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Outcomes

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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 RheumNow.com.  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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Novel Anti-TNF Shines in Rheumatoid Arthritis Trial

MedPage Today
Jun 30, 2022

A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said.



About 75% to 80% of patients receiving an investigational agent called ozoralizumab achieved 20% reductions in symptoms by

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Placebo Works Best in Combination

Jun 30, 2022

Analysis of two large clinical trial datasets shows that placebo response rates in randomised controlled trials (RCTs) of patients with rheumatoid arthritis are better when the patient continued background methotrexate (MTX). 



RA patients with an insufficient MTX can either continue

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New Updated GRAPPA Psoriatic Arthritis Recommendations

Jun 29, 2022

The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) treatment recommendations have been updated and the 2021 evidence-based guidance is rich in treatment recommendations based on the key disease "domains" - peripheral arthritis, axial disease, enthesitis,

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Gabapentin Implicated in Overdose Deaths

Jun 29, 2022

Recent FDA and MMWR warnings suggest that gabapentin was present and implicated in almost 10% of US overdose deaths between 2019 and 2020. This CDC report also stated that gabapentin was the cause of the death in half of these cases. 



Despite its FDA approval for the management of

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HCQ for RA: Not a Great Idea?

MedPage Today
Jun 28, 2022

Hydroxychloroquine (HCQ) appeared less safe from a cardiovascular standpoint than methotrexate in older patients with rheumatoid arthritis (RA), analysis of Medicare data indicated.



Among RA patients 65 and older with a history of heart failure, major cardiovascular events occurred

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Are You Wasting Money on Supplements or Vitamins?

Jun 27, 2022

The US Preventive Services Task Force (USPSTF) has updated its recommendations regarding the efficacy of supplements or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population.



The USPSTF concluded there is insufficient

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Inferior IL-17 Inhibitor Responses in Psoriatic Women

Jun 27, 2022

Pooled data from two large ixekizumab (IXE) trials show that male patients had greater clinical responses than did female patients with psoriatic arthritis are largely unexplored. Reasons for this differential treatment responses to an interleukin-17A inhibitor (IXE) between male and female

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Two Week Methotrexate Hold with COVID-19 Vaccination

Jun 24, 2022

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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Bimekizumab Safety in Psoriasis Patients

Jun 23, 2022

A pooled analyses of data from eight, phase 2 and 3 randomized clinical trials shows bimekizumab, a dual IL-17A/F inhibitor, to be effective in plaque psoriasis and was well tolerated aside from an increased incidence of mild to moderate oral candidiasis. 



The cohort included 1789

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Simultaneous Versus Staged Knee Arthoplasty?

Jun 23, 2022

Aside from cost, there are significant concerns regarding efficacy and safety outcomes and recovery time. These issues are compounded with the need for bilateral TKR, wherein the patient and surgeon need to decide whether to have both TKRs done simultaneously or staged (single TKR one after

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COVID Test Antibody

COVID-19 Death is Dependent on Age and Type I IFN Autoantibodies

Jun 22, 2022

A study in PNAS of has shown that autoantibodies against type I interferons (IFNs) are strong predictors of death from COVID-19. This adds to the evidence that evidence preexisting autoantibodies neutralizing IFNs are strong determinants of life-threatening COVID-19 pneumonia.

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Does Sunlight Trigger Lupus?

MedPage Today
Jun 22, 2022

Whether exposure to ultraviolet (UV) radiation from the sun can cause new-onset systemic lupus erythematosus (SLE) wasn't settled by data from a large, long-running epidemiologic study, but the trends indicated that it could.

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Modest Benefits of Diet on Arthritis

Jun 21, 2022

A EULAR taskforce systematically reviewd the literature on the effects of diet and lifestyle behaviors in rheumatic and musculoskeletal diseases (RMDs), and found little evidence suggesting dietary factors can substantially affect the outcomes in people with RMDs.

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Burnout Threatens the Rheumatology Workforce Conundrum

Jun 21, 2022

There is a shortage of rheumatologists in Canada and the recent 2020 Canadian Rheumatology Association (CRA) Workforce and Wellness study shows that the shortage may be compounded by rheumatologist burnout, especially among young and female physicians. 

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CC Genotype and Thiopurine Toxicity

Jun 20, 2022

Annals of Internal Medicine reports that thiopurine toxcicity risk is associated with the "CC" genotype and that azathioprine discontinuation was associated with hematopoietic toxicity and lower thiopurine doses. 



Prior studies have shown that azathiprine (AZA) use is associated with

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What Happened to Kawasaki Disease During COVID-19?

Jun 20, 2022

During the COVID-19 pandemic, a new COVID-related syndrome in children, the "Multisystem inflammatory syndrome in children" (MIS), was described as being similar to but distinctly different than childhood Kawasaki's disease (KD). A new epidemiologic report shows that while MIS-C cases rose, KD

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Two Week Twitter (6.17.2022)

Jun 17, 2022

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.




  1. Although Rheumatology currently ranks 2nd or 3rd in specialty use of telemedicine - the vast

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PsA UPLIFT survey: do rheumatologists and patients agree on treatment goals?

Jun 17, 2022

POS0309 at EULAR 2022 highlighted both similarities and differences between our patients and ourselves when it comes to PsA disease and treatment strategies. 

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Not All RA Drug Classes Are Created Equal

MedPage Today
Jun 16, 2022

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.



For one, patients using inhibitors of the Janus-associated kinase (JAK) pathway were more likely to stop them because of adverse

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Vaccination,vaccine

Flares Not Increased Following Recombinant Zoster Vaccine Injections

Jun 15, 2022

Insurance claims analysis has shown that the use of the (CDC recommended) recombinant zoster vaccine (RZV) for prevention of herpes zoster was highly used in patients with immune-mediated inflammatory diseases and was safe, as higher rates of arthritis flares were not evident.

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Spondyloarthritis and COVID-19

Jun 15, 2022

There are still questions surrounding COVID-19, and some common questions I receive from patients revolve around what to do with their current DMARDs or should they even start treatment during this pandemic. Two studies focused on this question. 

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Improved Pregnancy Outcomes in SLE (2010–2020)

Jun 14, 2022

A retrospective cohort study has shown that outcomes in pregnant systemic lupus erythematosus (SLE) patients has significantly improved in the last decade, but there still is a high risk of adverse pregnancy outcomes (APO).



A retrospective Danish SLE cohort was used to identify

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Smile feedback opinion yes no good back opinion

What do our lupus patients think about treat-to-target?

In SLE, two targets that are increasingly used are the DORIS 2021 Remission and the Lupus Low Disease Activity (LLDAS). T2T is more likely to be successful if the treating clinicians and the patients set the treatment goals together. What do our patients think about T2T and do they have any say/

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Yes No

Can we stop RA before it happens?

Jun 09, 2022

Rheumatologists have long hoped and wondered whether the right type of early intervention could prevent rheumatoid arthritis occurring in at-risk individuals. While it is often a point of substantive discussion at EULAR, this year’s meeting in Copenhagen provided further data on how therapy

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