Rheumatoid Arthritis

Moving Forward on RA Prevention Trials Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess… https://t.co/ppmWa27tgd https://t.co/lQEtBNRZRm
Dr. John Cush @RheumNow( View Tweet )
In elderly onset rheumatoid arthritis, Treg cells are increased, but have decr suppressor activity. Maybe due to elevated Type I IFN with IFN-β suppressing old Tregs and increasing PD-1 expression. https://t.co/51ww481FkJ https://t.co/8EA1fENaFm

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Dr. John Cush @RheumNow( View Tweet )
Moving Forward on RA Prevention Trials Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess… https://t.co/JpGqkHCznI https://t.co/t0bXPnfoCM
Dr. John Cush @RheumNow( View Tweet )
Linger on the Fingers (9.6.2024) Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow. This week with a focus on fingers and better prescriptive follow through. https://t.co/c9yvRjE9av https://t.co/mdN37AWHjX

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Dr. John Cush @RheumNow( View Tweet )
Animal model shows Aggregatibacter actinomycetemcomitans periodontitis can trigger macrophage/caspase-11/inflammasome activation leading to paw swelling in mice anti-collagen antibody-induced arthritis (CAIA) model https://t.co/0bui2Putob https://t.co/VePVsbffDI

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Dr. John Cush @RheumNow( View Tweet )
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Moving Forward on RA Prevention Trials

Jack Cush, MD

Now that multiple prevention clinical trials for rheumatoid arthritis (RA) have been completed, a group of investigators have reviewed the results and published their recommendations for future trial designs and drug development to assess interventions that may alter disease development.

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Does Rheumatoid Factor Influence Anti-TNF Responses in RA? Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated… https://t.co/Ux9gHXcGbv https://t.co/gpcuWrqVHi
Dr. John Cush @RheumNow( View Tweet )
EMA Updated overview of leflunomide (Arava) https://t.co/LbuqzDdTvf https://t.co/npfsRDdFiP

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Difficult to treat RA Approach https://t.co/2rmlv0kspP https://t.co/6yb5xj8jrn

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Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/s20wTKafR8 https://t.co/FPxc5VP4Xh
Dr. John Cush @RheumNow( View Tweet )
Study of 4821 pts (age 52 yrs) undergoig EGD - H. pylori infx seen in 2262, w/ long-lasting H Pylori (LLHp) infx in 1043 (21.6%). 6.3% dx w/ aCVD & 4.3% w/ RA. LLHp infection incr risk of aCVS (HR 1.57) & RA (HR 2.63) In RA, LLHp up risk for aCVD (7.89) https://t.co/FNOsEHKVIf https://t.co/dSeJuuuUMQ

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Linger on the Fingers (9.6.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.

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Is it possible that Helicobacter pylori (Gm neg) can exacerbate or cause RA? Infx of gastric epithelial cell line w/ H. pylori upregulated the expression of PAD4 and increased PAD4 activity, leading to Helicobacter pylori-induced citrullination? https://t.co/QeE3SmWLLp https://t.co/ZG2tYmdJNx

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Dr. John Cush @RheumNow( View Tweet )
Immunomodulatory Prevention of Uveitis Relapse in Behçet's The results of a randomised, open-label, head-to-head trial shows that adalimumab was superior to ciclosporin in preventing uveitis relapses in patients with severe Behçet's disease. https://t.co/12fpuIZFmA https://t.co/iDJJq29JMA

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Study of 4370 RA pts (26534 PYs) saw 362 MACE (CV) events. RA activity & inflammatory markers assoc w/ MACE risk in bDMARD non-users (not those on bDMARDs). 515 bDMARD vs 3855 non-users (n=3855). Each DAS28-CRP unit incr MACE risk (HR 1.21)https://t.co/lRaHxTHzqe https://t.co/usEiJctVYk

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Dr. John Cush @RheumNow( View Tweet )
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Does Rheumatoid Factor Influence Anti-TNF Responses in RA?

Jack Cush, MD

Smolen and colleagues have published a subanalysis of the EXXELERATE study that showed while certolizumab pegol [CZP] concentrations and efficacy was unaffected by high titers of rheumatoid factor (RF), patients treated with adalimumab had a blunted response in the face of high RF titers.

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Claims analysis, shows <0.5% of IBD or RA pts developed an invasive fungal infx within 1 year of TNF therapy initiation (. Histoplasmosis was the most common IBD = 3.3 IFI/100PY RA = 2.8 IFF/100PY https://t.co/ER9YCxecJT https://t.co/T0UNgB4h6R

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Points to Consider when Managing Inflammatory Arthritis with Cancer https://t.co/qLMPwDNMiy https://t.co/sL87mp0gd4

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Life Essential 8 (LE8) score studied in RA & SLE was neg. corrlated w/ DAS28 (r −0.96) & SLEDAI (r − 0.81) & assoc w/ 10 yr survival. LE8 score: smoking, sleep, physical activity, diet, BMI, non-HDL, BP, fasting glucose, & HgbA1c. https://t.co/DCpWKzmt80 https://t.co/eKqqEO1F65

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Dr. John Cush @RheumNow( View Tweet )
Renal Impairment in Rheumatoid Arthritis Patients with highly active rheumatoid arthritis (RA) experienced faster declines in kidney function than those whose disease was under better control, analysis of a large registry indicated. https://t.co/WaUDtJCitG https://t.co/RmPPLsihAG

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Dr. John Cush @RheumNow( View Tweet )
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Running with Data (8.30.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.

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Antibiotics May Increase Inflammatory Arthritis Risk A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP) https://t.co/5CEewNqirM https://t.co/FSOFp4N6ks

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Dr. John Cush @RheumNow( View Tweet )
Study of 425 RA pts & 36 mo. bDMARD retention rates w/ TNFi, IL-6i & ABA based on renal funct (eGFR: ≥60, 30–60, <30 mL/min) showing little effect of CKD w/ TNFi (45%, 28%, 34%), IL-6i (47%, 67%, 71%) & CTLA-4Ig (50%, 31%, 33%), maybe lower w/ TNFi & higher w/ IL6i… https://t.co/FhXoSnEfG1 https://t.co/N29nLBOoUj
Dr. John Cush @RheumNow( View Tweet )
eyes

Diagnosing Seronegative Sjogren's Disease

Jack Cush, MD

Sjögren disease (SjD) is highly prevalent, but diagnosis may be challenged if anti-SSA antibodies or a labial salivary gland biopsy are negative. A recent cohort analysis suggests a novel autoantibody profile has predictive value SSA negative SjD and also in those with a positive labial biopsy

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antibiotics,pills,capsules

Antibiotics May Increase Inflammatory Arthritis Risk

Jack Cush, MD

A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP). 

This isn't the first time this association between antibiotic usage and futher

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Recent Blogs

Best of 2023: New ACR RA-ILD Treatment Guidelines – What Were They Smoking!?

Richard Conway, MBBChBAO, PhD
Lungs ILD
Rheumatoid arthritis related interstitial lung disease (RA-ILD) is common, with symptomatic RA-ILD affecting approximately 8% of RA patients. There is a very limited evidence base supporting treatment and therefore the recent release of ACR guidelines is to be welcomed. However, the published guidelines appear discordant with the best available evidence base.  Read Post

Screening and Overdiagnosis of ILD in RA

Michael Putman, MD, MSCI
Putman RheumThoughts
Dr. Michael Putman (Milwaukee, WI) reviews his approach to screening for ILD and RA, the potential for overdiagnosis and how this impacts treatment choices. Does this differ from your approach? Read Post

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