Panacea of Prednisone & Cannabis (5.16.2025)

Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com.  Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!

  1. FDA approved the chikungunya virus vaccine (Ixchiq) in 11/23, but recently announced caution and pause use while it investigates Postmarketing Safety Reports of 17 SAE (cardiac & neurologic) & 2 deaths. 6 SAE in the USA, elderly w/ chronic med conditions. ~80K doses of Ixchiq https://t.co/XadqMEmSuD
  2. J&J announced results of Phase 3 ICONIC-TOTAL study of qd icotrokinra, an oral IL-23 receptor inhibitor, in 311 ps w/ difficult scalp and genital psoriasis (PSO) -success in 57%; skin clearance in 66% & genital psoriasis resp in 77% treated https://t.co/WftyEcDh8u
  3. CDC: U.S. Overdose Deaths Decrease Almost 27% in 2024, dropping from 110,037 deaths (2023) to ~80,391(2024). Despite these improvements, overdose remains the leading cause of death for Americans aged 18 to 44. https://t.co/UXTaOPf3P7
  4. #2 most downloaded paper in 2024 on Journal of Clinical Medicine was “IgA Vasculitis (Henoch–Schönlein Purpura): An Update on Treatment” - Steroids are 1st line Rx, esp in adults w/ severe IgAV; other Rx include colchicine, Dapsone, Hydroxychloroquine, Methotrexate, Leflunomide  calcineurin inhibitors, MMF ,RTX     https://t.co/F5jogxkoGr
  5. Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/Rf6c2gidpK
  6. National Inpatient Sample retrospective study of #RA pts using cannabis (n 42,415). Cannabis assoc w/ lower mortality (0.98% vs 2.71%; OR 0.50), depression (OR 0.47), chronic pain (OR 0.45), anxiety (OR 0.55); but more use of opioids (OR: 1.10), nicotine (OR: 1.35), & alcohol https://t.co/87SnCHVxkN
  7. Betw 2005 -2021, there was a substantial increase in HCQ use, but only modest steroid (GC) reductions. Swedish cohort study of 3891 SLE pts - over 5 yrs GC decr from 68% - 54% to 46%. HCQ increased by 29% over 5 years. https://t.co/sI7JWq3AGk
  8. SLE trends: pulse methylprednisolone followed by low dose steroids is rec by various guidelines. Risk factors for SLE flare after GC withdrawal: high Dz activity, active serology, younger age, shorter remission duration, faster tapering strategy, shorter duration/cessation of HCQ  https://t.co/g6LaTijOpA
  9. Single center study of 2741 ANA tests: 65% ANA negative, 31% ANA+ w/ nuclear staining patterns, & 2.0% ANA+ w cytoplasmic staining. Cytoplasmic - most were reticular, dense fine speckled next. Reticular assoc w/ primary biliary cholangitis (w/ Abs against M2). Dense fine https://t.co/SfBY9BShax
  10. Lupus Nephritis 2024 Guidelines 
  11. Comparing EULAR (2025) and ACR (2020) Guidelines on Safety of Lupus Medications in Pregnancy  
  12. Hydroxychloroquine for Everyone  
  13. ASK CUSH Anything
    • Dr. Ali Jawad – Nausea and MTX
    • Marissa M. Meissner MD – CPPD or what? 

ADD THE FIRST COMMENT

If you are a health practitioner, you may to comment.

Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.

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