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Anti-Rheumatic Rx

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What Worries You, Masters You (7.1.2022)

Jul 01, 2022

Dr. Jack Cush reviews recent news, regulatory and guideline updates from the past week on RheumNow.com.  Studies on methotrexate use, COVID vaccination, Supplements and vitamins, and arthrocentesis despite anticoagulation are discussed.




  1. FDA approved Abbvies risakizumab-rzaa

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Novel Anti-TNF Shines in Rheumatoid Arthritis Trial

MedPage Today
Jun 30, 2022

A new way of inhibiting tumor necrosis factor (TNF) for treating rheumatoid arthritis showed strong results in a phase II/III clinical trial, researchers said.



About 75% to 80% of patients receiving an investigational agent called ozoralizumab achieved 20% reductions in symptoms by

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Placebo Works Best in Combination

Jun 30, 2022

Analysis of two large clinical trial datasets shows that placebo response rates in randomised controlled trials (RCTs) of patients with rheumatoid arthritis are better when the patient continued background methotrexate (MTX). 



RA patients with an insufficient MTX can either continue

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New Updated GRAPPA Psoriatic Arthritis Recommendations

Jun 29, 2022

The GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) treatment recommendations have been updated and the 2021 evidence-based guidance is rich in treatment recommendations based on the key disease "domains" - peripheral arthritis, axial disease, enthesitis,

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HCQ for RA: Not a Great Idea?

MedPage Today
Jun 28, 2022

Hydroxychloroquine (HCQ) appeared less safe from a cardiovascular standpoint than methotrexate in older patients with rheumatoid arthritis (RA), analysis of Medicare data indicated.



Among RA patients 65 and older with a history of heart failure, major cardiovascular events occurred

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Are You Wasting Money on Supplements or Vitamins?

Jun 27, 2022

The US Preventive Services Task Force (USPSTF) has updated its recommendations regarding the efficacy of supplements or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population.



The USPSTF concluded there is insufficient

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Inferior IL-17 Inhibitor Responses in Psoriatic Women

Jun 27, 2022

Pooled data from two large ixekizumab (IXE) trials show that male patients had greater clinical responses than did female patients with psoriatic arthritis are largely unexplored. Reasons for this differential treatment responses to an interleukin-17A inhibitor (IXE) between male and female

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It's time to exonerate methotrexate in causing or exacerbating fibrotic interstitial lung disease in #RA patients https://t.co/AuEIWn8Pc4 https://t.co/razVTF6fFX
Dr. John Cush @RheumNow( View Tweet )
Jun 27, 2022
Treatment of pyoderma gangrenosum is clinically empiric. Full read ref w/ Graded Rx Recommendations: - 1st line: Steriods or Cyclosporin - Consider biologics: TNFi, IL-1, IL-12/23, IL-17, IL-23 - Others: MTX, MMF, AZA, Dap, colchic, thalidomide, IVIG https://t.co/uMJyfFzsRB https://t.co/vw4VqbjZWh
Dr. John Cush @RheumNow( View Tweet )
Jun 25, 2022
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Two Week Methotrexate Hold with COVID-19 Vaccination

Jun 24, 2022

A cohort study of rheumatoid arthritis (RA) patients evaluated immunogenicity of COVID vaccination with and without holding methotrexate (MTX) for and 2-weeks and showed better immunogenicity, but more RA flares with the second MTX withdrawal. 

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Bimekizumab Safety in Psoriasis Patients

Jun 23, 2022

A pooled analyses of data from eight, phase 2 and 3 randomized clinical trials shows bimekizumab, a dual IL-17A/F inhibitor, to be effective in plaque psoriasis and was well tolerated aside from an increased incidence of mild to moderate oral candidiasis. 



The cohort included 1789

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Simultaneous Versus Staged Knee Arthoplasty?

Jun 23, 2022

Aside from cost, there are significant concerns regarding efficacy and safety outcomes and recovery time. These issues are compounded with the need for bilateral TKR, wherein the patient and surgeon need to decide whether to have both TKRs done simultaneously or staged (single TKR one after

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Does Sunlight Trigger Lupus?

MedPage Today
Jun 22, 2022

Whether exposure to ultraviolet (UV) radiation from the sun can cause new-onset systemic lupus erythematosus (SLE) wasn't settled by data from a large, long-running epidemiologic study, but the trends indicated that it could.

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Modest Benefits of Diet on Arthritis

Jun 21, 2022

A EULAR taskforce systematically reviewd the literature on the effects of diet and lifestyle behaviors in rheumatic and musculoskeletal diseases (RMDs), and found little evidence suggesting dietary factors can substantially affect the outcomes in people with RMDs.

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Burnout Threatens the Rheumatology Workforce Conundrum

Jun 21, 2022

There is a shortage of rheumatologists in Canada and the recent 2020 Canadian Rheumatology Association (CRA) Workforce and Wellness study shows that the shortage may be compounded by rheumatologist burnout, especially among young and female physicians. 

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What Happened to Kawasaki Disease During COVID-19?

Jun 20, 2022

During the COVID-19 pandemic, a new COVID-related syndrome in children, the "Multisystem inflammatory syndrome in children" (MIS), was described as being similar to but distinctly different than childhood Kawasaki's disease (KD). A new epidemiologic report shows that while MIS-C cases rose, KD

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#EULAR2022 has concluded but you can find all our coverage here https://t.co/s62OVJPQ86 https://t.co/QAvPQYCABj
Dr. John Cush @RheumNow( View Tweet )
Jun 18, 2022
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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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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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There are 494K PCPs in the USA, While up to 1/3 will "refill" DMARDs, only 6-9% are confident or knowledgeable in "initiating" DMARD therapy in #RA. GIGANTIC NEED FOR PCP education in MSK & Rheum Dz https://t.co/VjgWWDt3nX https://t.co/dTRXxsrzG5

Dr. John Cush @RheumNow( View Tweet )

Jun 16, 2022
Vaccination,vaccine

Flares Not Increased Following Recombinant Zoster Vaccine Injections

Jun 15, 2022

Insurance claims analysis has shown that the use of the (CDC recommended) recombinant zoster vaccine (RZV) for prevention of herpes zoster was highly used in patients with immune-mediated inflammatory diseases and was safe, as higher rates of arthritis flares were not evident.

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Spondyloarthritis and COVID-19

Jun 15, 2022

There are still questions surrounding COVID-19, and some common questions I receive from patients revolve around what to do with their current DMARDs or should they even start treatment during this pandemic. Two studies focused on this question. 

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Improved Pregnancy Outcomes in SLE (2010–2020)

Jun 14, 2022

A retrospective cohort study has shown that outcomes in pregnant systemic lupus erythematosus (SLE) patients has significantly improved in the last decade, but there still is a high risk of adverse pregnancy outcomes (APO).



A retrospective Danish SLE cohort was used to identify

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ACR Applauds FTC Decision to Investigate PBM's

ACR Press Release
Jun 13, 2022

The American College of Rheumatology applauds the Federal Trade Commission’s decision to investigate the business practices of pharmacy benefit managers (PBMs), which continue to increase PBM profit margins while placing the burden of skyrocketing drug costs on America’s most vulnerable

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GLORIA Study Pred vs PBO in >65yrs RA x 2 years. 451 Pts & DAS28 4.5. 79% on DMARDs (14% biologics) Upside: Lower DAS28 -0.37 & less Xray progression -1.7 Sharp units Downside: 24% more AE (mild infxns), signif.small lowering of lumbar BMD -1% You Decidehttps://t.co/RRq0WcFsXz https://t.co/xLxjPPSMhh
Dr. John Cush @RheumNow( View Tweet )
Jun 13, 2022
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