1/600 Falls May Die (4.5.2024)
Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com - including problems w/ falls, pain and treatment of Dupuytren’s contractures.
Read Article
TAPIR study shows that GPA patients treated with rituximab can be safely weaned off low dose prednisone. But. 20% risk of relapse in those treated with non-RTX regimens @VasculitisBCN24 #vasculitis https://t.co/jDy0lOQQIP
Catherine Hill @CatherineL_Hill( View Tweet )
Serious Infections in Takayasu arteritis
The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.
Activity & Pain Tolerance (3.29.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.
Read Article
Study 1189 males athletes sanctioned for doping with Androgenic anabolic steroids compared to 59 450 controls. Anabolic steroids signifi. increased the mortality risk (HR 2.81) from both unnatural (accidents) & natural causes (CVD, etc) https://t.co/XJr1oUw1gM https://t.co/YIQhdCXd2y
Dr. John Cush @RheumNow( View Tweet )
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.
Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory
MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children
CDC
Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement. The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021.
Read Article
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".
Read Article
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 (
Read Article
Polyarteritis Nodosa: Clinical Features and Outcomes
A multinational study of polyarteritis nodosa (PAN) through the international GLOBAL-PAN network shows PAN to be a complex, multisystem disorder with a high risk of relapse and low risk of death (11% at 10 years).
Read Article
EGPA: Benralizumab or Mepolizumab
A multicenter, double-blind, phase 3, randomized, active-controlled trial has shown that Benralizumab (BEN) was noninferior to mepolizumab (MEP) for the induction of remission of patients with relapsing or refractory Eosinophilic granulomatosis with polyangiitis (EGPA).
Adults with
Read Article
Behçet’s Syndrome
A comprehensive overview of Behcet's syndrome appeared in last week's NEJM, reviewing the numerous advances in the immunogenetics, syndrome recognition, and targeted therapeutic approaches. Despite certain advances, there remains a need for better clinical trials, better diagnostic tools, and
Read Article
Long-Term, open-label study enrolled EGPA (MIRRA study) required prednisolone ≥5 mg/d, pts cont mepolizumab 300 mg Sc q 4 wks +SOC. 100 pts - 71% completed, 3% d/C due to AEs. Exposure~38 mos; 38% serious AEs (30/100PYs) (worsening of asthma, EGPA https://t.co/GKxXN8p2Wz https://t.co/TFd9s3tfjK
Dr. John Cush @RheumNow( View Tweet )
CD19 CAR T-Cell Therapy in Autoimmune Disease
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
Read Article
Retro study of 1,169 pts (age 66 yrs) receiving intra-articular steroids & changes on A1C. A1C increases were assoc w/ higher baseline A1C (OR 1.84) for A1C 7–8 (vs <7%) or A1C >8% (OR 4.8 ). YET most patients do not experience increase A1C after IACS https://t.co/eWyO0nHgdy https://t.co/4UQRbrUyz7
Dr. John Cush @RheumNow( View Tweet )
Curbside Consults (2.16.2024)
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
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)".
Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts
Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts, 68% Rx low-dose GCs (32% no GCs). After 3 yrsof b/tsDMARDs, 32% still on GCs, 23% D/C GCs, & 20% go on & off, 25% never took GCs. GCs use assoc w/ HTN (20 v 11%) & MI (2.3% vs 0) https://t.co/lWVfvJrAyp https://t.co/uTIWqDAjRG
Dr. John Cush @RheumNow( View Tweet )
Determinants of Gout Flares
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
Read Article
Do you have GCA patients on low dose prednisone? Feel reassured.
Dr. @philseo provides data showing that low dose prednisone may be helpful in remission maintenance. #RNL2024 @RheumNow https://t.co/oyOsczfkfv
Dr. Rachel Tate @uptoTate( View Tweet )
Do you need to pulse steroids in GCA?
ACR 2022 abstract#0459 data says oral only may be sufficient
Oral vs IV MP - p=0.621
Still favor IV in severe cases
@philseo #RNL2024 @RheumNow
Eric Dein @ericdeinmd( View Tweet )
#RNL2024 @RheumNow
@philseo: I now give Tociliizumab for nearly all patients with GCA
GiACTA shows we weren't doing well enough with steroid monotherapy
GiACTA shows dosing frequency does not make a big difference in new diagnosis, but makes a difference in relapsing disease https://t.co/JBgUQtZSAr
Eric Dein @ericdeinmd( View Tweet )
Rapid GC taper in ANCA vasculitis
#RNL2024 @RheumNow
@anisha_dua
PEXIVAS - reduced GC is safe, decreased ifns
Retrospective real world - 234 pts. Reduced dose GC+RTX increased death/ESKD HR 2.42. No difference in infections https://t.co/SWIUSyVbWb
Eric Dein @ericdeinmd( View Tweet )
Prevalence of Cardiovascular Disease in Rheumatoid Arthritis
A prospective study of the BioSTAR registry estimates the prevalence of cardiovascular disease in rheumatoid arthritis (RA) to be 4.6%.
Read Article
QD Clinic - GCA & Steroid Weaning
Weaning steroids in chronic GCA patient
https://t.co/HtrzP43Ivr https://t.co/xZZlNmeqP1
Dr. John Cush @RheumNow( View Tweet )
Recent Blogs
