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Biologics

Increased Preterm Birth Risk in Psoriatic Arthritis Pregnancies

Oct 22, 2021

Pregnancy outcomes may be affected by psoriatic arthritis or antirheumatic treatment; registry cohort study shows that preterm birth and cesarean delivery were mostly increased by antirheumatic treatment, especially biologics.



A nationwide Swedish register studied 921 PsA-pregnancies

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RheumNow Podcast – Rheumatologist Smoke-Enders (10.22.2021)

Oct 22, 2021

Today I have a few questions: Is tramadol really a weak narcotic? Should we really still be doing placebo-controlled trials? What are we going to do about our patients who are smokers? This and more, in this week's review of the news and journal articles.

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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Insights

Oct 21, 2021

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are among the most severe drug reactions, as they come with substantial mortality and morbidity.  A review of European centers dealing with SJS and TEN shows that despite best treatment practices, the 6-week mortality rate was

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Is It OK to Continue TNF Inhibitors with COVID-19 Infection?

Oct 19, 2021

Registry level data of patients with immune-mediated inflammatory diseases (IMIDs) diagnosed with COVID-19 should continue their TNF inhibitor (TNFi) therapy as such patients were less likely to experience adverse COVID-19 outcomes (compared to other immunomodulatory treatments).

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NOBILITY: a Trial of Obinutuzumab in Proliferative Lupus Nephritis

Oct 18, 2021

B-cell depletion therapy with obinutuzumab, a type II anti-CD20 monoclonal antibody, in lupus nephritis patients was shown to be effective in in combination with standard lupus therapies.



Prior trials testing the utility of type I anti-CD20 antibody therapies - rituximab and

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TICOSPA - Does Treat to Target Work in Spondyloarthritis?

Oct 18, 2021

Tight-control or treat-to-target (T2T) strategy is advocated in several diseases, but the recent TICOSPA trial in axial spondyloarthritis (axSpA) showed that T2T was not superior to usual care (UC).

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ICYMI: Risk of anterior uveitis w/ secukinumab is equal to etanercept; but both inferior to mAb TNFi (infliximab, adalimumab) ~ 5000 Rx starts, AU risk/100PY = SEC 6.8; ETA 7.5; INFLIX 2.9; ADA 4. SEC has a 2.3 fold greater risk than ADA/INFX https://t.co/DB9G2mz4mN https://t.co/91FbwCYsmj
Dr. John Cush @RheumNow( View Tweet )
Oct 17, 2021
Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://t.co/blbOps9zVQ

Dr. John Cush @RheumNow( View Tweet )

Oct 15, 2021

RheumNow Podcast – Quackademia (10.15.2021)

Oct 14, 2021

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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A randomized controlled trial has shown that treatment of plaque psoriasis via costimulatory blockade ( CD28/B7) with abatacept did not prevent psoriasis relapse after withdrawal of ustekinumab. Read the full story on #RheumNow. https://t.co/8qgxYFW7EE https://t.co/8hi7JmR59a
Dr. John Cush @RheumNow( View Tweet )
Oct 14, 2021
Costs of #JIA are substantial, total costs up to 44,832 USD annually. Direct costs up to $32,446 USD, accounting for 55-98 % of total. $$$ mostly related to meds; cost go up 3 fold after biologic initiation. (JIA Indirect costs are underrepresented) https://t.co/rukJPWqD0y

Dr. John Cush @RheumNow( View Tweet )

Oct 14, 2021

Abatacept After Ustekinumab Withdrawal in Active Plaque Psoriasis

Oct 13, 2021

A randomized controlled trial has shown that treatment of plaque psoriasis via costimulatory blockade ( CD28/B7) with abatacept did not prevent psoriasis relapse after withdrawal of ustekinumab.



The purpose of this trial was to determine if abatacept (costimulatory blockade) after 

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TNF Dose Reduction Succeeds in PsA, Axial Spondyloarthritis

MedPage Today
Oct 12, 2021

Patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) who were doing well on treatment with tumor necrosis factor (TNF) inhibitors were able to successfully taper the therapy when guided by disease activity, a retrospective cohort study found.

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Hepatitis B Reactivation with Rituximab and Abatacept

Oct 12, 2021

Hepatitis B reactivation is an uncommon complication of biologic therapy use. Now, a serologic study of  rheumatoid arthritis patients shows that HBV reactivation is seen with rituximab, and less so with abatacept, especially in patients without hepatitis B antibody (HBsAb) positivity.

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Upadacitinib was shown to be effective in two Phase 3 SELECT-AXIS trials. 1st trial: in bDMARD-IR AS pts the ASDAS resp was 44% vs 10% PBO at wk 14). 2nd trial: in nr-axSpA, the ASDAS response at wk 14: 42% vs 18% PBO. https://t.co/rnv9VVITeE

Dr. John Cush @RheumNow( View Tweet )

Oct 12, 2021

FDA Approves Avacopan for ANCA-Associated Vasculitis

Oct 11, 2021

October 8, 2021 the U.S. Food and Drug Administration (FDA) approved avacopan (trade name: Taveneos), an oral complement 5a receptor inhibitor, as an adjunctive treatment of adult patients with severe active anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis). It is

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

Oct 08, 2021

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in

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Lessebo effect: 31 RCT comparing Biologic originator to a biosimilar or to PBO: Lessebo effx =better responses in Biosimilar vs PBO (ACR20=70%) than w/ originator vs PBO (ACR20=59%). ? due to PBO effx in active comparator, nocebo in PBO trials https://t.co/kvANomTHrb

Dr. John Cush @RheumNow( View Tweet )

Oct 06, 2021
ICYMI: Biosimilar update: 31 FDA approved biosimilars, but only 60% made it to market. 2015 to 2019, drug spending grew 6.1%, biologic spending grew 14.6%; biologics are 43% of US drug spending. Most biologics at ~30% discount. https://t.co/4paYH8hkUi https://t.co/Ztjp9g3uo3
Dr. John Cush @RheumNow( View Tweet )
Oct 02, 2021
A placebo controlled RCT of canakinumab in 31 Adult Stills pts with arthritis showed responders (by DAS28) had signif reductions in calprotectin, IL-1RA, IL-18, IL-at wk 4. Unfortunately: didnt look at fever, rash, serositis, etc. https://t.co/p4Fohos2iU

Dr. John Cush @RheumNow( View Tweet )

Oct 01, 2021

RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

Oct 01, 2021

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com




  1. A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal

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Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib) https://t.co/MO4i5ngKkr

Dr. John Cush @RheumNow( View Tweet )

Sep 27, 2021
Patients with rheumatoid arthritis (RA) who had a history of cancer did NOT have an increased risk of new or recurrent cancers if treated with biologic therapies, a meta-analysis found. #RheumNow https://t.co/jM9oiRzXUk https://t.co/XYnaalEfe2
Dr. John Cush @RheumNow( View Tweet )
Sep 27, 2021

The #1 question I get from new consults: “How did I get arthritis?” Here is my list of 11 drugs (or drug classes) known to cause arthritis or rheumatic disorders (as an unintended consequence). #RheumNow https://t.co/GsV0Qj9ENr https://t.co/IrTkY5yFdY

Dr. John Cush @RheumNow( View Tweet )
Sep 24, 2021
Encouraging DBRPCT of Rituximab in #PMR: 116 screened, 49 enrolled, 47 completed: 23 on RTX vs 24 on PBO. Steroid-free remission at 21 wks seen with 11/23 (48%) RTX pts vs 5/24 (21%) on PBO (p=0·049). Infusion Rxns: 10 RTX vs 3 PBO); 1 SAE (PE) on RTX https://t.co/U2ZGNrpi0i

Dr. John Cush @RheumNow( View Tweet )

Sep 24, 2021
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