GI/Liver

Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib) https://t.co/MO4i5ngKkr

Links:

Dr. John Cush @RheumNow( View Tweet )

Sep 27, 2021
32 RA pts; each w/ 2 stool samples >6 mos apart - stool metagenome sequencing stool samples and pt activity assessed. Microbiome most influenced by age, followed by those achieving minimum clinically important improvement https://t.co/unaEOOuP34

Links:

Dr. John Cush @RheumNow( View Tweet )

Sep 17, 2021
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Effect of Diet on COVID Outcomes

Jack Cush, MD
Sep 15, 2021

A smartphone-based symptom study of COVID-19 patients has shown that a healthy plant-based diet was associated with lower risk and severity of COVID-19, especially amongst those living in areas with higher socioeconomic deprivation.



Data was collected from 592,571 individuals

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RheumNow Podcast – High Science and Future Treatments (9.10.2021)

Jack Cush, MD
Sep 10, 2021

This week: high science that affect future treatments; breakthrough infections in our patients, and what's up with that; and soon your radiologist is going to be replaced by AI. This and more in our review of the news and journal articles from the past week.

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UK study shows PreClin RA, Establ #RA 1) have increased bowel permeability; 2) gut permeability worsens w/ activity; 3) gut-permeability markers not affected by treatment; 4) in a RA Mouse model-blocking gut permeability ameliorates arthritis https://t.co/HZNl56cQnn

Links:

Dr. John Cush @RheumNow( View Tweet )

Sep 08, 2021
FDA, warning, side effect

FDA: New Cardiac and Cancer Warnings for All JAK Inhibitors

Jack Cush, MD
Sep 01, 2021

Today, Sept.1st, the FDA announced its decision regarding tofacitinib's safety concerns from the Oral Surveillance study - handing down warnings for not only Pfizer's JAK inhibitor, but also for other marketed JAK inhibitors from AbbVie and Eli Lilly & Co.

These safety concerns arise from

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TNF Inhibitor Induced IgA Vasculitis in IBD

Jack Cush, MD
Aug 31, 2021

A new descriptive series shows an uncommon association between IgA vasculitis (IgAV) and inflammatory bowel diseases (IBD), with most cases interestingly arising after  or during anti-TNF-α therapy.



A retrospectively analysis of the GETAID and FVSG networks identified, 43 patients

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Gut microbiome strongly influences irAE's in advanced melanoma pts taking checkpoint blockade targeting CTLA-4 and PD-1. Signatures for Bacteroides intestinalis & Intestinibacter bartlettii more grade 3+ irAE by inducing IL-1B https://t.co/rEHknJ3TSC

Links:

Dr. John Cush @RheumNow( View Tweet )

Aug 31, 2021
Study from the UK BSRBR for #AS & 2043 pts showed 44% w/ at least 1 comorbidity. Each comorbidity was associated w/ 0.40 unit increase in BASDAI and 0.53 in spinal pain. More Dz activity w/ Depression, CHF and peptic ulcer, not CRP/ESR https://t.co/0vAnbjHicw

Links:

Dr. John Cush @RheumNow( View Tweet )

Aug 02, 2021
Literature review examined safety of IL-17 inhibitors in 106 controlled RCTs, 40,053 pts. Inflammatory bowel disease was reported in 0.4% of IL-17i Rx patients. (same in 61 uncontrolled RCTs -0.36%). Other AE: diarrhea (2.5%), N/V(0.7%) https://t.co/2wSZQqB1Zs

Links:

Dr. John Cush @RheumNow( View Tweet )

Jul 30, 2021
RA, hands, MCP, deformity

Combo Methotrexate and Leflunomide Safety in RA

Jack Cush, MD
Jul 28, 2021

Methotrexate and leflunomide (LEF) are the most widely prescribed DMARDs worldwide; yet biologic DMARDs are the newest and best selling agents for rheumatoid arthritis worldwide. A recent study of combination therapy with MTX and LEF underscores the efficacy and safety of this approach and

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ICYMI: New-Onset IBD & IL-17 Inhibitors: What’s the Risk? https://t.co/zXDQotDiWV Patients w/ inflammatory/autoimmune diseases who initiated treatment w/ IL-17 inhibitors didnt have a higher risk for development of IBD, but only based on the severity of their underlying disease https://t.co/w3IpQkzmn7

Links:

Dr. John Cush @RheumNow( View Tweet )
Jul 25, 2021
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New-Onset IBD and IL-17 Inhibitors: What Is the Risk?

MedPage Today
Jul 21, 2021

Patients with inflammatory/autoimmune diseases who initiated treatment with interleukin (IL)-17 inhibitors did not have a higher risk for the development of inflammatory bowel disease (IBD), but only after taking into account the severity of their underlying disease, French investigators

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Serious problem! Pulmonologists believe that MTX causes and/or worsens ILD. MTX causes hypersensitivity pneumonitis, not ILD. RA, lupus DM, PSS cause ILD and they may need MTX to manage their disease. Do your own research, look at this paper to start. https://t.co/vUyCxJP2Mh

Links:

Dr. John Cush @RheumNow( View Tweet )

Jul 05, 2021
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RheumNow Podcast – As Good As I Ever Was (7.2.2021)

Jack Cush, MD
Jul 02, 2021

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

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Retrospective study of 258 IBD patients, 17% had MRI sacroiliitis (73% w/ bone marrow edema. Sacroiliitis was significantly associated w/ Female gender, back pain, and later age of CD diagnosis. >two-thirds of these pts never seen a rheumatologist. https://t.co/HYhAU6aRIf

Links:

Dr. John Cush @RheumNow( View Tweet )

Jun 29, 2021
Analysis of Ph 3 data Tofacitinib in Ulcerative Colitis shows no increase in Cancer; rates equal to that seen w/ Tofa in RA, PsA & other biologics in UC. In 1124 pts (2576 PtYrs) there were 20 cancers, excluding NMSC (IR, 0.75; 0.46–1.16) https://t.co/xiTIKYAtyY

Links:

Dr. John Cush @RheumNow( View Tweet )

Jun 28, 2021
Combination disease modifying antirheumatic drug (DMARD) therapy may not be only for rheumatoid arthritis; combining disease modifying agents may be the path to better renal response. Read more. https://t.co/0d1bxBlUS0 https://t.co/OZzJKwNJ4i

Links:

Dr. John Cush @RheumNow( View Tweet )
Jun 15, 2021
Video: Combination DMARD for Lupus Nephritis: Dr. Kathryn Dao ( @KDAO2011 ) #EULAR2021 https://t.co/RGVZ6jukYy https://t.co/PTjSOfM7YQ

Links:

Dr. John Cush @RheumNow( View Tweet )
Jun 09, 2021
#EULAR2021 POS0237: Gut dysbiosis linked to worse disease status in axSpA. ⭐️Dysbiosis in 33% of AxSpA vs 17% of controls wo rheumatic disease ⭐️Gut dysbiosis associated with worsening disease activity @RheumNow https://t.co/rRl4Zbs7xc
Eric Dein @ejdein1( View Tweet )
Jun 06, 2021
Gut dysbiosis linked to worse disease status in AxSpA ⭐️higher dysbiosis associated w/ worse EvalGlobal, ASDAS-CRP, BASDAI, BASFI, VAS pain ⭐️comparing dysbiosis vs. non-dysbiosis group - significant difference in BASDAI, BASFI, EvalGlobal Abs#POS0237 #EULAR2021 @RheumNow

Robert B Chao, MD @doctorRBC( View Tweet )

Jun 05, 2021
OP0010 at #EULAR2021. FLORA trial: Fecal microbiota transplant as add-on Rx to MTX. Small trial showing time-to-event curves show inferiority to sham but good safety. Fascinating concept exploring gut-joint interaction. @RheumNow. https://t.co/BIOmA5z6vK
Eric Dein @ejdein1( View Tweet )
Jun 02, 2021
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RheumNow Podcast – Heart, Lung & Liver (5.28.2021)

Jack Cush, MD
May 27, 2021

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

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Virtual DDW meeting this wk reports claims data comparing IBD to IBD with RA - IBD alone vs IBD w/ RA dx w/ more depression (21% vs 84%), anxiety (20% vs 47%). IBD w/ RA had more depression (OR 7.2); anxiety (OR, 1.25;) or both (OR, 2.3) https://t.co/B78xcJw584

Links:

Dr. John Cush @RheumNow( View Tweet )

May 27, 2021
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Tocilizumab Risk of Diverticulitis and GI Perforation

Jack Cush, MD
May 19, 2021

A French registry analysis compared the risk of diverticulitis and gastrointestinal perforation (GIP) in rheumatoid arthritis (RA) patients treated with biologics and found a greater risk of both in patients receiving tocilizumab (TCZ) compared with those on rituximab (RTX) or abatacept (ABA

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