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Two Week Twitter (6.17.2022)

Jun 17, 2022

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.




  1. Although Rheumatology currently ranks 2nd or 3rd in specialty use of telemedicine - the vast

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Biologic.choice.MD_.jpeg (keep)

Not All RA Drug Classes Are Created Equal

MedPage Today
Jun 16, 2022

Clear differences were apparent among the three major types of targeted medications for rheumatoid arthritis (RA) in a large European registry study.



For one, patients using inhibitors of the Janus-associated kinase (JAK) pathway were more likely to stop them because of adverse

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EULAR 2022 Top 10 Abstracts (6.10.2022)

Jun 10, 2022

Dr. Jack Cush reviews the top abstracts from EULAR 2022  As chosen by me with the  aid of the RheumNow EULAR faculty. “Top” is relative and subjective, but my criteria for inclusion are based on impact, water cooler talk potential, innovation and social media buzz.  Speaking of social media

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cancer search news magnify

Malignancy risk on b/tsDMARDs in patients with prior malignancy history

Jun 04, 2022

For autoimmune patients with a history of malignancy, the initiation of biologic or targeted synthetic disease modifying agents (bDMARD/tsDMARDs) may provoke concern. While data for biologic medications and malignancy risk has been largely reassuring, clinical trials have often excluded

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#Bestinclass. #Giantcellarteritis GCA lots of novel ideas. V short prednisone- 2 months with #Tocilizumab. Not RCT. Looked safe & effective but too small to know if blindness etc are increased. Don’t suggest you try this at home...yet! @RheumNow @eular_org #EULAR2022 OP0185
Jun 04, 2022
Unizony et al. GCA outcome on/after tocilizumab. 36.5% relapse after stopping tocilizumab. Generally stopped due to remission, 10% stopped due to adverse event @RheumNow #EULAR2022 POS0267 https://t.co/jlZDTinfCK
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Schmitt et al. Pharmacokinetic study of IV tocilizumab in 24 patients with known GCA. Using 6mg/kg or 7mg/kg. Effective on lab measures and no GCA flares. @RheumNow #EULAR2022 POS0268 https://t.co/uhxfGZvYTw
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Tomelleri @tomelleri_a et al. GCA. Tocilizumab weekly x 1 year, then every other week x 1 year, then stop. 2 PMR flares during toc. 1 month post-stop 100% remission. 6 months post-stop 24% GCA flare! Some patients seem to need indefinite toc @RheumNow #EULAR2022 POS0266 https://t.co/8I5GQ08HDr
Richard Conway @RichardPAConway( View Tweet )
Jun 03, 2022
Puzzle pieces

Polymyalgia rheumatica immunological puzzle further illustrated

Jun 02, 2022

Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research (abstract OP0015)

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Sanchez-Martin et al. Tocilizumab in newly diagnosed vs refractory GCA. 471 patients. Appears of relatively similar efficacy in both groups. Surprising that the difference is not greater given refractory GCA inherently more complex @RheumNow #EULAR2022 POS0817 https://t.co/HEWzYCz9YD
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
Preito-Pena at al. Tocilizumab in LVV-GCA and TAK. Similar responses in both, with 75% showing complete clinical response but only 20% complete imaging response at month 12. Clinical implications of these persistent imaging findings need clarification @RheumNow #EULAR2022 POS0804 https://t.co/sNbRzIkwnt
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
Unizony et al. Case series of tocilizumab + 8 weeks steroid in GCA. 30 patients, 50% new 50% relapsing. 77% in sustained remission at week 52! No vision loss. Exciting, needs an RCT @RheumNow #EULAR2022 OP0185 https://t.co/ohBYIWYxBC https://t.co/fsn4x17Hwv
Richard Conway @RichardPAConway( View Tweet )
Jun 02, 2022
Sanchez-Bilbao et al. TCZ for large vessel GCA. Has been a concern due to limited LVV/imaging in RCTs 196 patients. Seems to work well. 20% sustained remission month 6, 60% month 12. Clinically significant reduction steroid doses as shown in figure. @RheumNow #EULAR2022 POS0802 https://t.co/Z0HEVal6RI
Richard Conway @RichardPAConway( View Tweet )
Jun 01, 2022
TOFFIFE RCT in colchicine-resistant FMF. Tocilizumab normalises SAA and CRP/ESR with PGA response in 20-25%. Maybe response criteria too strict, or maybe TCZ only effective for subgroup of patients @RheumNow #EULAR2022 OP0043 https://t.co/kNs8DMzXFB https://t.co/QMDk1IUkjx
Richard Conway @RichardPAConway( View Tweet )
Jun 01, 2022
NORD-STAR TRIAL drug does better in ttmt naive eRA? 48wks CDAI remission ▶️ w/ ABA and CERTO PEG vs. MTX+ GCs while TCZ not stat ▶️. Is the difference clinically sufficient to recommend these in first intention over MTX ? not convinced 🧐 OP0058 #EULAR22 @rheumnow
Jun 01, 2022
PSS.scleroderma.arthritis.contractures

Immune Checkpoint Inhibitor Associated Arthritis

May 30, 2022

Immune checkpoint inhibitors (ICIs) have dramatically improved outcomes in numerous cancers but have been hampered by a growing spectrum of immune-related adverse events (irAEs). Rheumatic complaints may be less frequent than other irAEs associated with ICI in cancer patients. 

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The Inflammation Reflex (5.20.2022)

May 20, 2022

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.

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DMARDs,biologics,RA

Efficacy of Subsequent b/tsDMARD Use in Rheumatoid Arthritis

May 04, 2022

Analysis of rheumatoid arthritis (RA) data from the British Society for Rheumatology Biologics Register shows that, even after failing three or more biologic or targeted synthetic DMARDs (b/tsDMARDs), patients may continue to benefit from repeated trials of unused b/tsDMARDs. 

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RheumNow Podcast – What You Do For & What You Do To the Patient (4.8.2022)

Apr 08, 2022

Dr. Jack Cush reviews the news and journal articles from the past week and discusses the use of fibroscan in RA, steroid hip injections in OA and famous quotes from a famous cardiologist.




  1. CorEvitas Registry study of173 Axial #PsA pts showed 6 mos of bDMARD/tsDMARD resulted

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Ask Cush Anything! Have a rheumatology question or case for Dr. Cush? Submit it here and we may feature it on an upcoming podcast. https://t.co/KgPIeScthr https://t.co/nk4re9mlcH
Dr. John Cush @RheumNow( View Tweet )
Mar 25, 2022
COVID,hospital,ER,infusion

Tocilizumab Works Best in Non-Mechanical Ventilated COVID-19 Patients

Mar 04, 2022

JAMA has published a meta-analysis of 15 studies of hospitalized patients with COVID-19 treated with tocilizumab and corticosteroids, showing that a clinically meaningful mortality benefit from tocilizumab (and steroids) was best seen in those not requiring invasive mechanical ventilation (

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coronavirus,COVID,MISC,mask

ACR Updates Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With COVID

Feb 09, 2022

A Task Force from the ACR has provided an updated (version 3) guidance for the diagnosis and management of Multisystem Inflammatory Syndrome in Children (MIS-C), a COVID related condition characterized by fever, inflammation, and multiorgan dysfunction. The current guidance also applies to

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Yesterdays RheumNow Live Vote survey of 170 Rheumatologists, showed that 74-80% of Rheums are reporting shortages of IV tocilizumab (Actemra) -- TCZ listed by FDA site as a drug in shortage largely due to demand, Genentech says there is supply https://t.co/YAvR4vbVHV
Dr. John Cush @RheumNow( View Tweet )
Jan 21, 2022
RheumNow Live Vote survey of 159 Rheumatologists shows, because of the Actemra Shortage, Rheums are either changing to subQ TCZ (45%), changing to other biologic or tsDMARD (33%) or waiting for resupply of TCZ (21%). https://t.co/zNeyRsYClD @CreakyJoints https://t.co/aGYO2fqw7J
Dr. John Cush @RheumNow( View Tweet )
Jan 21, 2022
UTSW Rheum Grand Rounds - Dr. Nigrovic shows the efficacy of long acting IL-1 inhibition (canakinumab) and IL-6 (tocilizumab) in systemic JIA patients @UTSWRheum https://t.co/XdG8pAq1c4
Dr. John Cush @RheumNow( View Tweet )
Jan 20, 2022
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