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Is MTX Safe in the Elderly? (12.1.2023)
Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.
Read ArticleRheum Fellowship Slots Fill Up for 2024
While adult rheumatology programs continue to have high match rates, pediatric rheumatology programs remain less popular.The National Residency Matching Program announced yesterday that the 2024 rheumatology fellowship match filled 97.6% (124/127) of programs, and 98.9% (273/276) of rheumatology fellowship positions. This is on par with last years (2023) adult rheumatology match wherein 97.8% (265/271) of the rheumatology fellow positions were filled.
Read ArticleMTX Toxicity in Older CKD Patients
You know this; you've taught this; but here's a good study documenting a higher risk of methotrexate toxicity when used in the setting of older patients with chronic kidney disease.
Yesterday's JAMA published a higher 90-day risk of serious adverse events in older adults with CKD taking low-dose methotrexate, compared to hydroxychloroquine.
Here’s what will change my practice in Rheumatoid Arthritis
Here's what I learned at ACR23 that will change the way I practice in rheumatoid arthritis.
Read ArticleWithdraw DMARDS after remission?
The possibility of withdrawing DMARDs after patients achieve remission has been in our minds for a while. Yet when our patients ask whether it is a good idea to taper or stop their DMARD when they are doing well, most of us don’t have a black or white answer for them.
Read ArticleRace to the top: how high will treatment response rates in RA reach?
We have become accustomed to the 60/40/20% rule for the outcome of ACR 20/50/70 respectively for biologics and targeted synthetic DMARDs.
Read ArticlePlotting Future ACR Convergence Meetings (11.24.2023)
In this week's podcast, Dr. Jack Cush reviews the ACR Convergence 2023 meeting and proposes how to best learn at your next large medical meeting.
Read ArticleTNFi and RA-ILD – The Pendulum Swings Again
TNF inhibitors revolutionised the treatment of rheumatoid arthritis. While highly effective for the joint manifestations of the disease, a note of caution was sounded regarding the potential for worsening of ILD with these agents. Within this framework, a study by England et al presented at ACR23 was highly relevant.
Read ArticleWhy are older RA patients getting mistreated?
Most rheumatologists, if asked, would say that every rheumatoid arthritis patient should be started on a DMARD of some sort - if not at diagnosis, then pretty soon after. So I am genuinely shocked that, in a large United States Medicare 20% sample dataset between 2008-17, less than 30% of new RA patients aged 66 years or older have a DMARD initiated.
Read ArticleEarly aggressive treatment in SLE: are we there yet?
Early treatment with DMARDs has revolutionised the outcomes of patients with rheumatic arthritis. However, this concept has not been fully extrapolated to other autoimmune rheumatic diseases such as systemic lupus erythematosus.
Read ArticleRheumatology Roundup - ACR 2023
Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.
Read ArticleDavid Liew drdavidliew ( View Tweet)
Here at Last: Treatment Options for VEXAS
We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.
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