Eye

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 )
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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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Bimekizumab (dual-IL-17A/F inhib), may prevent uveitis in patients with axSpA. In phase 3 RCTs (MOBILE 1 & 2) double-blind period, uveitis seen in 0.6% on BKZ vs 4.6% on PBO (p=0.001). In pts w/ hx uveitis, again lower w/ BKZ (6.2/100 PYs vs 70.4/100 PYs) https://t.co/v0wMK45chz https://t.co/CVPdg1k41V

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Dr. John Cush @RheumNow( View Tweet )
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Factors Affecting Hydroxychloroquine Adherence

Jack Cush, MD

A study from the University of British Columbia has evaluated the trajectories of hydroxychloroquine (HCQ) use in patients with incident RA and SLE between1997 and 2021, and identified factors associated with high adherence. 

From a total of 27,510 RA/SLE patients taking

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The Window of Opportunity (5.24.2024)

Jack Cush, MD

Dr. Jack Cush reviews the journal reports and news from the past week on RheumNow.com. This week: blockbuster drugs, opioids in rheumatology and nontreatment of inflammatory arthritis?

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Risk Factors for Hydroxychloroquine Retinopathy

Jack Cush, MD

A long-term hydroxychloroquine users study found that 2.7% developed retinopathy, and identified risk factors as  increasing age, female sex, chronic kidney disease stage 3+ and tamoxifen use.

This Kaiser Permanente cohort study of 4677 patients initiating hydroxychloroquine, and

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Canary in a Coal Mine (4.19.2024)

Jack Cush, MD

Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.

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Autoimmune dz pts have higher risk of macular degeneration. Cleveland Clinic study of 200K AMD vs controls, finds: - SLE (RR 1.73) - Scleroderma (1.65) - Psoriasis (1.48) - Vasculitis (1.48) - RA (1.4) - UC &CD (~1.42) - Sarcoid (1.42) https://t.co/RrXaaqz3Aw https://t.co/9dGoGRCBYu

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Dr. John Cush @RheumNow( View Tweet )
Retrospective cohort compared 6147 new PsA pts vs 23,999 contros PsA. The uveitis risk was significantly higher in PsA (adj HR 2.38). Uveitis risk in PsA higher with prior uveitis (adj OR 136.4) and etanercept Rx (aOR 2.57). 106/107 Rx w/ topical steroids https://t.co/YVzIzSOaiB https://t.co/YORU8cQrAx

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Dr. John Cush @RheumNow( View Tweet )
Anti-TNF mAbs, JAKi & anti-IL17 Rx appear protective against anterior Uveitis in AxSpA pts. Network Metanalysis of 44 trials, AU IR -TNF mAb: 4.1, ETN: 5.4, IL17i: 2.8, JAKi: 1.5, & placebo: 10.8. AU risk: TNFi < JAKi < IL-17i < ETN << PBO https://t.co/3zIcvuIaBV https://t.co/UseZ6t00EB

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Dr. John Cush @RheumNow( View Tweet )
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New Year's Resolutions (1.5.2024)

Jack Cush, MD

Dr. Jack Cush imparts his new New Year's Resolutions for 2024 and also reviews the news and journal reports from the past week on RheumNow.com.

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ICYMI: Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

Meral K. El Ramahi, MD, FACP, FACR

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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Rheumatology,Roundup,2023

Rheumatology Roundup - ACR 2023

Jack Cush, MD

Drs. Jack Cush and Arthur Kavanaugh discuss highlights and key takeaways from ACR 23.

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My takeaways from #ACR23 #ReviewCourse session on Inflammatory Eye Disease - Dr. Laura Kopplin: 1. Systemic therapy has better long term outcomes than topical treatments, but many/most ophthalmologists are uncomfortable with prescribing there. 2. FAST Trial: Methotrexate better… https://t.co/eoSeWVHsf0

Paul Sufka, MD @psufka( View Tweet )

uveitis eye iritis

Reduction of AxSpa-Associated Acute Anterior Uveitis with Certolizumab

Meral K. El Ramahi, MD, FACP, FACR

Acute anterior uveitis is the most common extra-musculoskeletal manifestation in axial spondyloarthritis (axSpA) affecting up to 50% of patients in some age groups. AAU can have a significant impact on quality of life with risk of permanent visual deficits if not adequately treated. 

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HCQ and risk of retinopathy 👁️ DoD database HCQ 44000+ females & 10000+ males Risk retinopathy HR 1.5 Variations according to diagnosis SLE higher risk vs. RA, more so in males HR 2, females HR 1.7 No adjustment on HCQ dose @RheumNow #ACR23 ABST2452 https://t.co/TtTu6ixb45
Aurelie Najm ( View Tweet )
And to continue B-SAFE Clinical risk score for HCQ retinopathy 👁️ 10 years 4000+ pts, 3% retinopathy over 5yrs Predictors of HCQ retinopathy -body weight -sex -age -eGFR -weight based dose mg/kg -higher cumulative dose Risk ranges 1% to >20% @RheumNow #ACR23 ABST2453 https://t.co/h2tl6vH9M3 https://t.co/8iuRxoVaJ0
Aurelie Najm ( View Tweet )
ABS0524: ⭐️Benefit of Certolizumab (CZP) over standard non-biologic tx in reducing acute anterior uveitis (AAU) flares among high risk pts w/ axSpA ➡️active dz, HLAB27+, 2 or more AAU flares ⭐️CZP reduced AAU flare rate by 87% #ACR23 @RheumNow #ACRBest https://t.co/rW0N18agMO
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Abs#0501 @RheumNow #ACR23 Uveitis in SpA, from Greece AxSpA: 11.7% Uveitis. RF: HLA-B27 (OR 4.15), periperhal arthritis (OR 3.05) PsA: 2.7% Uveitis. Ass w/ SpA FHx, Axial dis at dx, disease duration Permanent vision loss in 16% AxSpA, 30% PsA pts, all with recurrent uveitis

Eric Dein ( View Tweet )

C-VIEW study on certolizumab use in preventing anterior uveitis in high risk pts with axSpA. All pts were B27+ w/ at least one episode of anterior uveitis Uveitis flares lower in certolizumab group compared to non-bDMARD use @RheumNow #ACR23 Abs#0524 https://t.co/CfnhzStBMv
Robert B Chao, MD ( View Tweet )
Bummed to miss sunny San Diego but still excited to join #ACR23 @RheumNow Time to get some learnin' on! Informative review on the role of systemic treatments and the rheumatologists role in ocular inflammation. https://t.co/0nFDEZHfGW
Robert B Chao, MD ( View Tweet )
Did you know about Tubulointerstitial nephritis uveitis (TINU) syndrome? Usually younger pts; uveitis may not be concurrent with the TIN. Risks: NSAID/abx, infx, genetics. Nice systematic review of this entity (link below). #boardquestion @rheumnow #ACR23 https://t.co/HDqLDHyGM6

TheDaoIndex @KDAO2011( View Tweet )

Systemic inflammatory conditions related to scleritis #ACR23 @RheumNow https://t.co/qc6szUnOUl
Dr. Antoni Chan ( View Tweet )
Keeping the eyes 👀 on the target. Early start to the day with the ACR review course on the eye 👁️ in rheumatic disease. Causes of uveitis #ACR23 @RheumNow https://t.co/g5y5Vs01RX
Dr. Antoni Chan ( View Tweet )
ID testing for pts with inflammatory eye disease: syphilis, TB, Lyme (where appropriate). Low yield is toxoplasma, toxocara and viral dz - Dr L Kopplin #ACRReview @RheumNow #ACR23 https://t.co/UyQ8Bc2cEy
TheDaoIndex @KDAO2011( View Tweet )

Recent Blogs

My Take on New Ocular Screening Guidelines for Plaquenil

Sergio Schwartzman, MD
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A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time). Read Post

The Role of Hydroxychloroquine Blood Levels in SLE

Michelle Petri, MD, MPH , Laura Durcan, MD

We review the available literature, with a particular focus on the recent findings in the Hopkins Lupus Cohort, regarding the clinical utility of hydroxychloroquine blood levels in helping to clarify some of the issues regarding retinopathy, how best to dose this medication, and medication adherence. 

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