet)
Patients with Financial Limits Struggle with Medication Adherence The National Health Interview Survey reveals that nearly 1 in 5 patients with rheumatologic disease in the U.S. face economic challenges, including food insecurity and CRM nonadherence. https://t.co/DhiLDq3fjZ https://t.co/zqQRAJDrzc

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Dr. John Cush RheumNow ( View Tweet)
Earlier RA Diagnosis Leads to Lower Costs of Care A study from the Leiden Early Arthritis Clinic shows that is RA is diagnosed within 12 weeks after symptom onset, treatment costs were lower in both autoantibody-negative and autoantibody-positive RA. https://t.co/TnrpZGZ4fX https://t.co/elNQ3Pde2a

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Dr. John Cush RheumNow ( View Tweet)
CDC warns of Listeria outbreak assoc w/ deli meats - in 12 US states (lead by NY, and MN, MO, IL, WI, PA, VA, GA, NJ, DE, MD, MA, NC), 28 cases, 28 hospitalized, 2 deaths. @risk are the pregnant, elderly, immunosuppressed. Cook deli meats >165F https://t.co/SWKMhIBQEi https://t.co/snLjBKn1UJ

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Drug Safety Update, from UK MHRA, shows impt interaction between tramadol and warfarin. Tramadol may increase the INR with risk of major bruising and bleeding when warfarin and tramadol are taken concomitantly. https://t.co/mgmeMJzdLa

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JAK Inhibitors Reduce Macular Degeneration Insurance claims data showed that patients with autoimmune disorders who took JAK inhibitors had lower rates of AMD, hinting that the drugs might treat the common eye disease. https://t.co/bx0UCp0o3r https://t.co/FXSlcFHYXI

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