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ACR guidance

ACR Updated Guideline on Vaccinations for Rheumatic Patients

d Jack Cush, MD

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).

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RA erosions bone ACR

The Approach to Difficult to Treat Rheumatoid Arthritis

d Jack Cush, MD

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.

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Risk of incident & recurrent H.Zoster higher after tofacitinib - Korean claims analysis of 11,720 seropos. RA pts Rx w/ bDMARD or tofacitinib (2011-19). 14% got HZ. Compared to other biologics (ABA), Tofa incr HZ (HR 2.5) & recurrence (HR 3.69) https://t.co/lDuqdtkIjR https://t.co/zJ3ArS3gGs

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Social Media Questions (7.29.2022)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and rheumatologist cases from the past week on RheumNow.com. This podcast is brought to you by StillsNow.com - be sure to sign up for our monthly StillsNow email and Monthly StillsNow Podcast.

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Study of 63 Thalassemia pts (50 transfusion dep) w/ 22% α-, 73% β-, 5% α- & β-thal. 23 had inflammatory rheumatic Dz (IRD: RA 9, gout 6, SLE 3, SpA 2). ANA+ in 10% w/o IRD & Transfusion Dep had more + tests for direct Coombs & ANA https://t.co/QW6ecv98F1 https://t.co/GO3xC86hLc

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TREAT EARLIER Study - Is MTX Intevention in Pre-Clinical RA Warranted? https://t.co/rGcm1DSwJk https://t.co/paBrJVMXdP

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Best of

U.S. News & World Report’s 2022–23 Rheumatology Rankings

d Jack Cush, MD

The Johns Hopkins Hospital has repeated its top rank among US Rheumatology centers - ranking #1 for the 18th year in a row, according to U.S. News & World Report’s 2022–23 Best Hospitals list released yesterday.

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No Risk of RA w/ coffee consumption -- Swedish EIRA study, included 2184 early RA pts. High Coffee (>6 cups/day) was assoc w/ increased RA risk (OR 1.50;1.20–1.88) that was lost after adjusting for smoking (OR 1.14;0.89–1.45). https://t.co/3SIeHD4fII https://t.co/NqkjmuzSaV

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BSRBR mandates LFTs q3 mos if on MTX. 1011 RA pts during the pandemic had median of 5 blood tests & median interval of 57 days. 61% pts had 1 prolonged interval (99-150d) & 24% had multiple. Cytopenia & ^LFTs were not increased by interval length https://t.co/VqY4qIMvOS https://t.co/HcTcmFBuvq

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210 consecutive #RA pts starting #MTX looked at effect of autoantibodies on drug response. DAS28-CRP low dz activity at 6 mos was significantly lower with SSA+ (56% v 76%, P=0.03) - which was more significant than CCP+ or RF+ https://t.co/DoEtldBXi4 Figures https://t.co/yIECjLiEwl

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TREAT EARLIER Study - Is MTX Intevention in Pre-Clinical RA Warranted?

d Jack Cush, MD

Management of arthralgias before a certified rheumatoid arthritis (RA) diagnosis is challenging - should one use DMARD therapy before clinically evident synovitis in a preemptive effort to avoid or forestall the diagnosis or damage of RA?

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Have you checked out our new sister-site, Still's Now? A new site for Still's disease, autoinflammatory & febrile disorders. https://t.co/oWEugnOB6k https://t.co/5jwiP2Xqrz

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Risk of hospitalized infection (SIE) goes up with #RA disease activity. Study of 3,254 RA Pts with 529 SIE - SIE rates lowest with remission (3.8/100PY), vs low dz activity (6.6/100PY; OR 1.60) vs moderate activity (8.8/100PY; OR 183) https://t.co/EWbX7N7fiG https://t.co/Y8bRn2XATF

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Sometimes the journey impacts as much as the destination. TREAT-EARLIER now @TheLancet: pre-RA (CSA+MRI) DBRCT: po MTX for 1y (+im mpred120x1) vs placebo eventual RA same but persistent benefit at 2y (1y post-MTX cessation): function, Sx, presenteeism, MRI a short thread🧵1/7 https://t.co/64b7us6hvS

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David Liew drdavidliew ( View Tweet)

Rheums: Got a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/QUTIbK3r89 https://t.co/FZcTLREida

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Rheumatologist Survey: What do you rely on MOST in diagnosing Still’s disease? Sxs? Labs? Both? Criteria? Fever? Vote here: https://t.co/oANKpKqJA5 https://t.co/LIjRSBHNBi

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pills,combo,push,blister

Continue the Methotrexate, Leave the Cannoli

d Jack Cush, MD

Placebo responses are to be expected in rheumatoid arthritis (RA) clinical trials, but are such placebo responses affected by continuing background DMARDs like methotrexate (MTX) even though there was an inadequate response (IR) to MTX? 

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RF.jpg

Abatacept Most Effective Early and in Seropositive RA

d Jack Cush, MD

An open-label, 2 year study evaluated the efficacy and safey (drug retention) of subcutaneous (SC) abatacept (ABA) in active rheumatoid arthritis (RA) and showed superior responses when ABA was given to biologic-naive and seropositive RA patients. 

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#OP0004 #EULAR2022 In line with EULAR President’s preech to go Digital, Prof Mosca highlighted a study which showed assessment of joints in RA could be done by taking photos and analysed their dorsal skin folds using convolutional neural network cc: @Yuz6Yusof : https://t.co/mn48vXtGad
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2021,year

ICYMI: 2021 Rheumatology Year in Review

d Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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