Cancer

Japanese registry study of CV & CA outcomes in #RA. CV (MACE) events = IR 0.49/100 PY. Cancer= IR 0.78/100PY. MACE risk factors: Male, age≥65, HTN, Renal or cerebrovascular Dz; CA risk w/ Male, age, NSAID, COPD, SIE, CA Hx. https://t.co/uBFbho25La https://t.co/3ClEwCvdDY

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Dr. John Cush @RheumNow( View Tweet )
Summary of JAKi Studies Dr. Peter Nash, at the 2024 ACR Convergence meeting in Washington, DC, talks about JAKi data presented in: the SELECT-GCA trial and safety signals; ILD; cancer; cycling; RA; uveitis; and new JAKs under study. https://t.co/ywmtrTi0iF https://t.co/nbFFojL1i4

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Dr. John Cush @RheumNow( View Tweet )
Primary Hypophosphatemia (HYPOPH) - Japan study 50,136 adults w/ 424,434 alk phosphatase (ALP) tests. Persistent HYPOPH seen in 0.54% (273) due to cancer(30%), steroids(21%), DMARDs (16%). Unexplained HYPOPH had pain, muscle weakness, fatigue & could have primary HYPOPH… https://t.co/kGPSXSYEZI https://t.co/RtwSRnzeU0
Dr. John Cush @RheumNow( View Tweet )
Primary Hypophosphatemia (HYPOPH) - Japan study 50,136 adults w/ 424,434 alk phosphatase (ALP) tests. Persistent HYPOPH seen in 0.54% (273) due to cancer(30%), steroids(21%), DMARDs (16%). Unexplained HYPOPH had pain, muscle weakness, fatigue & could have primary HYPOPH… https://t.co/8RbSnhS3vl https://t.co/NdRIA4oREr
Dr. John Cush @RheumNow( View Tweet )
Hands caring bond

Why should rheumatologists care about aging?

Patricia Harkins, MD

The global population is aging and none of our rheumatic diseases are immune to the impact of the complexities and so-called “geriatric syndromes”, including sarcopenia, frailty, falls and cognitive impairment, associated with the aging process. Whilst we are increasingly aware of these

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Playing it Safe with RA? JAK vs. TNF Debate The ORAL surveillance trial raised safety concerns that the janus kinase inhibitor (JAKi) tofacitinib was associated with an increased incidence of cancer and major adverse cardiovascular events (MACE), compared to tumor necrosis… https://t.co/sUSdRKRxEF https://t.co/XcjOqGlLVX
Dr. John Cush @RheumNow( View Tweet )
Biggest absence award at #ACR24 @ACRheum @RheumNow 🥇 Absence of discussion on 👇 #Oral #Surveillance Except for maybe Monitoring for mouth ulcers and cancers issues are not resolved but we are comfortable with ambiguity!

Janet Pope @Janetbirdope( View Tweet )

Yes No

Playing it Safe with RA? JAK vs. TNF Debate

Brian Jaros, MD

Reported safety signals, at odds with the efficacy of these medications, have left rheumatology clinicians in a difficult position when considering when during a patient’s treatment course and in which patients, specifically, JAKi should be used. Two abstracts from ACR convergence 2024 further

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TNFis preventing cancer compared to placebo, and JAKi being neutral to placebo and maybe preventing haem cancers also. #ACR24 abstract 0989 was certainly provocative. I've shared my thoughts on @RheumNow https://t.co/yQFoUGifEN

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Richard Conway @RichardPAConway( View Tweet )

Does vasculitis flare with checkpoint inhibitors? @MDAndersonNews experience: 17 stable pts 4 pts flared - all able to be controlled (i.e. 13 didn't flare) Encouragement that stable vasculitis pts that need ICI should get them! #ACR24 ABST1986 @RheumNow https://t.co/jO4w3HWBMd

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David Liew @drdavidliew( View Tweet )
Study of 25K+ patients using TrinetX on immune checkpoint inhibitors shows no significant mortality difference between those with pre-existing autoimmune disease (AID) and those without. Mortality rates: AID: 39.8% Non-AID: 40.2% Large-scale evidence supports ICIs in AID… https://t.co/BI5jK9jsoM

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )

We know most preexisting autoimmune disease is very mangaeable when checkpoint inhibitors are needed. So great to see that, in the VA, autoimmune disease pts largely haven't missed out on potentially lifesaving cancer immunotherapy. Keep on reassuring! #ACR24 ABST1985 @RheumNow https://t.co/ApOACBLi4K

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David Liew @drdavidliew( View Tweet )

Always looking for cancer/CV signals from JAKi in big observational datasets w extensive JAKi use nationwide 🇯🇵 claims data RA pts n=52k (JAKi n=4.3k) Cancer with JAKi vs TNFi: aHR 2.2 (esp lung, lymphoma) This is a problem. Watch these data. #ACR24 ABST1336 @RheumNow #ACRBest https://t.co/vsnT46De6T

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David Liew @drdavidliew( View Tweet )
Should you worry about giving TNFi to RA pts after a cancer diagnosis? Medicare data with colorectal, lung, prostate Ca: TNFi pts survival no worse (numerically better) than csDMARDs Cancer pts deserve good RA treatment! #ACR24 ABST0202 Suarez-Almazor @MDAndersonNews @RheumNow https://t.co/w58MNqRt1T

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David Liew @drdavidliew( View Tweet )
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ACR 2024 - Day 2 Report

Jack Cush, MD

Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.

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#Rheumatoid #arthritis is an independent risk factor for death in nonmetastatic clear cell renal ca ! 👇N=32K, 802 w RA also Caveats immunotherapy Offered = in RA Cancer specific mortality not affected By #RA Frailty & RA affected outcomes #ACR24 @RheumNow @ACRheum #1327 https://t.co/rAQ57BPA19

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Janet Pope @Janetbirdope( View Tweet )
Spicy network SRMA, 123pts w/JAK-TNF-PLBO TNF >> JAK w/respect to malignancy (expected) & better than PLBO (spicy!) JAK > PLBO for heme cancers (makes sense); no significant (but slight trend) toward PLBO > JAK for all cancer The debate continues #ACR24 @RheumNow Abstr#0989 https://t.co/tBnb02gyzF

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Mike Putman @EBRheum( View Tweet )
Give a listen to my @RheumNow interview w Josh Hsieh, a rising star at #ACR24, who is presenting his first (of many) research project as a high school sophomore! His work w @NamrataRheum explores what is known- & not yet known- for cancer survival in RA https://t.co/boqwpP9CUK https://t.co/UQ37pyvZT6

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Eric Dein @ericdeinmd( View Tweet )

Ab#474 #ACR24 Hsieh and @NamrataRheum Cancer Survival in RA Unable to do meta-analysis due to lack of data HR for lung cancer in RA 1.04 No clear evid of increased risk, but more data and studies needed Great research project by a high school student (!!) @RheumNow https://t.co/Sfrf2v2UO4

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Eric Dein @ericdeinmd( View Tweet )
Risk for atypical femoral fracture: 🚨Asian race - 4-6x higher risk Duration of use is greater risk than older age Higher risk when given for osteoporosis than cancer treatment - Compare: osteonecrosis of jaw more common with cancer Rx #ACR24 Review Course @RheumNow https://t.co/V8cD5QWNGp

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Eric Dein @ericdeinmd( View Tweet )
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ACR24 Preview Podcast (11.15.2024)

Jack Cush, MD

ACR 2024 starts tomorrow. Here are a few previews of abstracts to be presented, along with my recommendations of sessions you don’t want to miss.

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Biosimilar Slow Growth in USA A recent Forbes article, "Biosimilars Are Making Inroads In U.S., But It’s Still A Bumpy Ride", reviews the current state and reasons for slowish uptake of these significant cost-savings alternatives to biologic therapy in treating cancer and… https://t.co/yO3tUVk2jj https://t.co/ft6gqpnWMx
Dr. John Cush @RheumNow( View Tweet )
biosimilars2.jpg

Biosimilar Slow Growth in USA

Jack Cush, MD

A recent Forbes article, "Biosimilars Are Making Inroads In U.S., But It’s Still A Bumpy Ride", reviews the current state and reasons for slowish uptake of these significant cost-savings alternatives to biologic therapy in treating cancer and autoimmune disorders. The following are takeaway

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Blue Collar Arthritis (10.25.2024)

Jack Cush, MD

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

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Dot the "i", Cross the "t" (10.11.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.

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Recent Blogs

Hard Conversations: DMARDs and Malignancy

Michael Putman, MD, MSCI
Risk Option Decision
Cancer is the most difficult DMARD risk to discuss with patients. Few warnings could scare people away from a drug faster than the words “may increase risk of cancer,” yet the risks (even when substantiated) have all been low and may be counterbalanced by the benefits of disease control. Read Post

A Brief History of Rheumatoid Arthritis Mimics

Robert Schoen, MD, MBA
books history
Imagine that 100 years from now, your great granddaughter, an eminent rheumatologist, reviews the history of rheumatoid arthritis mimics. Read Post

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