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"Ask Cush Anything" Returns (7.21.2023)

Dr. Jack Cush reviews the news and journal reports and this week, takes on 5 cases/questions from "Ask Cush Anything"

  1. 988 -- the new 3 digit Suicide and Crisis Lifeline (available since July 2022). You don't need to be in crisis or suicidal to call 988 and speak with a counselor. It is a free service available at all hours, day or night, for anyone who needs support.
  2. Study of >19K RA pts in National Databank showed that Opioids vs NSAID use had similar MACE risk(20.6 vs 18.9/1000 PY), but opioids had higher mortality (13.5 vs 10.8/1000 PY; HR1.33) & VTE risk(HR=1.41). Opioids are not safer than NSAIDs
  3. Plantar Fasciitis study of 180 PF patients shows no clinically meaningful difference between pts treated with patient advice plus heel cup alone (PA) versus PA and lower limb exercise (PAX) versus PAX plus corticosteroid injection (PAXI)
  4. Research from 12 states with medical cannabis laws looked at 583‚ÄČ820 adults w/ chronic noncancer pain. Data over 3 yres shows < 0.05% change in the use of opioid prescriptions, nonopioid prescriptions, pain meds, or chr pain procedures
  5. In AUSTRALIA, 30% (~ 7million) have a chronic #MSK condition, costing $14.6 billion (10% of all healthcare spending) in 2019-20. Overall, 4 million w/ back problems, 3 million arthritis, 900,000 osteoporosis, 450,000 w/ #RA.
  6. Review of DMARDs on the immunogenicity of vaccines by Winthrop: - reduced by B cell depletion, MMF, CTX, AZA, ABA - no effect: IL-6 inhibitors & HCQ - MTX & steroids: gen suppressed by depends on dose & vaccine type
  7. Multicenter open label trial of 30 refract. Behcets (BD) pts treated w/ tocilizumab (TCZ) x 6 mos; TCZ was effective in 83% (18 complete & 7 partial resp). Complete responses seen w/ uveitis 67%, CNS 60%, mucosal 42%, articular 21%; plus steroid sparing
  8. Hold the Methotrexate for One Week
  9. Danger with Hydroxychloroquine Nonadherence in SLE
  10. "Ask Cush Anything" Submit your rheumatology question or case
  • Dr. Omer Ahmed Hamad Amin. Suppressing Anti-Drug Antibodies with Biologic
  • Dr. Marc Hirsh. Intravesical BCG risks with future biologic use
  • Dr. Anurag Aggarwal.  Drug choices in anklylosing spondylitis
  • Dr. Farzan Mahmood. MTP Gout flares despite ULT
  • Dr. Bruce Hoffman. Treating arthralgias with high positive CCP Abs.


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