Dr. John Cush RheumNow
3 years 8 months ago
Best of 2022: Methotrexate in PsA
Until the publication of the SEAM trial1, evidence in the medical literature for the efficacy of the most commonly used drug for PsA worldwide, MTX, has been lukewarm at best.
https://t.co/vl2u9JENpt https://t.co/SHHAfkFX9k
Dr. John Cush RheumNow
3 years 8 months ago
anti-IL-23 therapy is not effective in Axial Spondyloarthritis. While ustekinumab, guselkumab and risankizumab are approved in psoriasis (& PsA for GUS, RIZ), studies of Ustekinumab and risankizumab failed to show efficacy in axSpA https://t.co/hjXEopji6r https://t.co/FwzBa2YNzb
Dr. John Cush RheumNow
3 years 8 months ago
On Wednesday 12/21 the FDA approved tocilizumab (Actemra; 8 mg/kg, 60-min IV infusion ) for hospitalized COVID-19 on steroids, supplemental O2 & req ventilation, or ECMO; 1st MAb approved for COVID-19; Prev EUA issued in June 2021 https://t.co/BswLu4ZY5O https://t.co/7gpPkeoPZ4
Dr. John Cush RheumNow
3 years 8 months ago
Deucravacitinib, TYK2 inhib, studied in phase II trial 203 active PsA pts randomised to PBO, or DEUC 6 mg or 12 mg qd. At wk 16 ACR-20 responses were significantly higher with DEUC 6mg (53%, p=0.0134) and 12 mg (63%, p=0.0004) vs PBO. https://t.co/0zCcYXMQOD
#BestOf2022
Dr. John Cush RheumNow
3 years 8 months ago
213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/rBNDHrb3sh #BestOf2022
Dr. John Cush RheumNow
3 years 8 months ago
Lit review of MDA5 antibody-positive clinically amyopathic dermatomyositis w/ ILD - shows limited data from 15 studies, 388 pts, 1 RCT: ? best survival with high-dose steroids + immunosuppressive (CTX or CyA/tacrolimus). Refractory dz Rx w/PLEX, Tofa, RTX https://t.co/8yE4B3SfRg
Dr. John Cush RheumNow
3 years 8 months ago
Allopurinol Use Does Not Increase Mortality in Gout w/ Chronic Kidney Disease
A trial has shown that allopurinol use dose escalation and achieving target uric acid levels, was not associated w/ increased mortality in patients with gout and concurrent CKD.
https… https://t.co/IIBo3aOLio
Interactions of the gut microbiota in humans promote the release of a variety of metabolites with profound effects on human health and immune regulation.
JAK inhibitors have become enormously popular and while their side effect profile has been delineated and reviewed, little mention is made of acne – an adverse event that may affect up to one-quarter of patients taking JAK inhibitors (JAKi). Dermatologists often refer to this side effect as "JAKne".
Dr. John Cush RheumNow
3 years 8 months ago
Lumbar spinal stenosis affects 103 million worldwide (11% of older adults in US). 1st line Rx is activity modification, analgesia, PT. Benefits of epidural steroids havent been established. Decompressive surgery only for selected pts w/ pain & limitation https://t.co/zye3p5j2Hn https://t.co/HzVGLT8Qgl
Dr. John Cush RheumNow
3 years 8 months ago
Hyperuricemia as a biomarker of severe #PsA? Study of 242 PsA pts 30% had hyperuricemia & 6% had gout. Hyperuricemia was significantly associated with age, comorbidity, perph polyarthritis, Jt destruction, less response to treatment. https://t.co/6uUWYPyFKf https://t.co/9nVj0lYwMO
Dr. John Cush RheumNow
3 years 8 months ago
Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/DlJzREdj0h https://t.co/peqZzpQrWk
Dr. John Cush RheumNow
3 years 8 months ago
JAKi not yet safe in pregnancy - theyre fetotoxic at high doses (animals). JAKi do cross placenta. ACR Guidelines: no position due to no data. 47 tofa Rheum & 15 UC maternal exposures - no signif probs. Paternal use of JAKi is ok.
https://t.co/o4zqwwHwU9 https://t.co/NfFu3rb3gD https://t.co/72bJgfC6zx
Dr. John Cush RheumNow
3 years 8 months ago
Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%)
https://t.co/Kc1n4RVe3v
The drug talarozole – which increases retinoic acid – could be a promising new treatment for hand osteoarthritis.
