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Articles By Jack Cush, MD

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ACR Position Statement on Telemedicine

The American College of Rheumatology (ACR) has released an official position statement supporting the role of telemedicine as a tool with the potential to increase access and improve care for patients with rheumatic diseases.

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Is IL-23 Better than IL-17 Inhibition in Psoriasis?

Data presented at the recent American Academy of Dermatology meeting suggests that interleukin (IL)-23 inhibition with risankizumab was more effective than the IL-17 inhibition (secukinumab) based on a 52 week randomized head-to-head trial in moderate to severe psoriasis patients.

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Tocilizumab May Benefit COVID-19 Pneumonia

A retrospective, observational study published in Lancet Rheumatology has shown that tocilizumab (TCZ) may reduce the risk of death or the need for mechanical ventilation in severe COVID-19 pneumonia. This observational study included adults, with severe COVID-19 pneumonia, who were hospitalized between Feb 21 and March 24, 2020. All were on the standard of care (ie, supplemental oxygen, hydroxychloroquine, azithromycin, antiretrovirals, and low molecular weight heparin), and a non-randomly selected subset of patients also received TCZ.

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RheumNow Podcast – Lupus Mortality Declines, But… (6.26.20)

Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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Protective Benefit of Colchicine in COVID-19 Infection

Colchicine has been advocated as a potential anti-inflammatory intervention in patients with the coronavirus 2 infection and clinical trials have been developed to assess its effect in early COVID-2 infection.  JAMA has published a randomized clinical trial showing that low dose colchicine had less clinical deterioration without significant changes in biomarkers, such as high-sensitivity cardiac troponin and C-reactive protein.

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TNFi Cycling vs. Swapping Biologics in Rheumatoid Arthritis

For years, rheumatologists would rather fight to stay on a TNF inhibitor (TNFi) than switch to a non-TNFi biologic when rheumatoid arthritis (RA) therapy fails.

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Mortality in Lupus Declines between 2006 and 2016

The largest study, to date, shows that in‐hospital mortality of systemic lupus erythematosus (SLE) patients has significantly improved between 2006 and 2016, with a high mortality burden among U.S. Blacks and Hispanics with lupus.

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Hydroxychloroquine Fails as Postexposure Prophylaxis for Covid-19

Add this to the list of hydroxychloroquine (HCQ) letdowns in managing COVID-19 treatment or risk - prophylaxis with HCQ fails to prevent COVID-19 infection in those exposed to the SARS-CoV-2 virus.  NEJM has reported a prospective, randomized, double-blind, placebo-controlled trial from the US and Canada wherein adults with household or occupational exposure to someone with confirmed Covid-19 were treated with either placebo or HCQ within 4 days of exposure.

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Upside Down with Tocilizumab in COVID-19

Several recent reports offer conflicting views on the potential benefits and adverse outcomes of IL-6 inhibition with tocilizumab (TCZ) therapy in patients with severe COVID-19 infection. An Italian study grabbed the headlines yesterday with a press release stating TCZ did not improve respiratory symptoms, ICU admissions or mortality rates when given to 126 COVID patients with early disease. The study, supported by the Italian Medicines Agency (Aifa), stopped enrollment (about 1/3 of projections) after an interim analysis found insufficient evidence that TCZ would be effective.  This report has not been published or undergone critical review.

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RheumNow Podcast – Enough Already with Weaning (6.19.20)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

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