Rheumatoid Arthritis

Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study https://t.co/1fiNgBQUbr looks like lower ab response and drops over 6 mths - boosters important in our patients

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Peter Nash @drpnash( View Tweet )

Aug 15, 2022

Hit Parade Review (8.12.2022)
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Jack Cush, MD

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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Arthritis - a Leading Chronic Condition Among Young Adults (18─34 Yrs)
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Jack Cush, MD

Aug 11, 2022

MMWR from last week focused on chronic conditions in young adults showing they are common, costly, and major causes of death and disability. Overall arthritis ranks behind five more common chronic condition in young adults - obesity, depression, hypertension, hypercholesterolemia and asthma

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Study of diet & RA in 100 new RA & 197 controls; fish/seafood consumption assoc w/ less RA risk (OR 0.52; 0.27–0.98); but processed meat intake yielded increased RA risk (OR 3.45; CI 1.78–6.68). No significant association btw RA and red meats or poultry https://t.co/wLpHfA50mY https://t.co/p2EOLBKrwW

Links:

https://bit.ly/3QtuV5r

Dr. John Cush @RheumNow( View Tweet )

Aug 09, 2022

More Bad Safety News for Xeljanz
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MedPage Today

Aug 08, 2022

Another analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in rheumatoid arthritis are higher than with tumor necrosis factor (TNF) inhibitors.

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Study of 57 #RA pts. w/ ILD treated with abatacept. Lung progression in 46% before ABA. After median 27 mos of follow-up, ILD - 72% improved or stabilized - 23% worsened - 5% died. No significant change in FVC, DLCO ILD worse assoc w/ DAS28, FVC DLCO https://t.co/kLa61ZS8dt https://t.co/7XhqxcHuCt

Links:

https://bit.ly/3SttTbn

Dr. John Cush @RheumNow( View Tweet )

Aug 08, 2022

#RA disease activity drives risk of hospitalized infections (SIE). Study of 3,254 RA pts w/ 529 hospitalized infx. SIE seen 3.8/100 person Yrs in remission, 6.6/100PY w/ low Dz activity & 8/100PY w/ moderate Dz activity. HR was 1.60 w/ LDA and 1.83 w/ MDA https://t.co/i4bSsnRiHk https://t.co/kcN9ZvpSOn

Links:

https://bit.ly/3BQEQxI

Dr. John Cush @RheumNow( View Tweet )

Aug 05, 2022

521 clinically suspect arthralgia (CSA) pts were assessed - Low educational attainment was associated with increased risk of developing inflammatory arthritis (HR = 2.35), independent of BMI & smoking https://t.co/h1bXDfxaQk https://t.co/g2ign0HDmj

Links:

https://bit.ly/3Q8owwY

Dr. John Cush @RheumNow( View Tweet )

Aug 05, 2022

JAK Inhibitors in Difficult Still’s Disease
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Jack Cush, MD

Aug 05, 2022

A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.

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The Great Unknowns (8.5.2022)
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Jack Cush, MD

Aug 05, 2022

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

521 clinically suspect arthralgia (CSA) pts were

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The Approach to Difficult to Treat Rheumatoid Arthritis Tan and Buch have reviewed the approach to D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.https://t.co/CfCvgbl3VP https://t.co/OKzyY79shU

Links:

https://bit.ly/3Jy01qu

Dr. John Cush @RheumNow( View Tweet )

Aug 04, 2022

ACR Updated Guideline on Vaccinations for Rheumatic Patients
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Jack Cush, MD

Aug 04, 2022

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).

This guideline builds on past

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The Approach to Difficult to Treat Rheumatoid Arthritis
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Jack Cush, MD

Aug 03, 2022

Tan and Buch have reviewed the approach to difficult to treat rheumatoid arthritis (D2T-RA), with a new EULAR definiation of D2T-RA to foster an approach rationale and concideration of treatment options.

D2T-RA is defined by failure of at least two different mechanism of action

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Risk of incident & recurrent H.Zoster higher after tofacitinib - Korean claims analysis of 11,720 seropos. RA pts Rx w/ bDMARD or tofacitinib (2011-19). 14% got HZ. Compared to other biologics (ABA), Tofa incr HZ (HR 2.5) & recurrence (HR 3.69) https://t.co/lDuqdtkIjR https://t.co/zJ3ArS3gGs

Links:

https://bit.ly/3PTowkg

Dr. John Cush @RheumNow( View Tweet )

Aug 02, 2022

Social Media Questions (7.29.2022)
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Jack Cush, MD

Jul 29, 2022

Dr. Jack Cush reviews the news, journal reports and rheumatologist cases from the past week on RheumNow.com. This podcast is brought to you by StillsNow.com - be sure to sign up for our monthly StillsNow email and Monthly StillsNow Podcast.

Study of 63 Thalassemia pts (50

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Study of 63 Thalassemia pts (50 transfusion dep) w/ 22% α-, 73% β-, 5% α- & β-thal. 23 had inflammatory rheumatic Dz (IRD: RA 9, gout 6, SLE 3, SpA 2). ANA+ in 10% w/o IRD & Transfusion Dep had more + tests for direct Coombs & ANA https://t.co/QW6ecv98F1 https://t.co/GO3xC86hLc

Links:

https://bit.ly/3outIPt

Dr. John Cush @RheumNow( View Tweet )

Jul 28, 2022

TREAT EARLIER Study - Is MTX Intevention in Pre-Clinical RA Warranted?https://t.co/rGcm1DSwJk https://t.co/paBrJVMXdP

Links:

https://bit.ly/3vlx1MN

Dr. John Cush @RheumNow( View Tweet )

Jul 28, 2022

No Risk of RA w/ coffee consumption -- Swedish EIRA study, included 2184 early RA pts. High Coffee (>6 cups/day) was assoc w/ increased RA risk (OR 1.50;1.20–1.88) that was lost after adjusting for smoking (OR 1.14;0.89–1.45). https://t.co/3SIeHD4fII https://t.co/NqkjmuzSaV

Links:

https://bit.ly/3Q130cM

Dr. John Cush @RheumNow( View Tweet )

Jul 27, 2022

BSRBR mandates LFTs q3 mos if on MTX. 1011 RA pts during the pandemic had median of 5 blood tests & median interval of 57 days. 61% pts had 1 prolonged interval (99-150d) & 24% had multiple. Cytopenia & ^LFTs were not increased by interval length https://t.co/VqY4qIMvOS https://t.co/HcTcmFBuvq

Links:

https://bit.ly/3OvbDva

Dr. John Cush @RheumNow( View Tweet )

Jul 27, 2022

210 consecutive #RA pts starting #MTX looked at effect of autoantibodies on drug response. DAS28-CRP low dz activity at 6 mos was significantly lower with SSA+ (56% v 76%, P=0.03) - which was more significant than CCP+ or RF+ https://t.co/DoEtldBXi4Figures https://t.co/yIECjLiEwl

Links:

https://bit.ly/3J8tiaL

Dr. John Cush @RheumNow( View Tweet )

Jul 27, 2022

U.S. News & World Report’s 2022–23 Rheumatology Rankings
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Jack Cush, MD

Jul 27, 2022

The Johns Hopkins Hospital has repeated its top rank among US Rheumatology centers - ranking #1 for the 18th year in a row, according to U.S. News & World Report’s 2022–23 Best Hospitals list released yesterday.

U.S. News and World Reports ranking of U.S. Hospitals and

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Have you checked out our new sister-site, Still's Now? A new site for Still's disease, autoinflammatory & febrile disorders.https://t.co/oWEugnOB6k https://t.co/5jwiP2Xqrz

Links:

https://bit.ly/3PB1kal

Dr. John Cush @RheumNow( View Tweet )

Jul 26, 2022

TREAT EARLIER Study - Is MTX Intevention in Pre-Clinical RA Warranted?
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Jack Cush, MD

Jul 26, 2022

Management of arthralgias before a certified rheumatoid arthritis (RA) diagnosis is challenging - should one use DMARD therapy before clinically evident synovitis in a preemptive effort to avoid or forestall the diagnosis or damage of RA? A novel study has shown that MTX initiated in

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Risk of hospitalized infection (SIE) goes up with #RA disease activity. Study of 3,254 RA Pts with 529 SIE - SIE rates lowest with remission (3.8/100PY), vs low dz activity (6.6/100PY; OR 1.60) vs moderate activity (8.8/100PY; OR 183) https://t.co/EWbX7N7fiG https://t.co/Y8bRn2XATF

Links:

https://bit.ly/3BfP0aX

Dr. John Cush @RheumNow( View Tweet )

Jul 26, 2022

Sometimes the journey impacts as much as the destination. TREAT-EARLIER now @TheLancet: pre-RA (CSA+MRI) DBRCT: po MTX for 1y (+im mpred120x1) vs placebo eventual RA same but persistent benefit at 2y (1y post-MTX cessation): function, Sx, presenteeism, MRI a short thread🧵1/7 https://t.co/64b7us6hvS

Links:

https://twitter.com/TheLancetRheum/status/1550479166704852992

David Liew @drdavidliew( View Tweet )

Jul 23, 2022

Recent Blogs

Still's disease: paediatrics to adults, a continuum or not?
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Dr. Ilenia Di Cola and Dr. Piero Ruscitti

Jul 25, 2022

Still’s disease is a rare inflammatory disorder, affecting less than 1 person per 2000 people. This disease may occur in both children and adults, namely as systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease (AOSD). The paediatric form was described by George Still in 1896, whereas the adult variant later by Eric Bywaters in 1971. However only the adult disease is identified by the name of Still.Read Post