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RheumNow Podcast - 2019 Rheumatology Year in Review

d Jack Cush, MD

Dr. Jack Cush reviews highlights from 2019 on RheumNow.com. Topics covered in this annual review include: superheroes lost; venous thromboembolic events and JAKs; free medical tuition; women in rheumatology; 52 new drug approvals in 2019 and 330 drugs with a 2020 price hike; scleroderma disappointments; novel new treatments and newer tests; the boom of Shingrix; RheumNow.Live - and more.

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Best of 2019 - Is Methotrexate Necessary with Tofacitinib?

d RheumNow

Rheumatoid arthritis patients taking tofacitinib (Xeljanz) plus methotrexate who achieved low disease activity (LDA) may be able to withdraw from the latter agent without significant worsening of disease activity, a researcher reported at EULAR 2019 in Madrid.

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Best of 2019 - War on RA - Part 1: Walk on the Moon

d Jack Cush, MD

It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.

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Best of 2019 - Biologic Safety Guidelines from the British Society for Rheumatology

d Jack Cush, MD

In the United Kingdom, NICE has looked to the British Society of Rheumatology (BSR) to develop evidence based guidance on the safe use of biologic DMARDs in patients with inflammatory arthritis.

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Best of 2019 - Ups and Downs with Abatacept

d Jack Cush, MD

Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.

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Best of 2019 - War on RA - Part 3: Useless Drugs

d Jack Cush, MD

We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.

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Best of 2019 - Are Non-TNF Biologics Superior to TNF inhibitors?

d Jack Cush, MD

Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis.

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2019 YEAR IN REVIEW Podcast is up! Superheros, women, New Drugs, Novel Approaches, Failed drugs, MTX, Who's killing medicine & low dose pred Watch here>> https://t.co/sYb3KvivJK or Podcast Listen on iTunes https://t.co/FlPe6BQ3BW or Soundcloud >> https://t.co/FlPe6BQ3BW

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Dr. John Cush RheumNow ( View Tweet)

2019 YEAR IN REVIEW Podcast is up! Superheros, women, New Drugs, Novel Approaches, Failed drugs, MTX, Who's killing medicine & low dose pred Watch here>> https://t.co/sYb3KvivJK or Podcast Listen on iTunes https://t.co/FlPe6BQ3BW or Soundcloud >> https://t.co/FlPe6BQ3BW

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Check out my 2019 Rheumatology Year in Review - now on RheumNow https://t.co/sYb3KvivJK

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Rates of "indeterminate" results on quantiferon-IT assays were found to be significantly higher in systemic vasculitis (21%) than nonvasculitis pts and controls (7-7.5%). Indeterminate predictors were Syst vasculitis (OR 9.64), high NLR (OR 1.70). https://t.co/roZINmKgZ1

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Internet based study by Choi et al - looked at 517 gout patients and examined if gout flares were associated with vaccination. They found a twofold higher odds of gout flare (adjusted OR 1.99; 95% CI 1.01 to 3.89 in those who were vaccinated (any vaccine). https://t.co/dSkG6d1ay5

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anti-MDA5+ amyopathic dermatomyositis (ADM) with ILD is severe and refractory. NEJM letter reports on 18 ADM Rx w/ tofacitinibs who showed better 6 mo survival (100% vs 78%) (P=0.04) and improved ferritin, FVC, DLCO, & CT Chest over time. https://t.co/H8JPkVrQqR

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Can Febuxostat be given to Allopurinol Hypersensitivity? Such pts not included in registrations trials; yet many literature reports of no toxicity & rare cross-Rxn; PI says ULORIC indicated w/ intolerance to allopurinol or when allopurinol Tx not advisable https://t.co/Wyax2XZ8cC

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Do biologics work in relapsing polychondritis? French cohort of 41 pts use 105 biologics (TNFi=60; TCZ 17; anakinra 15; RTX 7; ABA6). While 63% resp in 1st 6 mos (on pred!), a complete response rate was 19%. Steroid sparing variable, high infx rates. https://t.co/knZqEAw9mb

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Study of 182 hospitalized adult-onset Still's disease patients shows predictive factors for developing macrophage activation syndrome to include: 1. Splenomegaly (OR 5.7), 2. pericarditis (OR 6.5), and 3. ferritin >2000 (OR 4.7). https://t.co/CNcIDrbU77

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CBD isn't entirely safe. Forbes reviews evidence of hepatotoxicity, esp with the CBD-based epilepsy drug Epidiolex; in studies 5-20% had liver issues. FDA has also warned of suicidal ideation, agitation, suicide, depression, aggression & panic attacks https://t.co/ZULPHReeYf

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RTX product label list these postmarketing AEs (not seen in trials) - uveitis, optic neuritis, systemic vasculitis, pleuritis, lupus-like syndrome, serum sickness, polyarticular arthritis, and vasculitis with rash. https://t.co/3U9Zwv5ojA

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Im starting a War on RA. I need you go get mad. Read it here https://t.co/oIekFqSZVN or watch it here https://t.co/4mBzQBSys0

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FDA has approved Otezla 30 mg bid for adults with oral ulcers associated with Behcet's Disease; based on the results showing apremilast lowers the number and pain of oral ulcers in a 12-week placebo-controlled Phase 3 study. https://t.co/kN7PdOY0MF

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