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Risk Option Decision

The art of talking about risks with our patients

David Liew, FRACP

On the first day of EULAR 2024, I am debating Janet Pope.

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Is Cannabis Safe? (6.7.2024)

Jack Cush, MD

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

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Cannabis Use is Common, But is it Safe?

Jack Cush, MD

Two current JAMA reports suggest that cannabis use is not only common, but that if heavily used may increase mortality rates.

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JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis?

Medpage Today

A Janus kinase (JAK) inhibitor outperformed tumor necrosis factor (TNF) blockers for substantially reducing rheumatoid arthritis (RA) symptoms in patients for whom conventional anti-rheumatic drugs had failed, a pragmatic head-to-head trial found.

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ACR’s Run at Goliath (PCPs) (5.31.2024)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and articles from this past week on RheumNow.com. The ACR (and Cush) address their new website designed to educate PCPs and APPs - what do you think?

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Metformin Lowers Gout Risk in Pre-Diabetes

Jack Cush, MD

A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout. 

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Biologic-treated Psoriasis has Less Progression to Psoriatic Arthritis

Jack Cush, MD

A single center study demonstrates that biologic treatment of psoriasis (PsO) significantly reduces the likelihood of psoriatic arthritis (PsA) development; suggesting a role for more aggressive treatment of PsO. 

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Hypertension not associated with High NSAID Doses in AxSpA

Medscape

At the recent SPARTAN annual meeting in Cleveland, Dr. Jose Meade-Aguilar reported that amongst axial spondyloarthritis patients receiving nonsteroidal anti-inflammatory drugs, there was no difference in the risk for hypertension when comparing those on high vs. low dose NSAIDs.

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More data from Jak-pot, the real-world multinational RA study, this time looking at infection in 14 national registries JAKi (vs TNFi) had no signal for general/serious infection (excluding HZ) Somewhat reassuring post-ORAL Surveillance infection data #EULAR2024 OP0092 @RheumNow https://t.co/ocAbc4NiV2

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David Liew drdavidliew ( View Tweet)
OP0053 #EULAR2024 @RheumNow #EULARBest Effect of #RTX in preclinical #RheumatoidArthritis RA-risk pts given 1 dose PBO or 1000mg RTX RTX in RA-risk pts delayed onset of RA by 1yr; no benefit on QoL Pts developing RA: RTX didn't alter PROs or disease severity when developing RA

Mrinalini Dey DrMiniDey ( View Tweet)

Shingrix in upadacitinib + MTX RA, in SELECT-COMPARE RCT: data now out to 60w good humoral and cellular response in most, even without MTX withheld (& good safety too) Important for our JAKi-treated patients to get the protection they need #EULAR2024 OP0020 @RheumNow https://t.co/FqVCCwUJOg

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David Liew drdavidliew ( View Tweet)
@Janetbirdope @RheumNow #EULAR2024 JAK-i Debate @drdavidliew (NOT in support of regulation) - is the signal real? Query about replicability & data came from N. America. Not reflected on real-world data of enriched cohorts - is the warning justified? - are there unintended consequences? @RheumNow https://t.co/TXUf90fqwN

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Asking the quintessential Australian question at #EULAR24 by @drdavidliew - does the ORAL surveillance study for JAKi *truly* pass the pub test? @eular_org @Janetbirdope @RheumNow What does #MedTwitter think? https://t.co/bqwPU8XX5S

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Benjamin Sutu benjaminsutu ( View Tweet)
#EULAR2024 JAK-i Debate. @Janetbirdope [Pro Regulatory Safety Measures] - to do no harm esp since there are other alternatives - supported by RCT - although JAK-i have different structures, data from individual RCT + LTE showed similar rates of malignancy & MACE @RheumNow https://t.co/jQKQmHE9Fg

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Boxed Warnings in Derm: - Topical Calcineurin inhib (atopic dermatitis): rare risk of cancer - IL-17 Inhibitors (PSO, PsA): exacerbation of IBD (38 RCTs: only 12/16,690 new IBD case - Psoriasis and suicidality: suicide risk same w/ or without treatments https://t.co/HsjO78NtjP https://t.co/v9Pys8RwcH

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Dr. John Cush RheumNow ( View Tweet)
Save the date! We are covering #EULAR24! We'll be sharing recaps, videos, and more. https://t.co/NMWtHB94Pi https://t.co/ok43pnagFg

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Dr. John Cush RheumNow ( View Tweet)
Hypertension not associated with High NSAID Doses in AxSpA At the SPARTAN meeting, Dr.Meade-Aguilar reported that amongst axSpA patients receiving NSAIDs, there was no diff in the risk for hypertension when comparing those on high vs. low dose NSAIDs. https://t.co/4XLr01wwo1 https://t.co/hdBYec6wmd

Links:

Dr. John Cush RheumNow ( View Tweet)
2 large 48-wk phase 3 trials (Be HEARD I/II) of Bimekizumab vs PBO in moderate-to-severe hidradenitis suppurativa shows BKZ to be safe & significantly effective (48% vs 29% & 52% vs 32%) vs PBO. https://t.co/qJykCPMn4U https://t.co/zVOTxLkW9R https://t.co/3I4eOfPYWk

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Dr. John Cush RheumNow ( View Tweet)
Do you have a rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/qvVEUoNYi5 https://t.co/duw6jg5xpp

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Dr. John Cush RheumNow ( View Tweet)
The Window of Opportunity (5.24.2024) Dr. Jack Cush reviews the journal reports and news from the past week on https://t.co/V10S4oVFsv. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis? https://t.co/zSjb2tKPWY

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Dr. John Cush RheumNow ( View Tweet)

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