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Are We Overcautious With TNF Inhibitors in Pregnancy?

Sep 27, 2022

What may seem like a prudent approach to treatment of inflammatory bowel disease (IBD) in pregnant women actually represents an overabundance of caution, suggested researchers who found no increased risk from tumor necrosis factor (TNF) inhibitors.

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IBD Ups Risk of Psoriatic Disease

Sep 15, 2022

Findings of a new study suggest a causal effect between inflammatory bowel disease (IBD) and psoriasis (PSO) as well as psoriatic arthritis (PsA), but not vice versa.

A mendelian randomization study based on genome-wide association studies including up to 463 372 European individuals

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How to predict IBD in AS/SpA? Study of 82 SpA pts undergoing colonoscopy showed: Rectal bleeding, diarrhea, abdominal pain, high Dz activity and calprotectin levels were suggestive of abnormal ileum inflammation and risk of IBD

Global Mortality Rates for PsA, SpA and Colitis

Aug 12, 2022

Global age-standardized mortality rate (ASMR) for 1000000 was for 0.13 for AS, 0.04 for PsA, 0.86 for CD and 0.76 for UC.

Using mortality data from the World Health Organisation (WHO), researchers showed that over time, while there has been no change in age-standardized mortality

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Hit Parade Review (8.12.2022)

Aug 12, 2022

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on

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French registry of IBD due to IL-17 inhib revealed 32 pts- risk of new IBD was low & decreased 2016 to 2019, w/ good outcome in 24/31. IBD more common w/ AS (27) vs PsO (4), IBD onse after 4 (1.5–7.5) mos; all cases w/ secukinumab

MTX + Pegloticase Combo FDA Approved

Jul 11, 2022

Horizon has announced that the U.S. Food and Drug Administration (FDA) has approved the expanded labeling of pegloticase (Krystexxa) injection to be co-administered with methotrexate (MTX), to improve response rates in patients with uncontrolled gout.

FDA approval is based on the 

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Allopurinol Safety in CKD Patients A study in the Annals of Internal Medicine reports chronic kidney disease (CKD) patients can be safely treated with allopurinol without an increased risk of mortality.
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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  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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Renal Tubular Disorders #NephTwitter #MedEd #MedDoodles
FDA approved Abbvies risakizumab-rzaa (Skyrizi) as the 1st interleukin-23 inhibitor for use in adults with moderately to severely active Crohn's disease (600 mg IV at wk 0, 4, 8, &q8wk @ 360 mg SC). Approval based on ADVANCE, MOTIVATE & FORTIFY RCTs
FDA approved Abbvies risakizumab-rzaa (Skyrizi) as the 1st interleukin-23 inhibitor for use in adults with moderately to severely active Crohn's disease (600 mg IV at wk 0, 4, 8, &q8wk @ 360 mg SC). Approval based on ADVANCE, MOTIVATE & FORTIFY RCTs
JAK Janus

JAK/STAT pathway in pyoderma gangrenosum: a new therapeutic highway?

Pyoderma gangrenosum (PG) is rare, but often associated with different forms of arthritis, in particular rheumatoid arthritis and inflammatory bowel diseases. 

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Gut microbiome of AS patients different from healthy controls. Different bacteria communities may be associated with disease activity. So much more to digest.... @RheumNow #EULAR2022 ABST#POS0330
Does diet drive IL-23 in IBD and PsA? Perhaps if you have the right baseline risk. The science is evolving quickly Stronger rationale that diet may be really important in some patients #EULAR2022 #IL23 @RheumNow
#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
Watch: Lupus Nephritis: The Blind Men and the Kidney with Dr. Joan Merrill Joan Merrill discusses treatment of lupus nephritis. This was previously recorded at RheumNow Live 2022.

Psoriasis and Nonalcoholic Fatty Liver Disease

May 26, 2022

A large US population based study shows that psoriasis is associated with a higher risk of nonalcoholic fatty liver disease (NAFLD).

The study included 5672 US patients, aged 20 to 59 years from the National Health and Nutrition Examination Survey. The main outcome was NAFLD, defined

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The Inflammation Reflex (5.20.2022)

May 20, 2022

Dr. Jack Cush reviews the news and journal reports from the past week on This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.

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RNL 2022: Spondyloarthritis Spectrum

May 18, 2022

This RheumNow Live 2022 session features highlights from lectures on Spondyloarthritis.

- Microbiome in Spondyloathritis - Jose Scher, MD

- Axial Psoriatic Arthritis - Philip Mease, MD

- Juvenile Spondyloathritis - Pamela Weiss, MD

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Early results from the U-ENDURE, Phase 3 RCT of upadacitinib in adult Crohns disease. Pts responding to UPA 45 mg/d were given PBO or UPA (15 or 30 mg). 52 wk UPA achieved CDAI (37% & 48% vs 15% PBO)& endoscopic remission (28% & 40% vs 7%)
Our response to statins is influenced by our gut microbiome New @MedCellPress
GALAXI-1 Study - Guselkumab effective in Crohn's Disease. 309 CD pts (1/2 refractory dz) Rx w/ either PBO, or IV GUS 200 mg, 600 mg, or 1200 mg at weeks 0, 4, and 8; At week 12, all 3 doses had signif. clinical and endoscopic improvements vs PBO
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$30 Billion and Counting (4.29.2022)

Apr 29, 2022

Dr. Jack Cush reviews the news and journal reports and takes viewer questions this week.

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Study of PCP Dx irritable bowel dz; 459 randomised to 8 weeks of oral antispasmodics or diet (low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP). Better responses with diet (71% vs 61%; p=0.03). Better adherence w/ diet.