Cancer

Immune Checkpoint Inhib causing Myasthenia Gravis w/ poor outcomes - 16 ICI Rx pts (9 Lung CA, 7 other tumors) Dx w/ MG; 11 w/ overlap myositis. Mean onset @ 49d. All Rx wp steroids, 6 immunosuppressives, 5 plasma exchange; only 2 complete resp. 6 deaths re: MG complications https://t.co/re73lh2Xfs
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No Extra Cancer Recurrence Risk with Biologics in RA Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional https://t.co/dCspjN2oys
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Retrospective Medicare Claims data study of RA pts w/ metastatic non-small cell lung cancer who recv Rx w/ immune checkpoint inhibitor; found that ICI- Rx RA had the same survival as non-RA pts, and sterid use was not associated with worse survival https://t.co/JLlCfrRwvN https://t.co/zeqeYt5ZHq

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Keys to Mastery (5.2.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/qyEy6iEiqb
Dr. John Cush @RheumNow( View Tweet )
No Extra Cancer Recurrence Risk with Biologics in RA Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional https://t.co/RSLMIFGn4U
Dr. John Cush @RheumNow( View Tweet )
Immune Checkpoint Inhib causing Myasthenia Gravis w/ poor outcomes - 16 ICI Rx pts (9 Lung CA, 7 other tumors) Dx w/ MG; 11 w/ overlap myositis. Mean onset @ 49d. All Rx wp steroids, 6 immunosuppressives, 5 plasma exchange; only 2 complete resp. 6 deaths re: MG complications https://t.co/PUc6kIE7FW
Dr. John Cush @RheumNow( View Tweet )
DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/hiQyeuZiTj
Dr. John Cush @RheumNow( View Tweet )
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No Extra Cancer Recurrence Risk with Biologics in RA

MedPage Today

Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional disease-modifying anti-rheumatic drugs (DMARDs).

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French REGATE registry study examined RA pts (n 1496) & Safety of tocilizumab (exposure 3991 PYs). 63 (4.2%) developed 75 cancers (35 solid, 11 Heme, 3 melanomas, 26 NMSC). CA incidence rate (excluding NMSC) was 7.5 /1000 PY. Independ Risk factors for solid CA = age (HR=1.05), https://t.co/3q8HIPa6qf
Dr. John Cush @RheumNow( View Tweet )
EMA approved a record 28 biosimilars in 2024 for cancer, osteoporosis, macular degeneration, and immune-related diseases like plaque psoriasis, ulcerative colitis, and Crohn’s disease https://t.co/NNzKRalLvF https://t.co/nfX082a7ON

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Cancer Survival with TNF Inhibitors Dr. Jack Cush reviews the news and journal reports from this past week on https://t.co/V10S4oVFsv https://t.co/MKJKAi0BPV

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Korea National Health Insurance Database review shows that risk of mortality in Behcets patients is 28% higher than gen. population; highest in 1st 12 mos (OR 2.66). Major causes were CA, CVD, GI (viscus rupture), respiratory, & infections. Higher in younger pts. https://t.co/vWJrUN9C0H
Dr. John Cush @RheumNow( View Tweet )
MD Anderson Cancer Center study of 1991 RA pts w/ prostate, lung or colon cancer showed TNFi use in 1st 3yrs did NOT affect survival. Use of TNFi vs csDMARDs - nonsign lowering in CRCA (HR 0·72;0·43–1·21), Lung CA (0·70;0·49–1·00), Prostate CA (0·80;0·44–1·44) https://t.co/8zJ0OBWjbm
Dr. John Cush @RheumNow( View Tweet )
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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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Predicting Premature Death with Multimorbidity

Jack Cush, MD

Machine learning (ML) models were used to predict premature death in inflammatory bowel disease (IBD) patients with multimorbidity, the co-occurrence of 2 or more chronic conditions. 

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Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs A retrospective US administrative claims cohort study of Rheumatoid arthritis (RA) patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a… https://t.co/8jqJwkEbZF https://t.co/cQ9aheU5mc
Dr. John Cush @RheumNow( View Tweet )
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World Changers (3.14.2025)

Jack Cush, MD

Dr Jack Cush and his podcast friends are out to change the world. Here is his weekly review of the news and journal reports from the past week on RheumNow.

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A Veterans study of 27,540 #RA pts shows the risk of multiple myeloma (MM) did not differ b/tsDMARD & csDMARD users. 30% took b/tsDMARD during follow-up (192,000 PYs). MM incidence rate: b/tsDMARD-naïve 0.37/1000PYs vs csDMARDs 0.42/1000PYs (HR 1.32; 0.78, 2.26)… https://t.co/Xp4v4eIQnd https://t.co/5MVdz5UQSb
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Metanalysis of cancer risk w/ abatacept vs placebo or TNFi in #RA. (18 RCTs, 10 LTE, 15 535 PYs ABA exposure) show no signif increase in malignancy for ABA vs PBO (IRR 0.58) or TNFi (IRR 0.72). Observational data ABA > other b/tsDMARDs (IRR 1.21; 1.15–1.28), but not csDMARDs… https://t.co/2aBfwyKv0e https://t.co/zUmaHZN3mR
Dr. John Cush @RheumNow( View Tweet )
Risk of Cancer on JAKi in RA (12 463 vs 38 345 controls). No incr risk of CA w/ exposure to JAKi (adj OR 1.04), TNFi (0.98), other bDMARDs (0.98). But JAKi was assoc w/ signif more lung CA (1.40; esp in males 2.12) & less breast CA (0.62) in women https://t.co/fr3VjPhJve https://t.co/zNehdWBbeI

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Cross-trait study of >300K patients’ electronic health records at UCSF and Stanford. Autoimmune conditions associate with greater Alzheimer’s risk (ORs 1.4–1.7). Women with autoimmune disorders have higher risk than men with autoimmune disorders https://t.co/bwtGhyNBs6 https://t.co/FNUdRNozCw

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Australian population study of 14,041 RA pts (68% F; age 65 yrs) vs 33,785 controls, preexisting cancer (CA) in RA was less prevalent (7.6% vs 14.2%). Cancer incid. rates lower in RA (CIR 19.68 vs 24.77) & stable over 3 decades. RA CIR higher for lung (CIR 1.17) & heme CA (CIR… https://t.co/k5KRwYT6jl https://t.co/MVfmuTGlth
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B Cell Depleters (2.21.2025)

Jack Cush, MD

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

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Korean insurance claims data shows #RA pts have a higher risk of renal cancer (vs gen. population), unrelated to serostatus. The renal CA risk (aHR 1.34;1.04–1.78) was higher in women (aHR 1.57); but RA was not assoc w/ risk of CA of bladder, prostate or testes… https://t.co/owSeqibcPu https://t.co/N3TRQuKZJs
Dr. John Cush @RheumNow( View Tweet )

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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