Blogs

Methotrexate: Where it All Began

Joel Kremer

It’s somewhat bizarre that a designer drug from over 65 years ago would become the cornerstone of treatment for rheumatoid arthritis in the 21st century. When Sidney Farber designed a molecule that would interfere with folate metabolism in the middle of the 20th century, he was looking for a ubiquitous antimetabolite to treat cancer. Farber was actually quite concerned with the potential side effects of a drug that competitively inhibits folate metabolism. That is part of the reason he combined the “met” for metabolism with an “x”. The x was found on poison bottles and he thought it wise to include it in the name of this agent.

 

The Week in Review: 5 February 2016

Jack Cush, MD

Dr. Cush reviews highlights from last week's news and research in rheumatology.

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It Took Me 30 Years to Learn This About Rheumatoid Arthritis

Jack Cush, MD

I’m alot better at RA in the last 10 years than I was when I started to practice 30 years ago. RA has not changed, but tools, knowledge and treatments have progressed admirably. Decades have taught me that many aspects of RA were wrongly taught, misunderstood or not apparent when I first started in rheumatology in 1984. Here are 10 things I've learned.

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Pushy Patients

Jack Cush, MD

Do your patients challenge you? Do you live up to their expectations? How many steps do you have to climb to be better?

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How to Handle Latex Allergies and Biologics

Kathryn H. Dao, M.D.

What to do when a patient has a latex allergy and you prescribe an injectable biologic (many having latex allergy as a contraintication)?

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2015 Rheumatology Year in Review

Jack Cush, MD

Was 2015 a good year for psoriasis, IL-17, biosimilars, narcotics, the ACR and gout? Our year end review discusses the most impactful news and research from the last 12 months.

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11 Pearls for Pregnancy Management in Rheumatoid Arthritis (Best of 2015: #6)

Artie Kavanaugh, MD , Jack Cush, MD

Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.

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5 Mistakes When Diagnosing Adult-Onset Still’s Disease (Best of 2015: #10)

Jack Cush, MD

Adult-onset Still's posses a interestng and diagnostic challeng when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

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The Born Again Rheumatoid

Jack Cush, MD

While there are currently 9 biologic agents approved and marketed for the treatment of RA, and although each has a valued place in our arsenal, I would propose none has been as influential or dramatic as TNF inhibitors. The “born again” rheumatoid feeling is not well captured by any of the usual metrics or measures. It’s not found in the HAQ, DAS28, SF36 (either mental or physical), fatigue score, or any lab parameter. I believe it’s best described by my patient RH who wrote me a letter soon after starting etanercept.

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Tried-and-True or Something New?

Jack Cush, MD

While decades of drug development have improved treatment options, some of our older drugs are harder to improve upon. The same can be said for old movies and new movies, or classic literature and current best sellers. Which do you prefer or rely on?

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The Best Kind of Arthritis …..Revisited

Jack Cush, MD

A reprise of a prior blog on the "best kinds of arthritis" to have.  This time with more commentary and good news.

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Drug Safety Risk Communication: The 800 lb Gorilla Approach

Jack Cush, MD

Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

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