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Ides of March (3.15.2024)

Jack Cush, MD

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.

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DMARD,trends,2021

US Trends in RA DMARD Use 2017-2021

Jack Cush, MD

A trend analysis of DMARDs shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use. Despite numerous DMARD advances and evolving treatment guidelines since 1990, older therapies are still commonly used and the latest agents make up a small percentage of overall DMARD use.

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Leflunomide

9 Facts about Leflunomide

Jack Cush, MD

Medscape has published an informative review of leflunomide, drawn from Dr. Eric Ruderman’s recent lecture on the subject at the February RWCS meeting in Maui.

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syringe, pill, DMARD, Treatment, therapy

JAMA Review of DMARD Use in Rheumatoid Arthritis

Jack Cush, MD

JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs". 

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Stills,continuum

Effective Treatments for Still's Disease

Jack Cush, MD

A systematic review of pharmacological treatments for adult-onset Still disease (AOSD) supports the efficacy of tocilizumab (TCZ), anakinra (ANK), and canakinumab (CNK).

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Depression and RA (3.8.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.

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Stop,pills,water

Can Mycophenolate be Stopped in Stable SLE?

Jack Cush, MD

In patients with clinically stable systemic lupus erythematosus (SLE) and lupus nephritis, the withdrawal of mycophenolate mofetil was not significantly inferior to mycophenolate maintenance, but MMF withdrawal had numerically more reactivations, while MMF maintenance had more infections.

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Sniffles & Arthritis (3.1.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual?  You decide....

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PSA068.jpg

Many with Psoriatic Arthritis Fail to Achieve Minimal Disease Activity

Jack Cush, MD

Despite the availability of numerous advanced therapies for psoriatic arthritis (PsA), there remains a substantial burden and unmet need for improved therapies, according to a newly published Canadian study.

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vasculitis.Churg-Strauss_syndrome.wikipedia.jpg

EGPA: Benralizumab or Mepolizumab

Jack Cush, MD

A multicenter, double-blind, phase 3, randomized, active-controlled trial has shown that Benralizumab (BEN) was noninferior to mepolizumab (MEP) for the induction of remission of patients with relapsing or refractory Eosinophilic granulomatosis with polyangiitis (EGPA).

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JAK-pot: 46913 Rx courses on JAKi, TNFi, other MOA. Rx D/Cs for AEs: - TNFi = JAKi (HR 1.0) - Other MOA > JAKi (HR 1.11) - TNFi < tofacitinib (0.81) - TNFi > baricitinib (1.15) - TNFi < JAKi; if >65yrs w/ CV risk (0.79) https://t.co/jCtLG3SNvP https://t.co/FN5U5Z1M9M

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Dr. John Cush RheumNow ( View Tweet)
Study 1189 males athletes sanctioned for doping with Androgenic anabolic steroids compared to 59 450 controls. Anabolic steroids signifi. increased the mortality risk (HR 2.81) from both unnatural (accidents) & natural causes (CVD, etc) https://t.co/XJr1oUw1gM https://t.co/YIQhdCXd2y

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Dr. John Cush RheumNow ( View Tweet)
Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory tract infections were most frequent with recurrence rate that remained stable over time https://t.co/zwELL2yevG https://t.co/GLbidGvjp3

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Dr. John Cush RheumNow ( View Tweet)
DANBIO #RA registry study: in 21,982 Rx starts (96K PtYrs) saw 1423 cancers w/ no overall increase in cancer risk with tocilizumab, sarilumab, abatacept, or rituximab (HRs from 0.7–1.1). No diff betw ABA vs TNFi (HR 1.41) nor HEME CA RTX vs TNFi (HR 0.09) https://t.co/mIEqALnnwI https://t.co/N1v3TzuBGm

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Dr. John Cush RheumNow ( View Tweet)
High risk pts on NSAIDs need prophylaxis!! @bcryer https://t.co/NAnHtkTNvL
Dr. John Cush RheumNow ( View Tweet)
Starting MTX at higher or subcut. doses yields better ACR20 responses. Review of 12 trials & 1,566 pts, shows: - higher initial MTX 25 mg (but more GI AEs) - SC MTX more ACR20 resp (85% vs PO 77%) - MTX non-response, success w/ SC MTX https://t.co/01PuDpkUIF https://t.co/vXLWEp4srH

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Dr. John Cush RheumNow ( View Tweet)
Have 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/a3XeAa2lcG https://t.co/dTZa2uQF97

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Dr. John Cush RheumNow ( View Tweet)
An assessment of screening for latent tuberculosis in patients initiating b/tsDMARD therapy found over 1 in 3 new b/tsDMARD users did not receive TB screening within recommended time window, as well as variation in screening between drug classes In AC&R https://t.co/MGsWNZCiPW https://t.co/QRFq1lqWt6

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ACR_Journals ACR_Journals ( View Tweet)
As of 11/23, FDA has approved 44 biosimilars to 14 different reference products. FDA systematic review on biosimilars found no differences in the risk of death, serious adverse events, or treatment discontinuations between the switch and no-switch arms.https://t.co/yVScZnP559 https://t.co/feswD1gJz9

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IBD extraintestinal & joint manifestations - systematic review of 61 studies (13,806 pts) found 8% new joint findings during advanced therapy (no signif difference betw vedolizumab (9%) & ustekinumab (6%). https://t.co/drFAtBG4ZU https://t.co/N8ixHS64HD

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Dr. John Cush RheumNow ( View Tweet)
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