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Coexistent Gout and Rheumatoid Arthritis

d Jack Cush, MD

While it is often said there is a negative association between gout and rheumatoid arthritis (RA), cases of coexistent disorders are uncommonly seen. A recent VA study describes 121 patients whith both RA and gout.

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CV Risks Raised in Myopathies

d Jack Cush, MD

Patients with the idiopathic inflammatory myopathies (IIMs) dermatomyositis and polymyositis are at increased risk for cardiovascular events, with risks similar to what has been documented for rheumatoid arthritis (RA), during the first 5 years after diagnosis, U.K. researchers reported.

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Liver Abnormalities in Psoriatic Arthritis

d Jack Cush, MD

A new report in the Journal of Rheumatology shows that liver abnormalities are common in psoriatic arthritis (PsA) and may be associated with obesity, more severe disease and select therapies.

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Premature Atherosclerosis in Autoimmune Rheumatic Diseases

d Jack Cush, MD

The VITAL study is a VA registry that has shown that both systemic lupus erythematosus  (SLE) and rheumatoid arthritis (RA) patients carry higher odds of both premature and extremely premature atherosclerotic cardiovascular disease and its consequences.

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COVID's Multisystem Inflammatory Syndrome in Children

d Jack Cush, MD

Two recent reports further characterize the newly described, Kawasaki-like,  syndrome affecting children with COVID-19 infections.

The NEJM describes the childhood syndrome as having Kawasaki’s disease, fever, toxic shock syndrome, acute abdominal conditions, and encephalopathy; hence the label Childhood Multisystem Inflammatory Syndrome. The disorder emerged in late April 2020, first in the U.K., and then similar cases were reported from many other countries. The CDC named this multisystem inflammatory syndrome in children (MIS-C).

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ACR Position Statement on Telemedicine

d Jack Cush, MD

The American College of Rheumatology (ACR) has released an official position statement supporting the role of telemedicine as a tool with the potential to increase access and improve care for patients with rheumatic diseases.

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UK population study shows fibromyalgia pts have a higher risk of Self harm (HR 2.06; 1.60,2.65)), RA (HR 1.59) & OA, but not ank spondylitis. Pain and depression are risk factors for self-harm & self harm is a key risk factor for suicide.https://t.co/vXmZKYq3Pe

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Dr. John Cush RheumNow ( View Tweet)

A Genetic Probability tool used to calculate risk of rheum Dz in 3 pt cohorts (1211 eMERGE, 245 Partners & 243 early inflam arthritis. Dx AUc: 0.69, 0.81 & 0.84. Likely dx made in 64% & r/o in 45%. ?Could be used to improve Dx accuracy in clinical practice?https://t.co/JiRIxtx3j5

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Dr. John Cush RheumNow ( View Tweet)

Rituximab (RTX)-associated autoimmune disease flare is rare and only seen in 7/185 pts (3.4%); all w/ type II mixed cryoglobulinemia vasculitis. Flare occurred a median 8 days post RTX, as acute kidney insuf, purpura with myocarditis or GI involvement https://t.co/pgvyddFnAd

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Dr. John Cush RheumNow ( View Tweet)

A federal appeals court on Wednesday upheld two patents for Enbrel (Amgen), rejecting Novartis AG’s effort to void the patents and clear the way for their etanercept biosimilar Erelzi (Sandoz). https://t.co/FsSpbM1O2j

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Dr. John Cush RheumNow ( View Tweet)

Series of 11 severe COVID-19 pts Rx w/ Anakinra. 7/11 recv anakinra w/in 36 hrs - none required ventilation. 4 got anakinra after 4days of Resp Sx & required ventilation; 1 died. Pts were SARS‐CoV‐2+, w/ fever, ferritin >1,000 ng/mL & acute resp failure. https://t.co/vegsJPrSGp

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Dr. John Cush RheumNow ( View Tweet)

66 critically ill & 13 non‐critically ill COVID‐19 were tested for multiple anti‐phospholipid (aPL)Abs. APL common (47%) in critically ill, may be transient (35‐39d post onset). Multiple medium/high levels aPLs may identify at risk for CVA or APS

Dr. John Cush RheumNow ( View Tweet)

Schulz-Koops reports 2 #RA patients Rx with RTX who died from COVID pneumonia and ARDS. Both were older, had comorbidities (COPD, HTN, OP) and had received last RTX either 2 wks and 6 mos before COVID infection onset; both had nl IgG levels https://t.co/j043Tggdbg

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Dr. John Cush RheumNow ( View Tweet)

Nested case-control study of 5858 SLE patients - 51 developed cancer; most common were thyroid CA (27%), cervical (20%), & lung (14%). No risk imposed by steroids, CTX, MTX or azathioprine. But HCQ use was associated significantly lower Cancer risk in SLE https://t.co/3R0iakKbVG

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Dr. John Cush RheumNow ( View Tweet)

National Inpatient study of 61,615 systemic sclerosis pts (1998–2016) finds most common serious infections were pneumonia 45%, sepsis 32%, SSTI 19%; by 2015–2016, sepsis 1.8X more common than pneumonia. Hosp SIE mortality decr over time (10% to 8%) https://t.co/nv1KjaL3w4

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Dr. John Cush RheumNow ( View Tweet)

According to the Agency for Healthcare Research & Quality, it is estimated that 40-80% of information a patient is told during an office visit is forgotten immediately, and that almost half of the information a patient does retain is actually incorrect https://t.co/XeGx2YXsOQ

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Dr. John Cush RheumNow ( View Tweet)

2000–2016, analgesic use for OA has changed in UK. Oral NSAIDs Rx decreased & other analgesics/opioids increased (P < 0.001). Pts w/ GI dz likely to recv topical NSAIDs, tylenol, opioids. Opioids moreso in elderly, women, obesity, smokers, comorbidities. https://t.co/AJiWUAycLb

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Dr. John Cush RheumNow ( View Tweet)

CHMP of the EMA has recommended approval of intravenous & subcutaneous formulations of CT-P13 (Remsima) for use in 5 conditions - Crohn, UC, ankylosing spondylitis, PsA & psoriasis. Remsima dose is 120 mg q 2wks regardless of body weight. https://t.co/eDUCvQost9

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Dr. John Cush RheumNow ( View Tweet)

A must watch with volume on! It is so relatable. I might adopt the same response next time I get that question "But where are you from? shortly after I said Cheshire. Even though I wasn't born here, I think spending best half of my life here qualifies the answer. https://t.co/dVdgjQl7pU

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Dr Yeliz Prior #BlackLivesMatter YelizPrior ( View Tweet)

Increased rate of hospital #COVID-19 cases associated with some but not all chronic #inflammatory or #autoimmune conditions compared with reference population. The risks seem to depend on age, the specific disease and previous therapies. https://t.co/8j6R0oO99y https://t.co/n3cEXFx9Kk

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ARD & RMD Open ARD_BMJ ( View Tweet)

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