Articles By Jack Cush, MD
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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Golimumab Effective in non-radiographic Axial Spondyloarthritis
The GO-AHEAD study was designed to assess the long-term efficacy and safety of golimumab (GLM) in non-radiographic axial spondyloarthritis (nr-axSpA). After the 16-week, placebo [PBO]-controlled double-blind phase, 189/198 (95.5%) entered the long-term extension (OLE) for 36 weeks wherein G
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RheumNow Podcast – Coconspirators: RA and Lung Disease
Dr. Jack Cush reviews and discusses more than a dozen news and journal articles from the past week on RheumNow.com.
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Diagnostic Delay in Spondyloarthritis
Literature review and metanalysis of many studies suggests that significant delay to diagnosis in axial spondyloarthritis (axSpA) exist, are longer than other rheumatic diseases and have not changed over time.
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Increased Methotrexate Liver Disease in Psoriasis
A Danish cohort study examined the risk of methotrexate related liver disease risk in patients with psoriasis (PsO)and psoriatic arthritis (PsA), and found that compared to rheumatoid arthritis (RA), psoriatic patients had up to a 3 fold higher risk of liver disease.
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