Articles By Jack Cush, MD
One-Third Rheumatoid Risk from Lifestyle
Analysis of the NHANES (National Health and Nutrition Examination Survey) data suggests that one-third of the risk of developing rheumatoid arthritis (RA) in the USA is attributable smoking, obesity and alcohol intake.
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Consults in Cars
In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?
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RheumNow Podcast – Rheumatology Burnout (1.29.2021)
Dr. Jack Cush reviews this past week's journal articles and news features on RheumNow.com. Colchicine, vaccine rollout, risk of RA in endometriosis patients, tREACH trial, lupus nephritis news, rheumatology burnout and more.
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Calculating Serious Infection Risk in IMID Patients
Predictive modeling of data derived from the DANBIO registry (of treated IMID patients) revealed a 4 fold increased risk of serious infection (SIE) in those starting biologic DMARD (bDMARD) treatment. From this large dataset, researchers developed a simple prediction model to estimate future infection risk that may inform shared decision-making in individual patients.
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High Placebo Responses in SLE Trials
A systematic review by Urowitz and colleagues examined placebo responses in randomized controlled trials of non-renal, non-neuropsychiatric SLE patients showing unexpectedly high placebo responses; with more than one-third of the placebo-treated SLE patients responding by validated outcome measures.
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Lupus Nephritis Despite Low Level Proteinuria
Kidney International reports on a series of systemic lupus erythematosus (SLE) patients, who despite inactive urinary sediment and low level proteinuria, had a high rate of glomerulonephritis (GN) proven by renal biopsy; moreover, the LN was not predicted by laboratory abnormalities.
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Urate Lowering Therapy During Acute Gout
Acute gout has its well defined protocols, and most state that urate lowering therapy (ULT) should be continued; but does ULT affect outcomes in an acute gout attack?
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Rheumatologists Rank 2nd in Physician Burnout
The 2021 Medscape Survey on Physician burnout ranks rheumatology second, just behind Critical Care medicine. The survey included over 12,000 physcians from 20 specialties. While 42% of MDs claimed to be burnt-out, Rheumatologists claimed this 50% of the time. The top 3 this year were Critical care (51%), Rheumatology (50%) and infectious disease (49%).
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Protective Effects of Colchicine in Non-Hospitalized COVID-19
A press release from Montreal Heart Institute announced that the COLCORONA clinical trial provided evidence of the protective effect of colchicine; demonstrating a 21% reduced risk of death or hospitalizations in patients with COVID-19 compared to placebo. COLCORONA trial was a contact-less, randomized, double-blind, placebo-controlled study of 4,488 non-hospitalized patients from Canada, the U.S., Europe, South America and South Africa.
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Voclosporin FDA Approved for Lupus Nephritis
On January 22nd, the FDA approved voclosporin (Lupkynis) for use in adults with active lupus nephritis; voclosporin is a calcineurin-inhibitor immunosuppressant indicated for use in combination with a background immunosuppressive therapy. FDA approval was based on data from the pivotal AURORA Phase 3 study and the AURA-LV Phase 2 study, which demonstrated the ability of voclosporin to significantly improve LN outcomes after 52 weeks of followup in SLE nephritis patients receiving background standard of care therapies like MMF, and low dose steroids.
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