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Review of Toll-like Receptor Research
EurekAlert!
A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of
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Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
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Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.
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More Comorbidity in Difficult to Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
CorEvitas RA registry study of 9601 RA pts starting b/tsDMARDs (52K yrs F/U) - 10.4% had eGFR<60 9CRI). Achieving CDAI remission was lower w/ CRI - 28% vs 19%(adj HR 0·76 [0·66–0·88]) https://t.co/E42N3PQHwG https://t.co/WNIGGCpCfZ
Dr. John Cush RheumNow ( View Tweet)
Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/SdcDtYGObO https://t.co/2UYGs5eTsu
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/8VnmVsuU2h
Dr. John Cush RheumNow ( View Tweet)
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/hwkpeav4MQ
Dr. John Cush RheumNow ( View Tweet)
Medicare analysis of RA pts w/ metastatic nonsmall cell lung CA (mNSCLC) looked at 663 ICI-treated pts - 46% Rx w/ glucocorticoids (median Pred 6.6 mg/d). GC use was not associated with survival outcomes https://t.co/mwQeAgyKTC https://t.co/SR2XRD5Rhx
Dr. John Cush RheumNow ( View Tweet)
Breaking the Rules: Dual-Advanced Combinations in Rheumatology
For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes.
https://t.co/4lyYTTwJUU https://t.co/sYpYbCjlzm
Dr. John Cush RheumNow ( View Tweet)
Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis
In this prospective observational study 811 CIA patients analyze outcomes in patients with and without MetS, including cardiovascular death/hospitalization and all-cause death/hospitalization. https://t.co/WT3wTpeGPi
Dr. John Cush RheumNow ( View Tweet)
More Comorbidity in Difficult-to-Treat RA
A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).
https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
Dr. John Cush RheumNow ( View Tweet)
Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi
Dr. John Cush RheumNow ( View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe
Dr. John Cush RheumNow ( View Tweet)
24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush RheumNow ( View Tweet)
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush RheumNow ( View Tweet)
French prospective study of pregnancy in 94 RA & 124 SpA pts. RA more likely to flare 1st 6 mos postpartum (62 v 43%), while SpA remained stable in preg & postpartum. bDMARD continuation during pregnancy was more frequent in SpA; 55-60%restarted bDMARD postpartum. https://t.co/usKHS4wYbN
Dr. John Cush RheumNow ( View Tweet)
Among 1074 #PsA tested annually, RF positivity was found in 16.1% overall (5.1% RF+ at baseline). RF+ rediced odds of MDA (OR 0.53) w/ incr risk of bDMARD discontinuation (OR 2.65) https://t.co/AmG6hkWABW https://t.co/MYhkfxAh0r
Dr. John Cush RheumNow ( View Tweet)
True or False: In a meta-analysis, RA was associated with a significantly increased risk of osteoporotic fractures in female patients but not in male patients. See if you got it right in the latest RheumIQ quiz at https://t.co/HCxOwRl2Tq. https://t.co/O9WRKQKmu4
Dr. John Cush RheumNow ( View Tweet)
Switch or Cycle - Upadacitinib vs Adalimumab in Refractory RA
After the first tumor necrosis factor inhibitor (TNFi) failure, patients with active rheumatoid arthritis (RA) responded by switching to upadacitinib, compared to cycling to a second TNFi, adalimumab. https://t.co/Cml3Z7ZyQP
Dr. John Cush RheumNow ( View Tweet)
