Articles By Jack Cush, MD
Autoimmune Thyroid Disease in Women
JAMA has posted an insights article reviewing autoimmune thyroid disease in women. Thyroid autoimmunity has a higher prevalence in women and with increasing age. Similar to many autoimmune disorders, thyroid disease is more common in women than in men.
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Higher Cardiovascular Risks with Systemic Lupus Erythematosus
The Journal of the American College of Cardiology has published the results of a study showing that patients with systemic lupus erythematosus (SLE) have an increased risk of heart failure (HF) and other long-term cardiovascular outcomes.
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Uric Acid: A Major Player in the Metabolic Syndrome
An open source, free read from the European Journal of Internal Medicine discusses how uric acid has evolved from the toxic cause of gout and nephrolithiasis and evolved, by way of science, into a pleiotropic recidivist in the evolution of obesity, diabetes, insulin resistance, renal disease, hypertension, fatty liver, and cardiovascular disease.
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RheumNow Podcast – Uppers and Downers
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Predictors of Methotrexate Toxicity
A metanalysis showed that while adverse events (AEs) are common when methotrexate is used in rheumatoid arthritis or inflammatory arthritis patients, serious AEs ranged from 2.1 to 9.5% and drug discontinuations ranged from 6.7% to 15.5%, mostly due to gastrointestinal events.
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Seven Year Delay in Diagnosing Spondyloarthritis
A large patient cohort study suggests that the mean diagnostic delay (DD) in European axial spondyloarthritis (axSpA) patients is 7.4 years, moreso in women and younger patients.
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Tofacitinib in Ankylosing Spondylitis
A phase III trial assessing the efficacy and safety of tofacitinib in adults with with active ankylosing spondylitis (AS) shows that JAK inhibitiion was superior to placebo in a 48 week study.
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Psoriatic Pregnancies Pose Risks to the Mother, Not Child
A metanalysis of pregnancy outcomes in women with psoriasis and psoriatic arthritis finds an excess risk of adverse maternal events, but not adverse neonatal events. This systematic review included 16 studies meeting inclusion criteria.
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Dual IL-17 Targeting is Effective but has More Candidiasis
Bimekizumab (BIM) is a monoclonal antibody that targets both interleukin-17A and interleukin-17F, which as a biologic target has worked well in the management of psoriatic disease. The current issue of the NEJM has two reports wherein BIM was shown to be more effective than secukinumab and adalimumab in treating patients with moderate-to-severe plaque psoriasis; however, safety concerns arise.
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Little Effect with Multimodal Treatment of CMC1 Osteoarthritis
A randomized clinical trial of patients with CMC1 osteoarthritis shows modest benefits when a combination of conservative treatments (education, splinting, hand exercises, 1% diclofenac sodium gel) was used compared to education alone. While there were small to medium benefits with regard to hand function, there was no benefit in pain outcomes.
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