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Outcomes

Immunosuppression Increasing (2.23.2024)

Feb 23, 2024

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.




  1. 2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA is

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No clear link between weather and MSK symptoms

EurekAlert!
Feb 22, 2024

There is a longstanding belief that changes in weather conditions, such as impending rain or temperature, can trigger or worsen muscle and joint pain but Australian researchers have found no clear pattern between the two.



The research found that high temperatures and low humidity may

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CD19 CAR T-Cell Therapy in Autoimmune Disease

Feb 22, 2024

The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.



The rationale to CD19 CAR-T cell transfer is to reset aberrant autoimmunity via deep depletion of B cells with

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Cochrane Review: How Good is Ultrasound Diagnosing GCA?

Feb 19, 2024

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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Curbside Consults (2.16.2024)

Feb 16, 2024

Dr. Jack Cush answers audience clinical case questions sent by email or "ask Cush anything". Cases and questions from:



  • Dr. William Hong - RA management in the setting of active TB or latent TB (LTBI)

  • Dr. Vrishali Dalvi - relapsing polychondritis monitoring

  • Dr
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APIPPRA Trial: Abatacept in at-risk rheumatoid arthritis patients

Feb 15, 2024

Abatacept has been studied in seropositive clinically suspect arthralgia patients (at risk for rheumatoid arthritis) and shows the potential to delay or prevent the disease. 



Individuals with serum antibodies to citrullinated protein antigens (ACPA), rheumatoid factor, and arthralgia

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Could Weight-Loss Drug Improve Hip Replacement Outcomes?

MedPage Today
Feb 14, 2024

The antidiabetic and weight-loss drug semaglutide (Ozempic, Wegovy, Rybelsus) either does or does not help patients undergoing total hip arthroplasty (THA) avoid complications and other poor outcomes, according to two retrospective studies presented here.

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Oral IL-23 Inhibitor Effective in Psoriasis

Feb 09, 2024

The NEJM has published the results of the FRONTIER 1 trial demonstrating the efficacy of JNJ-77242113, an oral interleukin-23 (IL-23) receptor antagonist peptide, in patients with psoriasis (PSO). 



This phase 2 dose-finding trial randomized 255 PSO patients, with moderate-to-

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VITAL Info on Autoimmune Disease (2.9.2024)

Feb 09, 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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Poly-Refractory Rheumatoid Arthritis

Feb 08, 2024

Refractory of difficult to treat (D2T-RA) rheumatoid arthritis (RA) comprises a minority of patients that can be categorized by clinical and imaging parameters to formulate a better therapeutic approach. 



A cross-sectional study of 1,591 RA treated with b/tsDMARDs were categorized as

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Inflammatory Arthritis in Systemic Sclerosis is Problematic

Feb 08, 2024

Inflammatory arthritis (IA) is a common manifestation in systemic sclerosis (SSc), affecting nearly one-third of patients.



A prospective study of SSc patients enrolled in the Australian Scleroderma Cohort Study assessed the frequency and the associations of IA with SSc and serological

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VITAL Study - Autoimmune Prevention Requires Continued Supplements

Feb 07, 2024

In the 2 years that followed the termination of the VITAL study, the preventative effect of vitamin D on incident autoimmune disease disappeared with supplement discontinuation; but n-3 fatty acid treated individuals had a sustained benefit in reducing the risk of autoimmune disease.

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Determinants of Gout Flares

Feb 06, 2024

Approximately 12 million US adults in the US have gout. Two recent literature reports highlight contributors to gout flares.



In JAMA, a retrospective review of 3613 gout patients with 3104 gout flares over 8.3 years showed an expected high rate of gout flares with higher baseline

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Racial and Ethnic Determinants of Psoriatic Arthritis

Feb 05, 2024

A study from a large metropolitan registry of psoriatic arthritis (PsA) patients showed several racial and/or ethnic groups are underrepresented and demonstrate differences in disease activity.

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Autoimmune disease and pregnancy

EurekAlert!
Feb 02, 2024

 For many aspiring mothers with autoimmune disease, pregnancy can be daunting and full of unknowns. In some cases, those suffering from specific autoimmune conditions have chosen to forego pregnancy altogether due to concerns about their disease treatments and adverse pregnancy outcomes.

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Leaving Academia (2.2.24)

Feb 01, 2024

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week we discuss hipsters undergoing hip replacement, pregnancy outcomes in RA and the future of academic clinicians.




  1. Celebrities/famous folk who've had hip replacement: Steve Carrell

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SeXXist Reason for More Women with Autoimmune Disease

EurekAlert!
Feb 01, 2024

Somewhere between 24 and 50 million Americans have an autoimmune disease, a condition in which the immune system attacks our own tissues. As many as 4 out of 5 of those people are women.



Rheumatoid arthritis, multiple sclerosis and scleroderma are examples of autoimmune disorders

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Pre-Treatment Testing with Biologics Falls Short

Feb 01, 2024

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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Outcomes of Acute, Subacute and Persistent Low Back Pain

EurekAlert!
Jan 30, 2024

Low back pain is a major cause of disability around the globe, with more than 570 million people affected. In the United States alone, health care spending on low back pain was $134.5 billion between 1996 and 2016, and costs are increasing.



"The good news is that most episodes of back

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Anti-Drug Antibodies and Biologic Drug Responses

Jan 25, 2024

A prospective cohort study suggests the presence of antidrug antibodies may be associated with bDMARDs nonresponse in rheumatoid arthritis (RA). Should we be monitoring ADAbs (especially in nonresponders)?

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Prevalence of Cardiovascular Disease in Rheumatoid Arthritis

Jan 25, 2024

A prospective study of the BioSTAR registry estimates the prevalence of cardiovascular disease in rheumatoid arthritis (RA) to be 4.6%.

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Best Treatments for COVID-Related MIS-C

Jan 24, 2024

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 immunoglobulin

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ACR Applauds Prior Authorization Rule

ACR
Jan 22, 2024

The American College of Rheumatology (ACR), on behalf of over 9,100 rheumatologists and rheumatology professional team members, applauds the Centers for Medicare and Medicaid Services (CMS) for finalizing its Advancing Interoperability and Improving Prior Authorization Processes for Medicare

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Severe Hypocalcemia Risk with Denosumab and CKD Patients

Jan 22, 2024

On 1-19-2024, the Food and Drug Administration (FDA) issued a Drug Safety Communication about the risk of severe hypocalcemia in chronic kidney disease (CKD) patients taking denosumab for osteoporosis, with an accentuated risk in older women who are dialysis-dependent.

This report is an update

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Methotrexate Nodulosis (1.19.2024)

Jan 19, 2024

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. How good (or not) are rheumatologists and what to do about MTX nodulosis?




  1. Network meta-analyses of 153 trials & 8713 patients w/ chronic pain from TMJ disorders; Most effective (pain

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