NEJM reports the results of the SELECT-Choice trial, a head to head study of upadacitinib (UPA) and abatacept (ABA) in biologic refractory rheumatoid arthritis (RA); 12 weeks results showed UPA was significantly more clinically effective than ABA using a DAS28-CRP remission, but ABA had fewer safety signals and serious adverse events.
Dr. John Cush RheumNow
5 years 11 months ago
EUSTAR study of ILD in systemic sclerosis: 826 pts with SSc-ILD finds 27% with progressive ILD (mod-severe FVC decline >5-10%) over 12 mos. Predictive factors for FVC decline over 5 yrs were male sex, higher mRSS skin score and reflux/dysphagia symptoms. https://t.co/lLd2FrMIkx
Cancer patients treated with immune checkpoint inhibitors (ICI) who develop severe arthritis may be at risk for progression of the malignancy, a single-center study suggested.
Angus Worthing MD AngusWorthing
6 years ago
@MattieRheumMD @News_CRA @statnews People are being crushed by co-pays- rheumatology patients' co-pays doubled to $1000 last year - and medical staff are wasting much time on paperwork. Plus, the @Aetna @CVSHealth merger caused prior auth meltdown in many. (Intentional?) Rebate system must go! ASK STAKEHOLDERS.
Dr. John Cush RheumNow
6 years ago
There have been many cases of Kawasaki vasculitis in kids ith COVID-19; now Lg vessel vasculitis in 79 yo Japanese man w/ COVID-19 pneumonia, CRP 17.7 mg/dL, spiking fevers and CTA and FDG-PET evid of aortic and LVV, neg ANCA, nl IgG4, but was HLA-DR4+. https://t.co/UpL4Z1qK2p
QD Clinic - When it's Not RA
What to do when its no longer RA or is "burnt-out" RA
The CDC has analyzed temporal trends in percent positivity by age group in COVID-19 hotspot counties before and after their identification as hotspots. Among 767 hotspot counties identified during June and July 2020, early increases in the percent positivity among persons aged ≤24 years were followed by several weeks of increasing percent positivity in persons aged ≥25 years.
Dr. John Cush RheumNow
6 years ago
Observational study of 123 Spanish rheumatic dz pts w/ COVID-19, finds 54 hospitalized. Admitted pts were 69.7 yrs, and 22% died. Admission was assoc w/ older age, autoimmune dz (vs inflammatory arthritis; OR: 3.55), but not DMARD Rx. https://t.co/UWNyhOKbvF
Mease and colleagues have reviewed the tofacitinib drug development and clinical trial data, finding the risk of venous (VTE) and arterial thromboembolism (ATE) to be low and augmented in patients with baseline cardiovascular abd VTE risk factors and those taking higher doses of tofacitinib (10 mg bid).
Dr. John Cush RheumNow
6 years ago
In elderly AAV, initial steroid dose should be rapidly reduced be required to safe outcomes. Study of 179 AAV pts 80yrs old w/ high Birmingham Vasculitis Score 16.1. 94% MPO+, 6% PR3+, Serious infections seen in high-dose Pred vs low dose (43% vs. 22%) https://t.co/mZbtKvPUIX
Dr. John Cush RheumNow
6 years ago
Studies of inflammasome generated kinase activity (using UCN-01-mediated inflammasome activation) shown to discriminate familial Meditteranean fever patients from healthy donors and other inflammatory disorders https://t.co/euThYpSQMx
Dr. John Cush RheumNow
6 years ago
Study of 196 RA pts shows lung Dz common by chest CT, regardless of serostatus. RA lung=higher mortality (HR of 5.3). RA lung dz found in 28%; 16% had ILD, 14% bronchiectasis, 9.5% w pleural dz. RA lung dz in both seropositive (29%) & seronegative (28%) https://t.co/upNX7cvlWq
QD Clinic - Which IL-1 Inhibitor?
Considerations for which IL-1 inhibitor to use with RA, Stills or autoinflammatory disease
Dr. John Cush RheumNow
6 years ago
Study of 5792 RA pts from 11 RCTs compared ACR Boolean remission with (4V) or without Pt Global scores (3V) using Xray & functional outcomes. 3V (TJC28, SJC28, CRP CRP mg/dL<=1) was as validi as 4V-remission in predicting Xray, less so functional, outcomes https://t.co/r1azrh3SHS
