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RETRO - Taper or Not: You Decide

Jack Cush, MD Oct 11, 2021

A prospective, phase 3 trial of rheumatoid arthritis (RA) patients in sustained remission has shown more than half will flare if disease-modifying antirheumatic drugs (DMARD) therapy is tapered or discontinued and that remission is best maintained by continued DMARD therapy.

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FDA Approves Avacopan for ANCA-Associated Vasculitis

Jack Cush, MD Oct 11, 2021

October 8, 2021 the U.S.

Diagnositic Imaging comparison in 36 acute Gout vs CPPD pts: - Better: MSK US sensitivity/specificity for gout 92%/83% & 91%/92% for CPPD - Less: DECT sensitivity/specificity for gout 63%/92% & 55%/92% for acute CPPD https://t.co/Ee2MFb8qyl

https://bit.ly/2Yz0SDM

Low dose #methotrexate in primary cardiac prevention #CIRT. Trial had LESS decline in GFR in those with mild renal impairment than placebo. ?meaningful or a fluke. Either way MTX can be used safely in mild CRF! Just follow creatinine/GFR. #ClinicalPearl @RheumNow https://t.co/SyfsxZEeUH

Matthew Sparks, MD on Twitter: "Thanks @ASNKidney for highlighting #Strozi…

As a loud, fast talking man that has no idea what he’s talking about, I can vouch for this. https://t.co/0pjuzHhEBK

Adam Grant on Twitter: "Don't confuse being a fast talker with being a…

The heterogeneous 🌍🌎🌏 world prevalence of systemic #lupus reflects heterogeneity in: ➡️ Ethnic mix ➡️ Genetic background ➡️ Age & sex ➡️ Year of the study ➡️ Socio-economic factors ➡️ Epidemiological methods ➡️ Environmental factors (?) Across populations https://t.co/QMJbJUf3vD

Excited to share that the 2nd ed. Musculoskeletal Ultrasound in Rheumatology Review is the #1 new release in ultrasonography books on @amazon #ultrasound #RheumTwitter #meded #MedTwitter #POCUS #FOAMed https://t.co/b0ptm3MKid

Upadacitinib was shown to be effective in two Phase 3 SELECT-AXIS trials. 1st trial: in bDMARD-IR AS pts the ASDAS resp was 44% vs 10% PBO at wk 14). 2nd trial: in nr-axSpA, the ASDAS response at wk 14: 42% vs 18% PBO. https://t.co/rnv9VVITeE

https://bit.ly/3v9kniA

Deucravacitinib (oral TYK2 inhibitor) in development, has been shown to be highly effective in psoriasis & PsA, but failed to meet its primary endpoints at wk 12 (remission) in Ulcerative Colitis in the phase 2 LATTICE-UC trial vs placebo https://t.co/ZGYuozFgOk

https://bit.ly/3BAmDl6

Check out the most recent podcast where we “Ask Cush Anything” and discuss a dozen news items from the last week. https://t.co/Xb81eWEZ1q #RheumNow

https://bit.ly/3Bl6MXD

Clinical Associations with Myositis Antibodies Read the full post on #RheumNow https://t.co/tzPU1scc8x https://t.co/F537tPAQTU

https://bit.ly/3mtrmPk

WHO's Strategic Advisory Group on immunisation has advised an addition COVID vaccination in those >60 years and the immunosuppressed (due to a higher risk of breakthrough infections) https://t.co/NcGr8EMDaO

https://reut.rs/3lxAvHa

The CDC estimates of the national prevalence of arthritis and arthritis-attributable activity limitations (AAAL) show a continued increase in absolute number: 58.5 million US adults have arthritis, 25.7 million of whom have AAAL. Read more on #RheumNow https://t.co/9RNIduVCZh https://t.co/fzxWMbcEfU

https://bit.ly/3As8FR3

Most common reasons for starting canakinumab? Survey of 58 MDs (caring for 147 febrile pts) 1) perceived efficacy(81%), 2) lack of prior response (41%), 3) good safety (40%). Efficacy w/ HIDS/MKD (91%), no response w/ FMF (52%) https://t.co/JjxaUyBnyB

https://bit.ly/3mLHWKe

Clinical Associations with Myositis Antibodies Read the full article on #RheumNow https://t.co/tzPU1scc8x https://t.co/xxF1gIulwY

https://bit.ly/3mtrmPk

ICYMI: Several studies have suggested that biologic Rx of Psoriasis may lower risk of later PsA. New study of nearly 2 million PSO (15k given biologic, 20K given oral Rx). The risk developing PsA higher w/ biologic (aHR 4.48) vs oral or phototherapy https://t.co/Na5EfWelkY https://t.co/0sL18UWjhO

https://bit.ly/2YvGzaG

We are reviewing cases from Ask Cush Anything and almost a dozen news items and reports on this week’s podcast. Download today. https://t.co/Xb81eWEZ1q https://t.co/K6zPKtwAD7

https://bit.ly/3Bl6MXD

ICYMI: An erosive hand osteoarthritis (EOA) study from the Osteoarthritis Initiative shows that EOA is more common in older women and is strongly linked to further progressive, articular structural damage. https://t.co/XOVKNj423l #RheumNow https://t.co/CYxW6mJpCH

https://bit.ly/3ainAT7

ICYMI: Upadacitinib RA program (5306 pts) the risk of H. zoster by Rx and dose (HZ/100PYs) MTX = 0.8/100PY ADA+MTX= 1.1/100PY UPA 15 mg= 3.0/100PY UPA 30 mg = 5.3/100PY Hence there is a 4-5X risk of HZ w/ JAKinhibitors https://t.co/wo9ih5PJ77 #RheumNow https://t.co/h1GoGzADdv

https://bit.ly/3AgAYSn

ICYMI: “Hiker’s feet” newly proposed cutaneous foot manifestations of dermatomyositis. Most pts had the antisynthetase syndrome (with anti-Jo-1) and almost all had mechanic’s hands. Such findings should prompt a search for ILD https://t.co/98EAQUHJbz https://t.co/Cw6rSIUyW2

https://bit.ly/3AowWaQ

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RETRO - Taper or Not: You Decide

FDA Approves Avacopan for ANCA-Associated Vasculitis

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