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Overmedication of America

d Jack Cush, MD

Recent research from the Lown Institute reports that 750 older Americans are hospitalized daily because of serious side effects from and the core problem is that of polypharmacy, especially in the elderly. 

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Hypersensitivity Reactions and Gout Tx: Watch the Dose

d RheumNow

Both allopurinol and febuxostat (Uloric) were associated with an increased risk of hypersensitivity reactions among new users of these urate-lowering therapies, a large U.S. study found.

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Bimekizumab Effective in Active Psoriatic Arthritis

d Jack Cush, MD

Interleukin 17 IIL-17) is important in the pathogenesis of psoriatic disease, with most current approaches targeting IL-17A. Now there is a noveal approach showing that dual neutralisation of IL-17A and IL-17F in psoriatic arthritis arthritis patients results in clinically significant improvement.

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DMARD Inertia by Registry Rheumatologists

d Jack Cush, MD

A registry study of metric use (primarily RAPID3 and CDAI) in the treatment of rheumatoid arthritis (RA) patients shows that, even in the face of moderate or high disease activity, treatment changes by rheumatologists were relatively low (35.6–54.6%).

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Upadacitinib Effective in Phase 3 Psoriatic Arthritis Study

d Jack Cush, MD

Abbvie has announced top line results of their SELECT-PSA trial of upadacitinib (UPA), wherein both the 15 and 30 mg doses met the primary endpoint of ACR20 response at week 12 and demonstrated radiographic inhibition at week 24.

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RheumNow Podcast- Best Biologics (2.7.20)

d Jack Cush, MD

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

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Bariatric Weight Loss Fails to Alter RA Risk

d Jack Cush, MD

Obesity has been shown to be a risk factor for the onset of rheumatoid arthritis (RA) and also shown to affect outcomes by impairing responses to many DMARD therapies. A Swiss study of RA patients undergoing bariatric surgery failed to show that bariatric surgery and weight loss had any effect on the incidence of RA.

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Which Biologics are Best in Psoriasis

d Jack Cush, MD

A metanalysis of phase II, III and IV trials in moderate to severe plaque psoriasis suggests comparative efficacy biologic treatments, but that that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa were shown to have the past skin (PASI) response rates.

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Aspirin after Hip or Knee Arthoplasty

d Jack Cush, MD

JAMA Internal Medicine has reported that use of low dose aspirin for venous thromboembolism (VTE) prophylaxis after total hip and knee replacement is equal in efficacy to other anticoagulants.

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Start with Anti-TNF in RA? Not So Fast

d

The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.

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Large UK database looked at 1281 Behcet Dz pts - prevalence of BD was 14.61 per 100k. BD was at increased risk of ischaemic heart disease [aHR 3.09), venous thrombosis [aHR 4.80] and mortality [aHR 1.40] iVS 5K controls. https://t.co/FghxE6bAZ0

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Dr. John Cush RheumNow ( View Tweet)

QD clinic - Seronegative RA. Watch the video.https://t.co/o7pZ0JPvvW Or listen to the podcast https://t.co/BRwO8Xa5OV

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Dr. John Cush RheumNow ( View Tweet)

"The truth is incontrovertible. Malice may attack it, ignorance may deride it, but in the end, there it is." - Winston Churchill

Dr. John Cush RheumNow ( View Tweet)

Register now to #EULAR2020 | Frankfurt and save with the regular registration fee! Join us at this major event in the calendar of world rheumatology to enjoy an exciting scientific programme and great networking opportunities! An all-inclusive fee 👉 https://t.co/ISveSzffEr https://t.co/p5VhVfoqz5

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The European League Against Rheumatism, EULAR eular_org ( View Tweet)
RA woman on Otezla, Kevzara, 10 pred, w/ no response, Now has SJC 9, TJC 11! Prev failed MTX, ETN, ADA, ABA, IL-6. What would treat w/?

Dr. John Cush RheumNow ( View Tweet)

Spanish study of 78 RA pts shows that Rituximab (#RTX) use was associated with a lower risk of functional respiratory decline compared with non-exposure (HR 0.51; 95% CI 0.31, 0.85). Higher w/ UIP; lower with steroids, disease activity & lower duration https://t.co/jyUXbmQDYl

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Dr. John Cush RheumNow ( View Tweet)

Open label study of Abatacept in 79 patients with primary Sjogrens syndrome showed no difference between those treated wtih ABA vs Placebo. https://t.co/tUfAn40k9S

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Dr. John Cush RheumNow ( View Tweet)

New Am Gastroenterology Assn Guidelines on Rx of Ulcerative colitis list infliximab, adalimumab, golimumab, vedolizumab, ustekinumab and tofacitinib for moderate to severe UC. Rec against TOFA until failing a TNFi; against using MTX. https://t.co/b0Xap3ijK7

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Dr. John Cush RheumNow ( View Tweet)

"If you have an important point to make, don't try to be subtle or clever. Use a pile driver. Hit the point once. Then come back and hit it again. Then hit it a third time - a tremendous whack." -Winston Churchill

Dr. John Cush RheumNow ( View Tweet)

Placebo and nocebo effects are powerful and pervasive in clinical practice. Neurobiologic mechanisms, information offered about treatment, prior encounters with a drug or procedure, and the therapeutic milieu can all generate these effects.

NEJM NEJM ( View Tweet)

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