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What Worries You, Masters You (7.1.2022)

Jul 01, 2022

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.




  1. FDA approved Abbvies risakizumab-rzaa

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heart,cv,meds, events, CVD

HCQ for RA: Not a Great Idea?

MedPage Today
Jun 28, 2022

Hydroxychloroquine (HCQ) appeared less safe from a cardiovascular standpoint than methotrexate in older patients with rheumatoid arthritis (RA), analysis of Medicare data indicated.



Among RA patients 65 and older with a history of heart failure, major cardiovascular events occurred

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It's time to exonerate methotrexate in causing or exacerbating fibrotic interstitial lung disease in #RA patients https://t.co/AuEIWn8Pc4 https://t.co/razVTF6fFX
Dr. John Cush @RheumNow( View Tweet )
Jun 27, 2022
450 axSpA pts followed 2868 Pt-yrs, 48% on TNFis. TNFi Rx pts had reduced CV risk (HR 0.30; 0.10–0.85), but no longer signif after adjustment for CRP, ESR (HR 0.37, 0.12–1.12, p = 0.077). Reduced CV risk, may not be specifically due to TNFi use https://t.co/mVHYn3PteL https://t.co/bgKWreBL8z
Dr. John Cush @RheumNow( View Tweet )
Jun 14, 2022
CV risk factors not equal when considering magnitude of risk What can we learn from Oral Surveillance? The Oral Surveillance trial has almost become a household word for rheumatologists.https://t.co/LHZTVZh4AK https://t.co/2SlxrG7UpQ
Dr. John Cush @RheumNow( View Tweet )
Jun 13, 2022
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CV risk factors not equal when considering magnitude of risk

What can we learn from Oral Surveillance?



The Oral Surveillance trial has almost become a household word for rheumatologists.



To recap, it was an FDA-mandated, open-label, randomized controlled trial that had high CV risk patients with active RA, on background stable dose

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New biomarker for atherosclerosis, cardiovascular risk and disease activity in axSpA? Low Irisin associated with subclinical atherosclerosis, high CV risk and more severe disease activity in axSpA @RheumNow #EULAR2022 ABST#POS0327

Robert B Chao, MD @doctorRBC( View Tweet )

Jun 04, 2022
Redondo-Rodriguez et al. Abatacept in RA-ILD. Prospective study 38 patients. 73.6% improved/stablised with abatacept at median 17 month follow-up @RheumNow #EULAR2022 POS0654 https://t.co/D2du0hAXIy
Richard Conway @RichardPAConway( View Tweet )
Jun 04, 2022
Associations with RA-BR (n=57 cases) compared to RA-no lung disease controls (n=36) ⬆️⬆️⬆️RF level (OR 4.4) ⬆️⬆️ ACPA level (OR 3.5) ⬆️older age at RA onset (OR 1.37 per 10 years) ⬇️ BMI (OR 0.94 per kg/m2) (i.e., higher risk in underweight) 🚫 associations: sex, smoking pk-yrs

Jeffrey Sparks MD MMSc @jeffsparks( View Tweet )

Jun 03, 2022
Alsing et al. Dutch study. Persistent excess stroke risk in RA in biologic era. @RheumNow #EULAR2022 OP0277 https://t.co/oLmsrniKw6 https://t.co/2zDkuUzq0S
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Szekanecz et al. ORAL Surveillance. Geographic differences in MACE largely driven by history CVD and high baseline risk in North America and ROW. @RheumNow #EULAR2022 POS0110 https://t.co/cR6a7N2KP5
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Was ORAL Surveillance really a surprise? Let's look post-hoc at all the other tofacitinib RCTs (ph 1-3b/4 +LTE) Cardiovascular risk-enriched pts were always in the same MACE ballpark with tofa ORAL Surveillance was worse, but clues were always there OP0264 #EULAR2022 @RheumNow https://t.co/rB5SwVX2oc
Jun 03, 2022
#OP0251 #EULAR2022 Any data to support association of RA-ILD with poor #COVID outcomes? A study is US >500 pts (9% ILD) showed ILD as well as poor RA status (RF+ & erosion) increased risk. Detailed analysis inc Radiographic + PFT cd help stratify risk further @RheumNow https://t.co/E89dd38GQS
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Jun 03, 2022
CTD associated ILD 🫁: lncRNA ENST00000604692 detected in PBMCs is associated with CTD-ILD and can distinguish SSc- ILD and RA-ILD vs. non ILD patients with AUC 0.79. As many lncRNA, unknown if biomarker only or has a pathogenic role. @RheumNow OP0114 #EULAR2022 https://t.co/sR4GmaMkXD
Aurelie Najm @AurelieRheumo( View Tweet )
Jun 02, 2022
Vadillo et al. Clinical course in IPAF (ping @leticiakawano ) . Most frequent females in 60s. Arthritis, raynauds most common features. Most NSIP. 50% PFT deterioration 16 months. UIP, baseline fibrosis, mod/high ANA titre assoc progression @RheumNow #EULAR2022 POS1427 https://t.co/qk9zK90Wuk
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
Rojas-Gimenez et al After adjusting for age, smoking, ACPA. Male sex (OR 4.2) and longer time of having RA (OR 1.08) associated with ILD @RheumNow #EULAR2022 POS0619 https://t.co/kzG76Qwe52
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
Comorbidity in AS from @rheum_cat , Karmacharya et al. Clustering of comorbidities. Depression and hypertension clusters assoc worse disease activity and function @RheumNow #EULAR2022 OP0154 https://t.co/jGQXayAYs9 https://t.co/SnVDhVYQq5
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
RABBIT registry data on CV events with JAKi. Incidence rate low 0.41/100PY. No increase compared to TNFi RR 0.94 (0.39-2.38). No increase in high-risk group RR 0.90 (0.37-2.17). Reassuring with wide CI's. @RheumNow #EULAR2022 OP0135 https://t.co/vBSsnfeBoR https://t.co/iYDZsNwMye
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
#EULAR2022 OP0136: PROTECT-RA Cohort - 150 pts established RA Cholesterol loading capacity (CLC) on macrophages ⭐️High CLC correlates with CV events ⭐️bDMARD use affects CLC @RheumNow https://t.co/9ngaH9yUI7
Jun 02, 2022
#EULAR2022 OP0071 Association between long-term exposure to air pollution (fine particulate matter) and immune-mediated disease in Italy ⭐️⬆️ risk of autoimmune disease, esp RA as well as CTD, IBD ⭐️Every 10 ug/m3 increase in PM, associated with incremental 7% risk @RheumNow https://t.co/x57CXUHSHb
Jun 01, 2022
Cdn cohort of #PsA and CV events - u risk factors were associated with MACE and NSAIDS ⬆️ risk and TNFi ⬇️risk and poor HAQ⬆️ risk. #OP0030 @RheumNow @eular_org Too small events, lipids often absent and spanning 30+ yrs.
Jun 01, 2022
#POS0065 #EULAR2022 What is the nature of ILD progression in #Sjogren and is it mostly stable? A cohort study in Oslo (N=702) showed after 15 yrs follow-up, 45% had radiographic progression. Hence, need to monitor lung function test @RheumNow https://t.co/ga7qer27ks
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Jun 01, 2022
RNL22 RA Best Management

RNL 2022: Rheumatoid Arthritis - Best Management

May 27, 2022

This week's Tuesday Night Rheumatology, hosted by Dr. Jack Cush, featured highlights from the 2022 RheumNow Live Rheumatoid Arthritis - Best Management Pod, followed by a lively audience Q & A. Lectures featured:



- Drug Cycling Vs Switching in RA - Janet Pope, MD, MPH,

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Recommendations – Good & Bad (5.27.2022)

May 27, 2022

Dr. Jack Cush reviews the news, regulatory updates and journal reports from the past week on RheumNow.com. This week gout worries, mortality risks, measuring anti-drug antibodies and a better way in lupus?




  1. May 2022 EMA meeting the CHMP recommended new indications for

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Cardiovascular Risk in Calcium Pyrophosphate Deposition Disease

May 26, 2022

The cardiovascular (CV) risks of inflammation and gout are well known, but until recently hasn't been tied to calcium pyrophosphate deposition (CPPD) disease. A recent EHR study shows that acute CPPD crystal arthritis was significantly associated with elevated risks for non-fatal CV events.

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