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Link Between Obstructive Lung Disease and Developing RA?

d Janet Pope, MD, MPH, FRCPC

We all know that the microbiome in the gut may be very important for multiple immune diseases. However, new findings from the ACR, 2019 in Atlanta reinforce how important the interface is between the lungs and developing rheumatoid arthritis.

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Steroids Use in Lupus Linked to Damage Accural

d Jack Cush, MD

A report from Lancet Rheumatology shows that glucocorticoid use contributes to damage accrual in systemic lupus erythematosus (SLE) independent of disease activity.

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FDA Warns 15 CBD Manufacturers

d Jack Cush, MD

Today, the U.S.

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RheumNow Podcast - Monitoring Methotrexate Safety (12-6-19)

d Jack Cush, MD

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

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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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Secukinumab Improves Enthesitis

d Jack Cush, MD

Secukinumabs (SEC) effect on enthesitis in psoriatic arthritis (PsA) was studied in the FUTURE 2 and 3 studies and SEC was shown significantly reduced enthesitis by more than 65% within 14 week. 

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Smoking Cessation Lowers RA Disease Activity and CV Risks

d Jack Cush, MD

A multinational cross-sectional cohort study suggests that smoking cessation in rheumatoid arthritis (RA) patients is associated with lower disease activity measures, improved lipid profiles and lower rates of cardiovascular (CV) events.

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TB is highly endemic in https://t.co/EbxAucKT9Y. S. African registry reports 97 TB cases in biologic users w/ TB rate 1240/100000 PYs vs zero in biologic naive pts. 1/3 were extra-pulmonary. TB risk highest w/ TNFi Mabs (1683) vs 861 ETN or 681 other MOAs. https://t.co/VUNHVjzkex

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up! Monitoring Methotrexate Safety, Palmoplantar pustulosis, diet in SLE, enthesitis Rx, & benefits of smoking cessation..... Listen here>> https://t.co/zoFp2vc7EB

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Dr. John Cush RheumNow ( View Tweet)

Newly Dx #SLE patients have a 62% higher risk of hip fracture. Canadian matched cohort study of 5,047 incident SLE vs and 25,235 non-SLE showed more hip fractures in SLE (HR=1.62 [95% CI; 1.06-2.48]). Implications for OP prevention in SLE patients? https://t.co/oDbYZPwMXD

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Dr. John Cush RheumNow ( View Tweet)

ACR MTX monitoring guidelines from 1994 (Alarcon et al) -pts should be screened for HBV, HCV, Alb. At AST, ALT should be checked at intervals of every 4-8 weeks. MTX should be stopped/adjusted or liver Bx if AST abnl in 5 of 9 (or 6/12) in 12 mos. https://t.co/8lcPz7sH3F

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Dr. John Cush RheumNow ( View Tweet)

Data from 5 RCTs of 733 pts with systemic necrotizing vasculitis examined risks for serious infection (SIE), finds that 20.2% had SIEs and 2/3 these occured within the first 2 yrs. Age, Lung involvement & 5 Factor Score were independent predictors of SIE https://t.co/imHVsZgVfG

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Dr. John Cush RheumNow ( View Tweet)

Propensity Score–Matched Cohort claims study compared 11,248 matched pairs RA pts starting either abatacept or TNF inhibitor. ABA had a signficiantly lower risk of hospitalized infx compared to infliximab (HR 0.63), but equal SIE risk vs ETN or ADA. https://t.co/brid5dAdIh

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Dr. John Cush RheumNow ( View Tweet)

Palmoplantar pustulosis has very low prevalence rates (<0.1%), qualifying as an orphan disease, Registry data from US, Denmark, Germany identified 1,435, 751 and German PPP patients, respectively; 14-61% also have Psoriasis, with higher risk of PsA https://t.co/S6r4GtG3bF

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Dr. John Cush RheumNow ( View Tweet)

Ultrasound study of 980 #gout pts finds Bone erosions were seen in 44%, with 78.4% of these found in the first metatarsophalangeal (MTP) joint. Independent predictors include age, duration of gout, tophi, US synovitis and and joint effusion. https://t.co/LxjgfM29Xd

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Dr. John Cush RheumNow ( View Tweet)

Of 1757 systemic sclerosis patients in the EUSTAR study, 25% had diffuse SSc and 9% had current or previous digital gangrene, 16% had digital ulcers (DUs), not CV risk factors. https://t.co/31ypT1V1zO

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Dr. John Cush RheumNow ( View Tweet)

Meta-analysis of 30 studies shows that ACPA-positive RA patients are marginally more likely to achieve EULAR and ACR20 responses with abatacept (RR 1.18; 95% CI 1.03, 1.35), but not with TNFα-i (RR 0.97; 0.86, 1.10) (compared to ACPA-negative) https://t.co/V5CviFVSGt

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Dr. John Cush RheumNow ( View Tweet)

ACR/ARP 2019 attendees get “sneak preview” of updated gout clinical practice guideline → https://t.co/VRyfj75nVu #ACR19

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American College of Rheumatology ACRheum ( View Tweet)

Metanalysis shows that although MTX may blunt some vaccine responses (eg Pneumococcal), the use of MTX, TNF inhibitors and other biologics should not deter vaccination as most vaccine responses are preserved despite therapy. https://t.co/KINrQMIQkt

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Dr. John Cush RheumNow ( View Tweet)

Study of two dietary patterns and the risk of SLE from the Nurses' Health Study (NHS, 1984–2014) and Nurses' Health Study II (NHSII, 1991–2015) shows no association between incident lupus and (healthier) prudent or (less healthy) Western diet. https://t.co/tvX2HqzWxF

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Dr. John Cush RheumNow ( View Tweet)

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