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IL-6

Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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US Trends in RA DMARD Use 2017-2021

A trend analysis of DMARDs shows that only half of rheumatoid arthritis (RA) patients are taking DMARDs, and that the COVID-19 pandemic substantially affected DMARD use. Despite numerous DMARD advances and evolving treatment guidelines since 1990, older therapies are still commonly used and

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JAMA Review of DMARD Use in Rheumatoid Arthritis

JAMA has reviewed the "2022 EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs". 

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Effective Treatments for Still's Disease

A systematic review of pharmacological treatments for adult-onset Still disease (AOSD) supports the efficacy of tocilizumab (TCZ), anakinra (ANK), and canakinumab (CNK).



Data and results from 44 studies abstracts evaluated treatments, including nonsteroidal antiinflammatory drugs (

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Depression and RA (3.8.2024)

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.

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Sniffles & Arthritis (3.1.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual?  You decide....





  1. No clear link between weather & MSK symptoms

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Cochrane Review: How Good is Ultrasound Diagnosing GCA?

Is temporal artery ultrasound equivalent or superior to the reference standard of temporal artery biopsy when diagnosing giant cell arteritis (GCA)?

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Dr. J. Giles reviews adipose tissue as a source of inflammatory cytokines like TNF, IL-6, IL-1, IL17, etc. #RWCS24 @RWCSmtg @RheumNow https://t.co/AYD9PpwNE6
Dr. Rachel Tate @uptoTate( View Tweet )

VITAL Info on Autoimmune Disease (2.9.2024)

Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".





  1. Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts

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Pre-Treatment Testing with Biologics Falls Short

US commercial insurance claim analysis of laboratory screening and monitoring practices in chronic inflammatory skin disease (CISD) patients shows that < 60% received the recommended pretreatment testing when starting systemic immunomodulatory treatment.

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Interesting nuance from @philseo re tocilizumab in GCA. For new onset disease, it may be appropriate to use every other week tocilizumab @RheumNow #RNL2024 https://t.co/moCvpQSkq0
Richard Conway @RichardPAConway( View Tweet )

Best Treatments for COVID-Related MIS-C

The RECOVERY trial focused on pediatric MIS-C patients treated with immunomodulators and anti-cytokine therapy demonstrated the benefits of first-line therapy with intravenous methylprednisolone or second-line tocilizumab in children refractory to initial treatment. Neither IV

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Real-world data of 5070 RA pts (1816 Rx w/ b/tsDMARDs) showed the use of tsDMARD considerably increased from 2012 to 2021. All b/tsDMARDs pts improved Dz activity & function/ 10 yr effiicacy best for IL6Ri in switch pts and ABA in bNAIVE pts https://t.co/h9j8Pk03if https://t.co/gC7Wloujm0
Dr. John Cush @RheumNow( View Tweet )

2023 Rheumatology Year in Review

Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.  



2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.  

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2023 Rheumatology Year in Review

Here is my top 10 list (in no particular order) of 2023 advances, game-changers, and developments that changed, or will soon change, rheumatologic practices.

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StillsNow Podcast December 2023 - ACR23 Highlights

Dr. Jack Cush reviews selected AOSD & systemic JIA abstracts from the ACR 2023 Annual meeting held in San Diego, November 12th thru 16th.





  1. Abstract 0761. EULAR / PreS Recommendations for the Diagnosis and Management of Systemic Juvenile Idiopathic Arthritis (sJIA) and

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Best of 2023: EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome

A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary

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UK Dermatology Registry of 13 699 Psoriasis pts on biologics (25K biologic exposures) found 1% risk of paradoxical eczema. Biologics included inhibitors of TNF, IL-17, IL12/23, IL-23. Lowest risk w/ IL-23i (0.56/100kPY), and higher w/ IL-17i (1.22) https://t.co/fOX6VGJQLk https://t.co/u1p1sidCte
Dr. John Cush @RheumNow( View Tweet )

When should we be starting therapy in GCA and PMR?

The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind a shrug of the shoulders, or the ambiguity of therapeutic inadequacy. The question that follows the presence of a therapy is the question as to how to best use it.

GCA

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Rheumatology Roundup - ACR 2023

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

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APTURA 1 study of tocilizumab biosimilar. Not surprisingly no difference. I'm excited about this product. Hopefully be the end to our tocilizumab supply issues and significant societal savings Abstr#0445 #ACR23 @RheumNow https://t.co/qvP7LCeAkm https://t.co/Zb1FUAlXlz
Richard Conway ( View Tweet )
Debaters and moderators acknowledge IL6i may not be the only steroid sparing agents that would work for #GCA. Abatacept, secukinumab, JAKi are being evaluated #greatdebate @rheumnow #ACR23

TheDaoIndex @KDAO2011( View Tweet )

@philseo on why we SHOULD use IL-6i in GCA and PMR 1) Infection risk similar to TNFi 2) Too many (63%) pts remain on steroids at 1-2 yrs 3) May accelerate remission 4) Steroids are Bad, even at low doses @RheumNow #ACR23 https://t.co/muPPcAc6LC
Robert B Chao, MD ( View Tweet )
#GreatDebate #ACR23 @RheumNow Advanced Rx 1st line in PMR/GCA @philseo IL-6 research in RA (STREAM, MOBILITY): safety of toci, sarilumab - compares to ADA Ifn risk driven by GCs GUSTO: TCZ w/ only 3d GC pulse - 13/18 in remission 24, 52w PMR: "its not just a little bit of pred" https://t.co/sAlQ0pttcq
Eric Dein ( View Tweet )
Should IL-6i be first line in GCA/PMR? Dr. Spiera says steroids work, are cheap; no evidence of using IL6i early in disease. there had been cases where pts still had active vasculitis while on IL-6i. He starts with steroids first then add IL6i #GreatDebate #ACR23 @rheumnow https://t.co/Oq5Q9HFtW3
TheDaoIndex @KDAO2011( View Tweet )