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Targeting the Wnt Pathway Fails in OA

d RheumNow

The Wnt pathway modulator lorecivivint failed to meet the primary endpoint in a phase IIa study for knee osteoarthritis (OA), but showed promise in certain patient subgroups, researchers reported.

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Cytokine storm

TNR Grand Rounds - Cytokine Storm Syndromes

d Jack Cush, MD

This week's Tuesday Nite Rheumatology featured Dr Randy Cron from the University of Alabama - Birmingham as he spoke and took questions on the immunology, immunopathogenesis and treatment of Cytokine Storm Syndrome, especially as they relate to COVID-19 and rheumatic disease patients. The program was moderated by Dr. Jack Cush.

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Boston and Wuhan Report Rheum COVID Patients at Risk for Respiratory Failure

d Jack Cush, MD

Two current reports from Boston and Wuhan describe cohorts of COVID-19 (+) rheumatic disease patients who generally do well but appear to have a higher risk of pulmonary involvement.

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Hydroxychloroquine Improves Survival in Lupus

d Jack Cush, MD

Hydroxychloroquine (HCQ) has dominated the news in recent weeks, because of poor outcomes reported when used in COVID patients. Yet, a recent report reaffirms what rheumatologists have known for years - that HCQ use is associated with better outcomes in systemic lupus erythematosus, including survival.  

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Low Risk of COVID-19 Pneumonia in Rheumatic Patients

d Jack Cush, MD

A current letter in the Annals of Rheumatic Disease details the rheumatic disease patient cohort outcomes from the University of Siena, Italy showing only 2 cases of COVID-19 among 859 patients treated with tsDMARDs and bDMARDs.

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Great NY Times article on 30+ years of an adversarial friendship between Dr. Tony Fauci and AIDS activist Larry Kramer (who recently passed away). Keen that adversaries can still be on the same side, pushing for change differently https://t.co/lnfk6fXfF2

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Dr. John Cush RheumNow ( View Tweet)

BTK inhib (fenbrutinib-FEN) effective in #RA. In a 12 wk RCT, 480 MTX-IR pts Rx either PBO, adalimumab or FEN (50 mg or 150 mg/d). ACR50 resp was PBO 15%; ADA 36%; FEN 50mg 18%, 150 qd 28%, 200 mg bid 35%. FEM NO effx on myeloid & B cell biomarkers. https://t.co/JIb4FtiOQG

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Dr. John Cush RheumNow ( View Tweet)

NEJM reports no difference between 5d and 10d course of Remdesivir in severe Covid-19 not requiring mechanical ventilation; but this trial did not include a placebo control https://t.co/mxAR2qQzPa

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Dr. John Cush RheumNow ( View Tweet)

CORRONA registry compared Triple DMARD (MSH) to TNF/MTX Rx; MSH is infrequently used; Triple DMARD pts were older, longer Dz duration, less Dz activity, more CA & comorbidities. Comparatively MSH had more Discontinuations & less likely to get to LDAS https://t.co/WSHgzrfcIn

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Dr. John Cush RheumNow ( View Tweet)

Case-control study of risk factors for [rheumatic use] hydroxychloroquine retinopathy: cumulative dose, duration of intake, creatinine clearance and geographical origin sign^ in multivariate analysis, what is driving the geo finding? genetics? https://t.co/2NGaZiqpsc @RheumJnl

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Dr Philip Robinson philipcrobinson ( View Tweet)

NEW RESEARCH: Repeat ANA testing after a negative result has low utility and results in high cost https://t.co/Zfc2vqRue1 #LancetRheumatology https://t.co/N9iHfdNYix

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The Lancet Rheumatology TheLancetRheum ( View Tweet)
Proud of this amazing collaboration with @zach_wallace_md: 52 rheumatic cases vs. 104 non-rheumatic comparators, all infected with COVID-19. Rheum cases had 3-fold risk of mechanical ventilation @BrighamResearch @MGHMedicine https://t.co/nBXe78i4JU

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Jeff Sparks jeffsparks ( View Tweet)

Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash. AAV w/ skin Sxs have more systemic dz (GN, alveolar hemorrhage) https://t.co/zL7a38aDIt

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Dr. John Cush RheumNow ( View Tweet)

Studies have shown a higher risk of gout w/ obstructive Sleep Apnea;a recent study shows higher risk (OR 1.86) disappears (OR 1.05) after adjusting for BMI, CHF, DM, diuretics, and renal dz. Gout associates with comorbidities, including obesity and OSA https://t.co/39Wen3uydM

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Dr. John Cush RheumNow ( View Tweet)

Be sure to catch tonights 8pm EST Grand Rounds - Cytokine Storm Syndrome given by Dr. Randy Cron (UAB) part of the Tues Nite Rheumatology seriies. Go here to register (this is for rheums) https://t.co/RtugDyTBRX

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 15 studies & 552,019 pts with RA shows the risk of diabetes to be significantly reduced in RA patients on HCQ (HR 0.61), methotrexate (HR 0.81), TNFi (HR 0.63), but increased with glucocorticoids (HR 1.46 < 10 mg; HR 2.25 for > 10 mg) https://t.co/gULTBtSvYU

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Dr. John Cush RheumNow ( View Tweet)

10 FALSE reasons for not wearing a mask - https://t.co/psGrN4iYMs Please wear a mask out of concern and care for others !!

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Dr. John Cush RheumNow ( View Tweet)

Well Being Trust (WBT) reports that there are 151,964 deaths from alcohol, drugs, and suicide last year. In less than 3 mos, COVID-19 will kill over 100,000 Americans. WBT estimates that COVID could cause between 27,000-68,000 deaths of despair. https://t.co/yIf1yrzkbr

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Dr. John Cush RheumNow ( View Tweet)

Gilead announced phase 2/3 trial results of their JAK1 inhibitor, filgotinib, showing 200 mg qd (not 100 mg qd) dose was effective in ulcerative colitis (SELECTION study) with higher remission rates at weeks 10 (vs PBO); at wk 28 both 100mg and 200mg were superior to PBO

Dr. John Cush RheumNow ( View Tweet)

Do your part. Show respect. Wear a mask.

Andrew Cuomo NYGovCuomo ( View Tweet)

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