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Bidirectional Association Between Depression and Rheumatoid Arthritis A recent meta-analysis suggests a bidirectional association between RA and depression. Finding RA patients with depression yields an 80% increased mortality risk. https://t.co/1o2ObHd76V

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Dr. John Cush RheumNow ( View Tweet)

depression oh no HA

Bidirectional Association Between Depression and Rheumatoid Arthritis

d Jack Cush, MD

A recent meta-analysis suggests a bidirectional association between rheumatoid arthritis (RA) and depression.  Finding RA patients with depression yields an 80% increased mortality risk.



Anti-cytokine therapies represents a potential alternative for the treatment of depression.

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73 #RA pregnancies w/ live births. 88% were in remission/low disease before conception. RA flares occurred in 37% (in 1st &2nd trim). Preterm assoc w/ Flares; flares more likely if bDMARD D/C @ +Preg test (55% w/ flare vs. 30% w/o flare, p 0.03, OR 2.9) https://t.co/hVtUuX3lfr https://t.co/bFbyQZbcim

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Dr. John Cush RheumNow ( View Tweet)
JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY

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Dr. John Cush RheumNow ( View Tweet)
Study of 209 Early RA (<1yr) pts found 23 (11%) with Drug Free Remission (DFR) after 74 mos of F/U; DFR maintained x 48 mo (18–82). DFR was assoc w/ early persistence on Therapy (HR 3.84). Adhering to prescribed treatment may lead to DFR https://t.co/WAX6RWhToU https://t.co/ChlbHDDKCZ

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Dr. John Cush RheumNow ( View Tweet)
No benefit to social networking (SN) in RA. 210 #RA pts randomized to RA website +/- guided discussion/sessions; most were facebook familiar. @3 & 6 mos knowledge & self efficacy improved in both groups; w/ more satisfaction in FB grp (p≤0.04) https://t.co/TQtsRyse59 https://t.co/rY2DBTFjp0

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology question or case for Jack 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/cvmbzknQqA https://t.co/6mX5eRUNuU

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Dr. John Cush RheumNow ( View Tweet)
Study of 209 Early RA (<1yr) pts found 23 (11%) with Drug Free Remission (DFR) after 74 mos of F/U; DFR maintained x 48 mo (18–82). DFR was assoc w/ early persistence on Therapy (HR 3.84). Adhering to prescribed treatment may lead to DFR https://t.co/oO8wKOKfxE https://t.co/DPX9JudplX

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Dr. John Cush RheumNow ( View Tweet)
Has insurance moved to a new tactic to intimidate doctors from appeals? I was expecting to do a peer to peer to get #Xeljanz approved, they put me on the phone with a courtroom judge to make me swear I am telling the truth about why the medicine is needed for the patient.

TheDaoIndex KDAO2011 ( View Tweet)

Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study https://t.co/1fiNgBQUbr looks like lower ab response and drops over 6 mths - boosters important in our patients

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Peter Nash drpnash ( View Tweet)

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Hit Parade Review (8.12.2022)

d Jack Cush, MD

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on popularity, measured by rheumatologist engagements on the website and social media.

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morbidity,covid,heart,lung,brain

Arthritis - a Leading Chronic Condition Among Young Adults (18─34 Yrs)

d Jack Cush, MD

MMWR from last week focused on chronic conditions in young adults showing they are common, costly, and major causes of death and disability. Overall arthritis ranks behind five more common chronic condition in young adults - obesity, depression, hypertension, hypercholesterolemia and asthma.

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Study of diet & RA in 100 new RA & 197 controls; fish/seafood consumption assoc w/ less RA risk (OR 0.52; 0.27–0.98); but processed meat intake yielded increased RA risk (OR 3.45; CI 1.78–6.68). No significant association btw RA and red meats or poultry https://t.co/wLpHfA50mY https://t.co/p2EOLBKrwW

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Dr. John Cush RheumNow ( View Tweet)
URI.infection.COrona.jpg

More Bad Safety News for Xeljanz

d MedPage Today

Another analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in rheumatoid arthritis are higher than with tumor necrosis factor (TNF) inhibitors.

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Study of 57 #RA pts. w/ ILD treated with abatacept. Lung progression in 46% before ABA. After median 27 mos of follow-up, ILD - 72% improved or stabilized - 23% worsened - 5% died. No significant change in FVC, DLCO ILD worse assoc w/ DAS28, FVC DLCO https://t.co/kLa61ZS8dt https://t.co/7XhqxcHuCt

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Dr. John Cush RheumNow ( View Tweet)
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JAK Inhibitors in Difficult Still’s Disease

d Jack Cush, MD

A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.

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The Great Unknowns (8.5.2022)

d Jack Cush, MD

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

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#RA disease activity drives risk of hospitalized infections (SIE). Study of 3,254 RA pts w/ 529 hospitalized infx. SIE seen 3.8/100 person Yrs in remission, 6.6/100PY w/ low Dz activity & 8/100PY w/ moderate Dz activity. HR was 1.60 w/ LDA and 1.83 w/ MDA https://t.co/i4bSsnRiHk https://t.co/kcN9ZvpSOn

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Dr. John Cush RheumNow ( View Tweet)
521 clinically suspect arthralgia (CSA) pts were assessed - Low educational attainment was associated with increased risk of developing inflammatory arthritis (HR = 2.35), independent of BMI & smoking https://t.co/h1bXDfxaQk https://t.co/g2ign0HDmj

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Dr. John Cush RheumNow ( View Tweet)
The Approach to Difficult to Treat Rheumatoid Arthritis Tan and Buch have reviewed the approach to D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options. https://t.co/CfCvgbl3VP https://t.co/OKzyY79shU

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Dr. John Cush RheumNow ( View Tweet)

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