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NSAIDs May Impair Healing if Taken Nightly

d Jack Cush, MD

A new study in Scientific Reports suggest that circadian rhythms play an important role in wound healing, and that nonsteroidal anti-inflammatory drugs (NSAIDs) may be disruptive if taken at night given primary healing that occurs in a body at night. 

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2019 EULAR Recommendations for the Management of Rheumatoid Arthritis

d Jack Cush, MD

The 2019 update to the EULAR recommendations on the use of synthetic and biological disease-modifying antirheumatic drugs in rheumatoid arthritis (RA) have been published in Annals of Rheumatic Disease - highlighting the efforts of an international consensus committee effort.

In the end, the task force put forth 5 overarching principles and 12 recommendations concerning use of conventional synthetic DMARDs, glucocorticoids, biological DMARDs, biosimilar DMARDs, and targeted synthetic DMARDs (the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib).

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RheumNow Podcast- A Good First Impression (1.24.20)

d Jack Cush, MD

Dr Jack Cush comments on this week's journal articles, reviews and studies.

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Administrative claims study from British Columbia showed the risk of type 2 diabetes is significantly lower in SLE pts taking Plaquenil (HCQ). 1,498 SLE pts (91% F) were followed 4.6 yrs with 140 incident T2DM; lower HR (0.61) for those adherent to HCQ https://t.co/OqUQtHz6Hf

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Dr. John Cush RheumNow ( View Tweet)

New ACR guidelines for OA hip/knee give a conditional recommendation for Balance exercises. https://t.co/2YLKuhZ92M A systematic review of 11 studies shows Knee OA pts at risk for falls. Risk factors: impaired balance, weakness, comorbidities, # of joints https://t.co/fAzYHtIpEM

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Dr. John Cush RheumNow ( View Tweet)

QD clinic on RheumNow began last week - these ar short vignettes from the clinic that instruct, question or enlighten common clinic issues. You can view these daily on RHeumNow or listen to the once a week compilation PODCAST on iTunes or here https://t.co/mvL5z6Lxkw

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Dr. John Cush RheumNow ( View Tweet)

"Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of their society. Moral courage is ... the one essential, vital quality for those who seek to change the world which yields most painfully to change" -Robert F. Kennedy

Dr. John Cush RheumNow ( View Tweet)

A good coach can change a game. A great coach can change a life. —JOHN WOODEN

Dr. John Cush RheumNow ( View Tweet)

“People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe”. —SIMON SINEK

Dr. John Cush RheumNow ( View Tweet)

Congratulations @Sarah_L_Mackie on guidelines for GCA including #ultrasound in the algorithm! Advancing #POCUS in #vasculitis @skyanna723 @markmatzamd @AlisonBays #rheumatology https://t.co/F42XFmV6bx

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Minna Kohler, MD, RhMSUS minnakohlermd ( View Tweet)

The RheumNow Podcast is up! This week: what happens before PsA; DASH diet and urate; and are RA patient reported Flares valid? Check out the videocast https://t.co/JDbYOiMYvU or listen to the podcast on iTunes or SoundCloud https://t.co/nK6l6z39fR

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Dr. John Cush RheumNow ( View Tweet)

Article on Yahoo about "7 Red Flags You Need a New Rheumatologist" 1 )When they discourage your own research 2) Don’t believe you 3) Bad info on health insurance 4) Rx everyone the same 5) Dx by lab results 6 ) No questions allowed 7) "nothing I can do” https://t.co/KMQNKnADBM

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Dr. John Cush RheumNow ( View Tweet)

New EULAR 2019 Rheumatoid Arthritis Treatment recommendations are out. Rheumatologists are the specialists who should care for RA; decisions are based on disease activity, safety issues and other patient factors (comorbidities) https://t.co/4NwYcR8l8G

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Dr. John Cush RheumNow ( View Tweet)

#MLK - "No person has the right to rain on your dreams" Martin Luther King, Jr.

Dr. John Cush RheumNow ( View Tweet)

Health Care Utilization prior to the Dx of Psoriatic Arthritis #PsA is significantly 2 fold higher. Study of 462 PsA & 2310 comparators shows more visits to PCP for MSK issues in 1-5 yrs prior, as well as use of other MSK specialists in 5 yrs preceding Dx. https://t.co/5729ya9Ahr

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Dr. John Cush RheumNow ( View Tweet)

Data from the Swedish Rheumatology Quality register (2716 RA pts) shows that biologic naive patients had longer drug survival. Men (HR 0.86) and MTX users (HR 0.85) were less likely to discontinue abatacept, https://t.co/Vhy3XtEg8R

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Dr. John Cush RheumNow ( View Tweet)

Fantastic article from @HealioRheum detailing the history and the hard work of CSRO. With phenomenal leaders like Dr. Michael Schweitz and @MattieRheumMD, CSRO will continue to effectively advocate for high-quality rheumatology care at an affordable rate! https://t.co/ImA9aeaXqh
CSRO CSROAdvocacy ( View Tweet)

#UTSW Dr Nicole Bittencourt on fever and autoinflammatory workup. Here are sources for genetic testing. I rec the Invitae autoinflammatory panel (or cash pay ~$100) https://t.co/XsJ0k7q0ex

Dr. John Cush RheumNow ( View Tweet)
60% The percentage of patients at @NIH's autoinflammatory disease cohort that are undifferentiated and do not have a specific disease diagnosis -Dr. Amanda Ombrello. #ACR19 @rheumnow https://t.co/d85OtnEA8o
Jonathan Hausmann MD hausmannMD ( View Tweet)
In 80 RA pts, SJC & TJC flares seen in 36% of pts. Pt-reported flares usually reflected incr Dz activity (MD exam & US). Pts & clinicians agreed in 79–93% of joints, moreso SJ than TJ. Using US, there was high specificity (>86%) & low sensitivity (<34%) https://t.co/jMRQg5fUuS

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Dr. John Cush RheumNow ( View Tweet)

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