For years, rheumatologists would rather fight to stay on a TNF inhibitor (TNFi) than switch to a non-TNFi biologic when rheumatoid arthritis (RA) therapy fails. A new prescriber analysis shows that after the first TNFi failure, a second TNFi is still preferred over swapping to a non‐TNFi, even though there was greater time on drug with a non‐TNFi biologic.
The largest study, to date, shows that in‐hospital mortality of systemic lupus erythematosus (SLE) patients has significantly improved between 2006 and 2016, with a high mortality burden among U.S. Blacks and Hispanics with lupus.
Dr. John Cush RheumNow
6 years 3 months ago
Tocilizumab may be effective in refractory ocular-, neuro-, vasculo-Behcet's. Study of 47 Behcet's pts Rx w/ TCZ - good at ocular (24/25), CNS (6/6), vascular (7/7) & amyloidosis(2/2) but less effective w/ oral/genital (8/21), skin (6/14) or joints (4/11) https://t.co/lKY8D706bi
Dr. John Cush RheumNow
6 years 3 months ago
TNFi, ABA, TCZ Retention rates looked at in 1362 RA according to age. For < 65 years, 3-year retention was best for TCZ 69%. For pts 65–74 years, retention rates highest for TCZ . For ≥ 75 years, 3-year retention rates best for ABA & TCZ (63% & 58%). https://t.co/7RRO9M4Wf0
Dr. John Cush RheumNow
6 years 3 months ago
Comparison of elderly-onset (>60yrs) #RA (EORA) to younger-onset (YORA) finds significantly more treatment resistant synovitis and Xray progression in EORA pts with worse overall prognosis compared to YORA (clinical, UA, and pathology). https://t.co/17XSz3Ilap
Dr. John Cush RheumNow
6 years 3 months ago
Metanalysis of 8 studies and >130,000 patients shows that IBD (Crohns & UC) have a significantly higher risk of developing #RA (RR = 2.59; 95% CI: 1.93–3.48). https://t.co/ipYRZ6DQPQ
I attended the #whitecoats4blacklives rally at Dallas City Hall a few weeks ago to support our black colleagues, patients, and friends. It was inspiring, humbling, and emotional. I encouraged other physicians to join me, posting on the Dallas Physician Facebook page that we need to lead by example for our community and our children to fight structural racism. One black physician posed a very important point to my post, “What permanent
Dr. John Cush RheumNow
6 years 3 months ago
Pt w/ severe systemic JIA & recurrent macrophage activation syndr underwent whole exome sequencing & found to have gain in function CASP1 variant leading to inflammasome & NF-κB hyperactivation (hi IL-6, IL-1β IL-18, IFNγ) Rx w/ IL-1 & IL-6 inhib https://t.co/SE3p5CTEak
Dr. John Cush RheumNow
6 years 3 months ago
23 yoF with 1 mos digital ulcers, hair loss, sicca Sxs, dysphagia; No sclerodactyly but finger tips cyanotic w/ distal pitting scars, ischemic ulcers, periungual erythema & dilated nailfold capillaries (no hemorrhages). +tests for ANA, Ro52, Ro60 and Scl-70 Abs. How to treat?
With a global pandemic, protests, fake news, real news, politics, home schooling, quarantine, and constant change to our day to day lives looming, the time to reprioritize is now. We need to step up for our patients, staff, loved ones, and ourselves. This week, I challenge you to reconsider how your mental health affects not only your life, but those of everyone around you.
Among patients with rheumatic diseases, age and female sex were important factors associated with the development of a first adverse event after initiating biologic treatment, Spanish researchers reported.
Dr. John Cush RheumNow
6 years 3 months ago
A negative RCT shows yearly treatment with Zolendronic acid fails to change tibiofemoral cartilage volume (by MRI) in Knee Osteoarthritis patients with bone marrow lesions. 223 knee OA pts recv ZOL vs PBO x24 mos , w/ no change inVAS pain (-11.5 vs -16.8) https://t.co/N7N0rL8iCX
Dr. John Cush RheumNow
6 years 3 months ago
35 pregnant women w/ baseline & postpartum MRI-SIJ. 27/35 (77%) had SI bone marrow edema postpartum, 60% met ASAS definition of +MRI. 6 and 12 mos after, 46% and 12% still showed BM edema. Findings assoc w/ short labor & no epidural https://t.co/mhX3W96zR3
Dr. John Cush RheumNow
6 years 3 months ago
NEJM case report of PD-1 inhibitor induced immune related colitis successfully treated with tofacitinib 10 mg bid for 30 days - patient improved after 5 days of TOFA. https://t.co/skfU6TKnlK
Dr. John Cush RheumNow
6 years 3 months ago
WHO global safety database shows increased risk of DVT & PE with tofacitinib & baricitinib, who were likely to be older with preexisting VTE risk. In EU, TOFA risk for DVT/PE was OR 2.3; BARI risk was OR 3.4. No VTE risk for BARI in US, TOFA 2.0 VTE risk https://t.co/PUBUzfrydn

