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Is Cannabis Safe? (6.7.2024)

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

  1. FDA has approved upadacitinib (Rinvoq), for use in pediatric patients (age >2 years) w/ active polyarticular juvenile idiopathic arthritis (pJIA) & psoriatic arthritis (PsA), after inadequate resp/intolerance to TNFi. Also available as oral solution.
  2. Is there an Increasing Risk for Tick-Borne Disease ? JAMA article purports this to be so..... I think not - not unless you live in endemic areas. Other wise these still are rare, rare or misdiagnosis based on serologic inaccuracies - just my opinion.
  3. Study of 150 #PsA pts & Aortic stiffness (carotid-femoral pulse wave velocity (cfPWV) - cfPWV signif higher in PsA vs controls (p=0.034). , cfPWV assoc w/ Dz duration (r=0.3), systolic BP, GFR, RDW. cfPWV was superior to SCORE (16% vs 8.7%) at CV risk
  4. Israeli study shows the prevalence of Psoriatic arthritis has tripled since 2006 - 2006: 0.073% - 2016: 0.165% - 2022: 0.221% ~2 fold higher rate if Jewish, High SES, Obese
  5. Full read review on Psoriasis Flares; risks: - mechanical stress - infections -dysbiosis -drugs (Lithium, B-blockers, HCQ, tetracyclines, ACEi, IFN) - environment(smoking, obesity) -lifestyle - stress - hormonal/metabolic
  6. Chinese study of 552 pts w/ ANCA Assoc. Vasculitis - 23 had cancer prior to AAV Dx; 43 after Dx (w/in 4.3yrs)= SIR: 2.24. CA mostly lung CA (SIR: 5), followed by kidney, bladder, ureter, prostate. Higher risk if male (HR:2.8) and older (per year, HR:1.04)
  7. 202 adults w/ idiopathic inflammatory myositis (IIM) studied. Multiple myositis-specific Abs seen in 22% (2/3 w/ tRNA synthetase Abs (ARS+) & half MDA5+). Multiple MSA pts had better survival (HR 0.11), less RP-ILD, fever, rash; more muscle & dysphagia
  8. Systemic sclerosis sine scleroderma in children is more aggressive than in adults. 18 juvenile vs 38 adults - ssJSSc more female (39% vs 89%), more digital pitting scars/ulcers (35 vs 10.5%), Pulm (50 vs 24) & CV (50 vs 3%); w/ more deaths
  9. Ankylosing spondylitis Tx w/ Tofa- How quick do they respond? Post hoc analysis 269 pts: - 4 wks for Pain >30% - 4 wks for ASDAS improved ≥ 1.1 points - 8-24 wks for ≥ 50% improved pain, enthesitis, AM stiffness, BASDAI & fatigue
  10. Australian study of informal caregivers (not working) of arthritis pts shows excess cose of $388 million (in 2015), expected to increase to $576.9 million by 2030. Informal caregivers less likely to work, due to the demands & duties of their caregiving
  11. Canadian study of 44,438 older adults (age 76) w/ gout found only 52% reached serum uric acid (SUA) target w/in 12-mos, improving from 45% (2010) to 61% (2019). ULT adherence was 55%, also improved annually. Only 3.5% Rx by Rheumatologist!
  12. Disjointed incomplete arthritis care! 82 arthritis pts w/ new complaints surveyed; 29% went to the ED (1/3 repeat visit) for arthritis flare. Only 26% referred to a rheumatologist of which 38% were unable to do so in the time frame suggested.
  13. Role of Diet in Gout Risk Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.
  14. Cohort study of 25 315 women followed 25 years shows adherence to the Mediterranean diet associated with a 23% reduced all-cause mortality - explained by lipids, inflammation markers and BMI; more than cholesterol or glycemic measures
  15. TriNetX US claims study of 7580 RA pts Rx w/ tofacitinib or adalimumab found Tofa signif. more likely to cause dyslipidemia (HR 1.250), but no difference betw TOFA & ADA in MACE (HR 0.995; 0.76–1.3) or all-cause mortality (HR 1.4; 0.89–2.2)
  16. JAK or TNF Inhibitor as First Drug for Rheumatoid Arthritis? 
  17. Cannabis Use is Common, But is it Safe?  
  18. We are covering #EULAR24! We'll be sharing recaps, videos, and more.


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The author has no conflicts of interest to disclose related to this subject