A Mayo Clinic/ Olmsted County study of psoriatic arthritis (PsA) patients has shown that more than half (55%) of PsA patients had a diagnostic delay of > 2 years, and that this delay has not improved over time.

Wow! I hope you read part I of yesterday's “Greatest Rheumatologist” article.  So many big names and yet, other names and stories that were equally inspirational. If you read the comments of the part I article you can clearly see several themes emerge.

Who is the greatest rheumatologist? What makes for a great rheum? Is it clinical acumen, scientific achievement, educational prowess or years of unrivaled service or mentoring? Rheumatologists are quite opinionated on this subject and very nostalgic about their mentors and leaders. When I’ve posed this question in small groups, it’s plain to see how moved they become when discussing mentors or peers who influenced them. Thus, I posed this

FDA JAK inhibitor warnings and what it means (also: what do you think?); other news released this week; and, two questions submitted from listeners. Dr. Cush discusses this and more in this week's podcast.

Chronic inflammatory disease (CID) patients are urged to receive the COVID-19 vaccines; but when a cohort of CID patients treated with immunosuppressive medications were given an mRNA-based SARS-CoV-2 vaccination, only those treated with glucocorticoids and B cell depleting therapies (BCDT) had lower SARS-CoV-2 vaccine antibody responses.

Dr. Jack Cush is joined by Drs. Roy Fleischmann (Dallas), Allan Gibofsky (NYC), and Artie Kavanaugh (San Diego) to discuss the 9/2/21 FDA Drug Safety Communication regarding the cardiovascular and cancer risks arising from the Pfizer 1133 (ORAL Surveillance) tofacitinib study, but also applied to baricitinib and upadacitinib.

Today, Sept.1st, the FDA announced its decision regarding tofacitinib's safety concerns from the Oral Surveillance study - handing down warnings for not only Pfizer's JAK inhibitor, but also for other marketed JAK inhibitors from AbbVie and Eli Lilly & Co. These safety concerns arise from the Oral Surveillance study - a large, post-marketing, safety trial of tofacitinib versus adalimumab in high risk patients. New warnings about the

A new descriptive series shows an uncommon association between IgA vasculitis (IgAV) and inflammatory bowel diseases (IBD), with most cases interestingly arising after  or during anti-TNF-α therapy. A retrospectively analysis of the GETAID and FVSG networks identified, 43 patients with both IgAV and IBD, in 38 (88%) the IBD (mainly Crohn’s disease (CD) preceded IgAV by a median interval of 9.2 years.

Data from 4 parallel case-control studies within The Health Improvement Network looked at risk factors for developing psoriatic arthritis (PsA), psoriasis, rheumatoid arthritis (RA), and ankylosing spondylitis (AS) showed both shared and differentiating risk factors, but statin use was protective in all 4 conditions.

TNFi are frequently used first line in RA patients; and a new analysis shows that repeat use of TNFi dominates over the use of non-TNFi biologics when the initial TNFi therapy has failed. This retrospective analysis of commercial insurance records analyzed the patterns of drug use in adult RA patients who switched to their second biologic or targeted disease-modifying antirheumatic drug.

We have a lot of news, information and approvals to review and discuss, though I need to begin with what's weighing heavily on my mind. After, we'll dive into what we learned this week.

The current NEJM reports that the use of the Pfizer mRNA vaccine (BNT162b2) demonstrated a very low risk for certain serious adverse events, including the risk of myocarditis (1 to 5 events per 100,000 persons). 

Can an antiinflammatory diet impact axial spondyloarthritis (axSpA)? A 6-month dietary intervention shows that adherence to a Mediterranean diet lowers disease activity in axSpA; but dietary adherence is often incomplete.

The American College of Rheumatology has issued an updated version of its COVID-19 Vaccine Clinical Guidance for Patients with Rheumatic and Musculoskeletal Diseases following recent recommendations from the CDC that certain immunocompromised patients receive a third dose of an available mRNA vaccine.

A prospective study evaluated the value and associations with morning stiffness in patients with clinically suspect arthralgia, and found that the presence of morning stiffness increases the odds of inflammation (as detected by CRP and MRI synovitis).