RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

Jack Cush, MD

Oct 08, 2021 12:22 am

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com; plus questions & cases from viewers in (#ACA) Ask Cush Anything.

Upadacitinib RA program (5306 pts) the risk of H. zoster by Rx and dose (HZ/100PYs) MTX = 0.8/100PY ADA+MTX= 1.1/100PY UPA 15 mg= 3.0/100PY UPA 30 mg = 5.3/100PY Hence there is a 4-5X risk of HZ w/ JAKinhibitors https://bit.ly/3AgAYSn
Epi-4 studies of 4,376 military service persons shows the prevalence of fibromyalgia = 2.9% predeployment, but was significantly higher in those with postemployment PTSD (10.8%) (not without PTSD-0.8%) but higher if in PTSD RCTs (40%) https://bit.ly/3AgD4So
Having both Cancer & Systemic sclerosis (SSc) is rare. Study of 1481 SSc pts saw cancer Dx w/in 2, (1.35), 3 (2.1%) & 5 yrs (3.5%;mostly breast, GYN, Heme CA). Higher 2 yr risk w/ topoisomerase I Ab (OR 3.43), U1-RNP (5.54), but not RNA polymerase III) https://t.co/dVuchv8Afv
Study of 52 pts with Juvenile Systemic Sclerosis (JSSc) -10% were without skin dz (SSc sine scleroderma). 7 pts reviewed, all had cardiac dz (86 vs 16%; 3 cardiomyopathy, 3PAH), longer Dx delay (20 vs 8 mos), worse outcomes, (42 v 6%) https://t.co/7wGuX8QVBO
SLE hospitalized with ARDS from COVID-19 have significantly higher risks of death and poor outcomes (RR=1.7), compared 319 SLE vs 251,800 nonSLE - SLE was more impactful than other comorbidities in such poor outcomes https://t.co/8VJjdOmTbi
Metabolic syndrome (MetS) is associated with radiographic & nodal hand OA (HOA). 896 MetS positive & 1613 w/o MetS assessed w/ propensity matching. MetS had more xray HOA ((OR 1.32), PIPs (OR 1.52), DIPs (1.38), hand pain (1.25) https://t.co/aNEV5b6Tmv
Erosive Hand Osteoarthritis Portends Worse OA
The AAOS has published their Clinical Practice Guideline for Management of Osteoarthritis of the Knee (Non-Arthroplasty); updating 19 of the 29 evidence-based recommendations and focuses on nonsurgical treatments to provide pain and patient function. https://t.co/faLi0X840d
EHR record study: prevalence of Psoriatic arthritis (#PsA) was increased w/ psoriasis severity. PsA prevalence=2.9 per 100 PY; Based on severity - Mild 2.1/100PY; Moderate 9.9/100PY & severe PSO: PsA risk was 17.6/100PY https://t.co/hXeA773KN4
Several studies have suggested that biologic Rx of Psoriasis may lower risk of later PsA. New study of nearly 2 million PSO (15k given biologic, 20K given oral Rx). The risk developing PsA higher w/ biologic (aHR 4.48) vs oral or phototherapy https://bit.ly/2YvGzaG
Prevalence of Arthritis Rising in the USA
ASK CUSH ANYTHING
- Best biologic for PsA with pulmonary Histoplasmosis
- Can you give COVID-19 vaccine during disease flares?
- Elderly PsA and severe gouty tophus/erosion in spine
- How to consume 2000 abstracts at Virtual ACR 2021