Drug Safety

Biologics Prevent AA amyloidosis progression to ESRD The study suggests that biologic drugs can prevent serious complications of rheumatologic and autoimmune diseases, with some products showing greater effectiveness than others. https://t.co/f04Jrzy9ae https://t.co/O6dgD5RvxZ

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alveolar hemorrhage acute

PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

Jack Cush, MD

A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance. 

Diffuse

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Patients with Financial Limits Struggle with Medication Adherence The National Health Interview Survey reveals that nearly 1 in 5 patients with rheumatologic disease in the U.S. face economic challenges, including food insecurity and CRM nonadherence. https://t.co/DhiLDq3fjZ https://t.co/zqQRAJDrzc

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Dr. John Cush @RheumNow( View Tweet )
Earlier RA Diagnosis Leads to Lower Costs of Care A study from the Leiden Early Arthritis Clinic shows that is RA is diagnosed within 12 weeks after symptom onset, treatment costs were lower in both autoantibody-negative and autoantibody-positive RA. https://t.co/TnrpZGZ4fX https://t.co/elNQ3Pde2a

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CDC warns of Listeria outbreak assoc w/ deli meats - in 12 US states (lead by NY, and MN, MO, IL, WI, PA, VA, GA, NJ, DE, MD, MA, NC), 28 cases, 28 hospitalized, 2 deaths. @risk are the pregnant, elderly, immunosuppressed. Cook deli meats >165F https://t.co/SWKMhIBQEi https://t.co/snLjBKn1UJ

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Drug Safety Update, from UK MHRA, shows impt interaction between tramadol and warfarin. Tramadol may increase the INR with risk of major bruising and bleeding when warfarin and tramadol are taken concomitantly. https://t.co/mgmeMJzdLa

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Dr. John Cush @RheumNow( View Tweet )

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Biologics Prevent AA amyloidosis progression to ESRD

MedPage Today

One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.

Among 83 patients receiving biologic agents for their underlying

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Patients with Financial Limits Struggle with Medication Adherence

Jack Cush, MD

Analysis of the National Health Interview Survey shows that nearly 1 in 5 patients with rheumatologic disease in the United States struggled economically, suffering from food insecurity and cost related medication (CRM) nonadherence.

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JAK Inhibitors Reduce Macular Degeneration Insurance claims data showed that patients with autoimmune disorders who took JAK inhibitors had lower rates of AMD, hinting that the drugs might treat the common eye disease. https://t.co/bx0UCp0o3r https://t.co/FXSlcFHYXI

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Dr. John Cush @RheumNow( View Tweet )
Study of 478 CA pts Rx w. anti-PD-(L)1 Ab or anti-CTLA4 Ab - 28 (6%) had pre-existing Autoimmune Dz (AI). irAE (w/ checkpoint inhib) were higher w/ preexisting AI (57% vs 35%), but activity of AI was not related to irAEs occurrence. https://t.co/CHIdaH91qR https://t.co/XuaLk4D205

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Dr. John Cush @RheumNow( View Tweet )
RheumNow Podcast square

Best Rheumatologists (7.19.2024)

Jack Cush, MD

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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JAK Inhibitors Reduce Macular Degeneration

Mepage Today

Insurance claims data showed that patients with autoimmune disorders who took Janus kinase (JAK) inhibitors had lower rates of age-related macular degeneration (AMD), hinting that the drugs might treat the common eye disease.

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192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs https://t.co/SOMzzXXj0b

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Dr. John Cush @RheumNow( View Tweet )
Febuxostat is assoc w/ a reduced risk of kidney events and slower decline in eGFR. Metanalysis of 16 RCTs, shows febuxostat w/a reduced risk of kidney events (RR=0.56) & slower decline in eGFR; & reduced urine albumin to creatinine ratio https://t.co/GQ8UopbA88 https://t.co/WQskc1yZ02

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Dr. John Cush @RheumNow( View Tweet )
PSS.scleroderma.arthritis.contractures

Updated EULAR Recommendations on the Treatment of Systemic Sclerosis

Medscape

Medscape has published an overview to the 2024 updated recommendations for the treatment of systemic sclerosis (SSc) presented in Vienna at EULAR 2024 by Professor Francesco Del Galdo, MD, PhD on behalf of a 27 member task force.

The new recommendations (n=20)

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scleroderma,month,organ,heart

Systemic sclerosis sine scleroderma

Jack Cush, MD

Systemic sclerosis sine scleroderma (ssSSc), which accounts for nearly 10% of systemic sclerosis (SSc) patients and was first described in 1962, is a subset of SSc.

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Efficacy of Biologics in Patients with CKD A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy. https://t.co/rL2ZondUsE https://t.co/1hM237Jl83

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Dr. John Cush @RheumNow( View Tweet )
FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/IVsGwqpiJK https://t.co/4epOHdNHbO

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Dr. John Cush @RheumNow( View Tweet )
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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

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

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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU

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ICYMI: Can Mycophenolate be Stopped in Stable SLE? https://t.co/WJv2CajgW9 https://t.co/AU8X5bVSJQ

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CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV https://t.co/VgFiCKfMqB

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Dr. John Cush @RheumNow( View Tweet )
kidneys

Efficacy of Biologics in Patients with Chronic KIdney Disease

Jack Cush, MD

A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly

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FDA adverse event study of JAKi in #RA assoc w/ signif more VTE, ischemic heart Dz, & tachyarrhythmias. 75,407 on JAKi vs 303,278 on biologics (TNFi, RTX, TCZ); JAK had more VTE (ROR=2.11), CVA (ROR=1.25), IHD (1.23), arrhythmias (1.15 ), esp in 1st yr. https://t.co/BmNPk6zN6o https://t.co/fbzHQmPmH5

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Dr. John Cush @RheumNow( View Tweet )
EULAR 2024 Recommendations on Reproductive Health https://t.co/QuXQlpQv8O https://t.co/nHC7LOLLl8

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Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post

Advancing PMR

Eric L. Matteson, MD, MPH
Dr. Eric Matteson
Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR. Read Post

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