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Lupus

Shingles Risk with JAK Inhibitors and Other Biologics

Jul 29, 2021

Registry data suggests an increased risk of herpes zoster (HZ, shingles) in rheumatoid arthritis (RA) patients taking JAK inhibitors (JAKi) but also with other biologic DMARDs, compared to csDMARDs.



RA patients from the German RABBIT register were prospectively enrolled (2007 - 2020)

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Claims data analysis of US Adult Medicaid patients shows and association between PTSD and increased risk of #SLE. 10K SLE compared to >100K controls. Prevalence of PTSD was significantly higher in SLE (10.74 vs 7.83 per 1000 (adj OR 2.0) https://t.co/p9F5iYENAu

Dr. John Cush @RheumNow( View Tweet )

Jul 27, 2021
CMAJ: nice full read review of biologic use during pregnancy. 1) autoimmune/arthritis pts may use biologics during pregnancy 2) mom/infant should avoid live vax 1st 6–12 mos 3) Minimal biologic transfer in breast milk 4) no risk of congenital anomalies https://t.co/mlZTrDjXSi

Dr. John Cush @RheumNow( View Tweet )

Jul 27, 2021

DMARD Effects on COVID-19 Outcomes

Jul 26, 2021

Sparks and colleagues have published data from the Global Rheumatology Alliance noting that among rheumatoid arthritis (RA) patients afflicted with COVID-19 infection, there was little influence of their baseline biologic or targeted synthetic (b/ts) disease-modifying antirheumatic drugs (

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ICYMI: Neuropsychiatric Events Common in Lupus Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for. https://t.co/cBDZI8OLKD https://t.co/on4fA3P9GS
Dr. John Cush @RheumNow( View Tweet )
Jul 26, 2021
#ClinicalPearl Palmar erythema in #SLE #lupus is sometimes painful, may not be fixed and also may have erythema of distal fingers on flexor side https://t.co/C5mysB8pFS
Janet Pope @Janetbirdope( View Tweet )
Jul 26, 2021
Top Tweet Last Week: Potential Birth Defects with Hydroxychloroquine HCQ is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use. https://t.co/IHNKjHVXaU https://t.co/Oay2ayVr9m
Dr. John Cush @RheumNow( View Tweet )
Jul 18, 2021
Osteonecrosis in Lupus A single center analysis of systemic lupus erythematosus (SLE) patients found symptomatic osteonecrosis (ON) in nearly 10%. https://t.co/PoVsm6TYT1 https://t.co/MTeTiUXDS4
Dr. John Cush @RheumNow( View Tweet )
Jul 16, 2021
NEJM posts images of the malar rash, typical of #SLE. https://t.co/YZsnAXyhVX

Dr. John Cush @RheumNow( View Tweet )

Jul 16, 2021

Osteonecrosis in Lupus

Jul 15, 2021

A single center analysis of systemic lupus erythematosus (SLE) patients found symptomatic osteonecrosis (ON) in nearly 10%.



Researchers analyzed data from 912 SLE patients admitted to the hospital (1981 to 2012).  Of these 912 SLE patients, 97 had symptomatic ON with an overall

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Slow Steroid Tapering Succeeds in SLE

MedPage Today
Jul 13, 2021

Gradual withdrawal of glucocorticoids was successful among patients with systemic lupus erythematosus (SLE) after 2 years of clinically quiescent disease, without an increased likelihood of flares, Canadian researchers reported.



At 12 months, the flare rate among patients who had

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Potential Birth Defects with Hydroxychloroquine

Jul 13, 2021

Hydroxychloroquine (HCQ) is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use.



While HCQ is generally considered safe in pregnancy, studies have been too few and

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185 Lupus pts undergoing renal transplant for ESKD saw good outcomes. Pt survival = 88%, 82%, 78% & 67% (@ 1,3,5,10 yrs). Graft survival was 93%, 89%, 87% & 89% (@ 1,3,5,10 yrs). Immunosuppressive use was protective & only 2 cases of recurrent LN seen https://t.co/xgFYskeX0a

Dr. John Cush @RheumNow( View Tweet )

Jul 12, 2021
These companies do auto-inflammatory gene testing in the USA. @RWCSmtg https://t.co/89bWd0SiAI
Dr. John Cush @RheumNow( View Tweet )
Jul 08, 2021
Textbooks say fever is common in lupus ("36%–86%") BUT IT IS NOT! Lupus is cause of FUO in 5%; Fever is seen in a minority of SLE onsets; Fever occurs w/ SLE complications - vasculitis, pneumonitis/serositis/alveolar hem, CNS, & INFECTION! https://t.co/KvZeo6Q1WY

Dr. John Cush @RheumNow( View Tweet )

Jul 07, 2021
Metanalysis of 9 studies, and 1132 lupus pregnancies shows that hydroxychloroquine treatment significantly reduced the risk of preeclampsia (OR 0.35), pregnancy hypertension (OR0.41)and prematurity (OR 0.55), but no effect on rates of HELLP, DM, Ab https://t.co/P9MXjDpuiO https://t.co/DxVWiUAPpe
Dr. John Cush @RheumNow( View Tweet )
Jul 06, 2021

ICYMI: Actemra FDA Approved for Systemic Sclerosis Interstitial Lung Disease

Jul 06, 2021

Genentech announced Thursday that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adults SSc-ILD.

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Serious problem! Pulmonologists believe that MTX causes and/or worsens ILD. MTX causes hypersensitivity pneumonitis, not ILD. RA, lupus DM, PSS cause ILD and they may need MTX to manage their disease. Do your own research, look at this paper to start. https://t.co/vUyCxJP2Mh

Dr. John Cush @RheumNow( View Tweet )

Jul 05, 2021
Download this week’s podcast titled “Good as I Ever Was”. You can find us on SoundCloud and wherever you download your podcasts. https://t.co/hVMf8X5Dx3 https://t.co/uUDCXzO2eU
Dr. John Cush @RheumNow( View Tweet )
Jul 04, 2021

Neuropsychiatric Events Common in Lupus

Jun 30, 2021

Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.

A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with

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ACR Stands Against Insurer Mandated Infusion Locations

ACR
Jun 28, 2021

The American College of Rheumatology (ACR) has released an updated position statement on patient safety and site of service for biologics outlining several reasons why the ACR strongly believes infusions should be administered in a monitored health care setting with onsite supervision by a

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EULAR 2021 Lupus Panel Drs. Cush, Dao, Pope, Dein and Yusof discuss a number of lupus presentations as well as abstracts presented at the virtual EULAR 2021 meeting. Lupus nephritis and treat-to-remission presentations were discussed by the panel. https://t.co/yUEXTOatpR

Dr. John Cush @RheumNow( View Tweet )

Jun 27, 2021
Watch our video on the three new medications for lupus. https://t.co/IrHEJdpHqK https://t.co/ox7YNU2fFe
Dr. John Cush @RheumNow( View Tweet )
Jun 23, 2021
Is Rituximab and Belimumab the Combination to Beat Lupus? Dr. Eric Dein ( @ericdeinmd ) shares learnings from #EULAR2021. https://t.co/r4aNG7KR5h https://t.co/2kedsCL904
Dr. John Cush @RheumNow( View Tweet )
Jun 21, 2021
Watch: Lupus and the Economic Burden of Mental Health https://t.co/Ag3oz6U4mF https://t.co/cA5LmGRImf
Dr. John Cush @RheumNow( View Tweet )
Jun 20, 2021
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