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Anti-Rheumatic Rx

Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
Dr. John Cush @RheumNow( View Tweet )
This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs In AC&R https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
ACR_Journals @ACR_Journals( View Tweet )
Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
Dr. John Cush @RheumNow( View Tweet )

Burnout or Retire (4.12.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?

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World Congress on OP, OA & MSK Disorders

EurekAlert!

Bone and musculoskeletal disease researchers and physicians from around the world will meet today in London, UK for the opening of the largest scientific event in the field, the World Congress on Osteoporosis, Osteoarthritis and

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Neuropsychiatric SLE - 2/3 Improved at 12 Months

The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data. 

A retrospective cohort study identified 350 NPSLE events (between 1999-2015) defined by ACR definitions and categorized as being:

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JAMA: SLE Review

Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.

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Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/tuIigaswDK https://t.co/DAh3lgRufA
Dr. John Cush @RheumNow( View Tweet )

Seasonal Pathogens and Henoch-Schönlein Purpura

Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers. The importance of infection was recently shown with nonpharmaceutical interventions (

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1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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Serious Infections in Takayasu arteritis

The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.

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Mortality in Psoriatic Arthritis

The Annals of Rheumatic Disease reports that mortality risk in psoriatic arthritis (PsA) is about 10% higher than in the general population, primarily from excess comorbidity and with increased risks in women, with longer disease durations.

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CBD Products Disappointing for Pain

EurekAlert!

There is no evidence that CBD products reduce chronic pain, and taking them is a waste of money and potentially harmful to health, according to new research led by the University of Bath in the UK.

CBD (short for cannabidiol) is one of many chemicals found naturally in the cannabis

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Korean claims study of #RA & pregnancy (& adverse preg outcomes (APO), shows MTX or LEF use w/in 3 mos of conception assoc w/ incr. in APOs (aOR 2.14-.68). In 5728 preg: 1152 APOs, HCQ most commonly used, DMARD use decreased during preg. https://t.co/7UBsNdpRgx https://t.co/cY1N73FG8Q
Dr. John Cush @RheumNow( View Tweet )

Activity & Pain Tolerance (3.29.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.

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Systemic Score Predicts Still's Disease Severe Complications

A multinational study of adults with Still's disease  found that calculating their systemic score at baseline significantly predicted the patients risk for life-threatening outcomes (MAS or death).

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Chikungunya Arthritis - 2 studies show benefit of dexamethosone (up to 4mg/d) w/ improved DAS28 scores; Uncertain benefit however with MTX; 133 Brazilian pts studied for 5 mos & 31 pts studied for 8wks. https://t.co/Ko3aRYX0xi https://t.co/rtC4RCRjnU https://t.co/XOoFYw0dR4
Dr. John Cush @RheumNow( View Tweet )

ACR Supports FY 2024 Budget

ACR

The American College of Rheumatology (ACR) today expressed strong support for several key measures included in the Fiscal Year (FY) 2024 budget. The budget allocates crucial funding to the Department of Defense’s Congressionally Directed Medical Research Program (CDMRP) for research on

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BIOBADASER registry 1128 RA pts Rx w/ 1st ts/bDMARD, Among the 9.3% w. multimorbidity they noted higher DAS28 dz activity, but no differences in ts/bDMARD retention rates betw those w/ and without multimorbidity https://t.co/hZDpceuOFq https://t.co/pxSg6rKNNr
Dr. John Cush @RheumNow( View Tweet )

Window of Opportunity in Psoriatic Arthritis

A Dutch Early Psoriatic Arthritis cohort study shows that psoriatic arthritis (PsA) patients treated early (referred and diagnosed  within in less than 12 weeks) had the best clinical outcomes. 

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Secondary Sjogren’s Ups Rheumatoid Arthritis Severity

A Swiss observational study has shown that rheumatoid arthritis (RA) patients with concomitant Sjögren’s disease (SjD) are more likely to have a severe RA phenotype, and be less responsive to treatment.

From a total of 5974 RA patients, there were 337 patients with concomitant SjD. All

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Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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CV Risk Early with Rheumatic Disease Diagnosis

A Finnish populaton study shows that the temporal relationship between cardiovascular (CV) comorbidities in rheumatic diseases (RMD) is seen early after the RMD diagnosis.

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2023 EULAR Psoriatic Arthritis Recommendations

EULAR has updated its treatment recommendations from the prior 2019 guidelines, since which there have been several newly developed agents. The updated guidance includes 7 overarching principles and 11 recommendations regarding treatment strategy and pharmacological therapies.

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Expert Panel Guidance on Managing Psoriatic Arthritis and Comorbidities

An expert panel has published their consensus guidelines for the management of psoriatic arthritis (PsA) and it's comorbidities in the journal Rheumatology. 

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