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New ACR Guidelines for Gout Management

d Jack Cush, MD

The ACR has published the 2020 guidelines on the management of gout that includes strong recommendations favoring treat‐to‐target management and starting urate lowering therapy (ULT) for patients with frequent flares, radiographic damage or tophi due to gout.

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Secukinumab Better than Adalimumab - Maybe?

d Jack Cush, MD

The EXCEED study was a head-to-head trial of secukinumab (SEC) versus adalimumab (ADA) as first-line monotherapy in psoriatic arthritis (PsA) patients; this 52 week trial showed that while SEC failed to achieve clinical superiority over ADA, SEC treated patients demonstrated higher

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RheumNow Podcast – The Beat Goes On (5.8.20)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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Study of 274 women with axSpA shows that longer time to pregnancy (TTP) was associated with older age, nulliparity, and longer disease duration. https://t.co/GznVvnPAwO

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Dr. John Cush RheumNow ( View Tweet)

Why are more MEN (severely?) affected in COVID-19? Men have higher levels of circulating ACE2 (unrelated to ACEi or ARB HTN meds) based on a Biobank study of 1485 men, 537 women. ACE2 is found in lungs, heart, kidneys, vessels & testes https://t.co/CWXevTNYWm

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Dr. John Cush RheumNow ( View Tweet)

A new feature of COVID-19; "Covid toes" manifest as multifocal, asymmetric, erythema, ecchymoses, ischemic changes that blister or appear vasculitic. The toes, heel and soles can be affected. Healing in 12-20 days. https://t.co/Isqn9ebnQj

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Dr. John Cush RheumNow ( View Tweet)

Subanalyses of Mobility and Monarch studies show that #RA patients with highest tertiles of IL-6 (and CRP) had more disease activity, more Xray damage and better responses (less Xray change) to Sarilumab (vs Adalimumab or MTX). https://t.co/5mTePETFAQ

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Dr. John Cush RheumNow ( View Tweet)

1194 participants in Osteoarthritis Initiative shows 10 yr risk of incident Xray Knee OA was not increased by long term sitting, low-moderate physical activity (adjOR 0.69; 0.48-1.01) or strenuous phys activity (aOR 0.75; 0.53-1.07) https://t.co/7pCOwLpscr

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Dr. John Cush RheumNow ( View Tweet)

"There's a rule in acting called "Don't play the result." If you have a character who's going to end up in a certain place, don't play that until you get there. Play each scene and each beat as it comes. And that's what you do in life: You don't play the result." -Michael J. Fox

Dr. John Cush RheumNow ( View Tweet)

Why are more MEN (severely?) affected in COVID-19? Men have higher levels of circulating ACE2 (unrelated to ACEi or ARB HTN meds) based on a Biobank study of 1485 men, 537 women. ACE2 is found in lungs, heart, kidneys, vessels & testes https://t.co/CWXevTNYWm

Links:

Dr. John Cush RheumNow ( View Tweet)

Anakinra studied in COVID(+) ARDS (nonICU) pts w/ high CRP L or ferritin; 29 high dose Anakinra vs 17 controls. At day 21, more survival with anakinra 90% vs. Controls 56% (p=0·009). Anakinra also more improved CRP+resp function (72 vs 50%) https://t.co/wxjlQG44Oc

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - The Beat Goes On.... anakinra, nr-AxSpA, Smoking & GPA, PSS guidelines, IFNa, COVID and IL-6, HCQ,QTc, and Thromboses https://t.co/BsaALcHclv

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Dr. John Cush RheumNow ( View Tweet)

European Medicines Agency (EMA), FDA and Health Canada have all issued warnings about the use of hydroxychloroquine & chloroquine in coronavirus, stating they should only be used in drug studies or hospitalized pts. https://t.co/HT39sT31Rq

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Dr. John Cush RheumNow ( View Tweet)

American Hospital Association (AHA), in a new report, projected a loss of $202.6 billion from COVID-19 expenses and lost revenue for US hospitals and health systems from Mar 1 to Jun 30—about $50 billion in losses each month. https://t.co/pidOduwnDb

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Dr. John Cush RheumNow ( View Tweet)

Anakinra works in CPPD. Metanalysis of biologics use finds 74 pts Rx with anakinra for refractory dz (85%) or w/ contraindications (23%). Anakinra resp seen in 81% of acute and 43% of chronic CPPD pts. Few adverse events reported (4.1%) https://t.co/PwJO4ta6i7

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Dr. John Cush RheumNow ( View Tweet)

COVID-19 Does alot of Damage via thrombotic complications - a role for complement or autoantibody mediated thrombotic microangiopathy? #COVID19 https://t.co/33R8WxE5C0

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Dr. John Cush RheumNow ( View Tweet)

Grand Rounds tomorrow at Rutgers - Im Lecturing on “Disease Modifying and Biologic Use for COVID-19 & the Cytokine Storm Syndrome” https://t.co/FYsr77a68Z Meeting ID: 934 0443 3549

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Dr. John Cush RheumNow ( View Tweet)

Random thought about virtual clinics. Beginning to think that phone just as good as a stop gap as video. Less performative, more relaxed, and less tiring. Rheumatology is mainly (mainly) about history esp for those patients you know well.

Ronan Kavanagh RonanTKavanagh ( View Tweet)

“Middle-high level of RF-IgM could lead to false-positive reactivity of SARS-CoV-2 IgM “ As more people want SARS-CoV2 antibody testing, I am afraid this will give people a false sense of security ⁦@RheumNow⁩ ⁦@ACRheum⁩ NCBI - NLM - NIH https://t.co/vkjWRJQV27

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k dao KDAO2011 ( View Tweet)

Check out a great Grand Rounds by Dr. Len Calabrese @LCalabreseDO on "IL-6 in Health & Disease" - great 30 min lecture and great Q&A session - Bravo Lenny! https://t.co/eWTKotQya3

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Dr. John Cush RheumNow ( View Tweet)

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