Articles By Jack Cush, MD
Telehealth Diet and Exercise Benefits Knee Osteoarthritis
Annals of Internal Medicine has reported the results of a randomized clinical trial showing that telehealth-delivered exercise and diet programs improved pain and function in knee osteoarthritis patients who were overweight. While both were beneficial, exercise had a greater effect than die
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FDA Puts Boxed Warnings on JAK Inhibitors
Based on the safety review of tofacitinib in Pfizer's Oral Surveillance (1133) study, the FDA has added serious boxed warnings to all three marketed JAK inhibitors (for inflammatory diseases) and formalized the recommendation that patients should be started on a TNF inhibitor (TNFi) before trying a JAK inhibitor. These recommendations apply to tofacitinib, baricitinib and upadacitinib.
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Telemedicine Upside Interview with Dr. Alvin Wells
In spite of the transformative growth of telemedicine during the COVID-19 pandemic, rheumatologists use of telemedicine is waning, much like the use of masks. Dr. Jack Cush interviews telemedicine guru, Dr. Alvin Wells, on the current state of telemedicine and what the future holds for telehealth in rheumatology.
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Rheumatoid Arthritis, Dementia and Cognitive Dysfunction
Rheumatoid arthritis (RA) has been linked to a higher risk of dementia and cognitive dysfunction, but interestingly this association has diminished in the last few decades with aggressive DMARD and targeted therapies..
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Cytokine Inhibitor Lung Disease in Still's Linked to HLA-DRB1 Alleles
Pulmonary complications in the setting of Still's disease (juvenile and adult) has seldom but consistently been reported, including reports of pneumonitis, pulmonary hypertension and a severe or fatal lung disease, often associated with hypersensitivity to anticytokine therapy. A multicenter study reports that drug hypersensitivity and pulmonary reactions in Still's patients receiving IL-1 or IL-6 inhibitors is strongly associated with HLA-DRB1*15 haplotypes.
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DORIS - Defining Remission in Lupus
Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE. A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016.
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RheumNow Podcast - 60/40/20 Interview with Dr. Ed Keystone
Dr. Jack Cush interviews Professor Edward Keystone, MD (University of Toronto) on the origins and science behind the 60/40/20 benchmark and outcomes in rheumatoid arthritis.
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Safety of Psoriatic Biologics in Pregnancy
Little is known about the safety of newer biologic use during pregnancy, especially in patients who either conceive while on a biologic or must remain on a biologic during pregnancy (often the case with IBD and inflammatory arthritis).
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Does Control of Inflammation Lower Cancer Risk?
Dr. Jonathan Kay's provocative video addresses whether the increased cancer risk associated with tofacitinib (Tofa) seen in the Pfizer Oral Surveillance (1133) study represents a real increased risk, an increased risk relative to a decreased risk with TNF inhibitors (TNFi) or an actual decreased cancer risk (unknown as there was no placebo comparator in this trial).
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Improving Rheumatology Practice
How to best book patient appointments in rheumatology clinic? Should these be scheduled every 3 or 4 months regardless of patient status? Should they be scheduled by patient need or disease activity?
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