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Drug Safety

Empty out your medicine cabinets. Sat Oct 24th is DEA "TAKE BACK" day. Dispose of unused, unwanted, controlled drugs, narcotics, e-cigarettes. Theyll take your tablets, capsules, patches, pens, liquids (BUT NOT syringes, sharps, illegal drugs) Where?

Dr. John Cush RheumNow ( View Tweet)

Oct 21, 2020

Clinical Trial Boom or Bust in Severe COVID-19

Oct 20, 2020

A number of recently published clinical trials are further defining the efficacy and outcomes of tocilizumab or remdesivir in treating SARs-CoV-2 infection.



Remdesivir

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Lilly has announced results of Phase 2 SERENITY trial showing the IL-23 inhibitor, mirikizumab, was more effective than PBO at week 12 (PRO and endoscopic outcomes) in moderate to severe active Crohn's disease.

Dr. John Cush RheumNow ( View Tweet)

Oct 19, 2020
SELECT CHOICE, H2H study of UPA vs ABA in TNF-IR RA pts; UPA had better DAS28-CRP & ABA had better Safety outcomes; Which would you use?

Dr. John Cush RheumNow ( View Tweet)

Oct 19, 2020
Not sure why this study was done...BUT...

Dr. John Cush RheumNow ( View Tweet)

Oct 19, 2020

TNF Inhibitors or non-TNF Biologics - First Best Choice?

Oct 18, 2020

Prospective observational findings from the CORRONA registry of rheumatoid arthritis (RA) patients compared clinical outcomes between initial aggressive therapy using either a tumour necrosis factor inhibitor (TNFi) or a non-TNFi (biological disease-modifying antirheumatic drugs (bDMARDs) and

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FDA Warning on NSAIDs in Pregnancy

FDA
Oct 16, 2020

The U.S. Food and Drug Administration announced today in a Drug Safety Communication that it is requiring labeling changes for nonsteroidal anti-inflammatory drugs (NSAIDs). These changes include new labeling to explain that if women take the medications around 20 weeks or later in their

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RheumNow Podcast – Good Time Charlie…. (10.16.20)

Oct 15, 2020

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

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Abatacept vs. Upadacitinib in Biologic Refractory Rheumatoid Arthritis

Oct 15, 2020

NEJM reports the results of the SELECT-Choice trial, a head to head study of upadacitinib (UPA) and abatacept (ABA) in biologic refractory rheumatoid arthritis (RA); 12 weeks results showed UPA was significantly more clinically effective than ABA using a DAS28-CRP remission, but ABA had fewer

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ICI Arthritis Tied to Cancer Progression

Oct 14, 2020

Cancer patients treated with immune checkpoint inhibitors (ICI) who develop severe arthritis may be at risk for progression of the malignancy, a single-center study suggested.



Almost 90% of patients treated with ICI develop immune-related adverse events, which can include pulmonary,

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@MattieRheumMD @News_CRA @statnews People are being crushed by co-pays- rheumatology patients' co-pays doubled to $1000 last year - and medical staff are wasting much time on paperwork. Plus, the @Aetna @CVSHealth merger caused prior auth meltdown in many. (Intentional?) Rebate system must go!

Angus Worthing MD AngusWorthing ( View Tweet)

Oct 14, 2020

Tofacitinib and Thromboembolic Risk

Oct 13, 2020

Mease and colleagues have reviewed the tofacitinib drug development and clinical trial data, finding the risk of venous (VTE) and arterial thromboembolism (ATE) to be low and augmented in patients with baseline cardiovascular abd VTE risk factors and those taking higher doses of tofacitinib (

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Thrombotic Risk in Rheumatoid Arthritis Linked to Disease Activity

Oct 11, 2020

A large RA cohort study from the Swedish Rheumatology Quality Register shows a higher risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA)  and that risk is linked to RA disease activity. 

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Hydroxychloroquine Shows No Benefit in Hospitalized COVID-19 Patients

Oct 09, 2020

The NEJM reports on a controlled clinical trial showing patients hospitalized with Covid-19 given hydroxychloroquine (HCQ) do not have a lower incidence of death compared to those receiving routine care.



A total of 4716 patients who were hospitalized with Covid-19 were randomly to

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RheumNow Podcast – Bad Disease & Bad Outcomes (10.9.20)

Oct 08, 2020

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

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Biologics Beneficial in Eosinophilic Vasculitis

Oct 08, 2020

Two biologic therapies showed promise in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) in a retrospective European study.



Among 63 patients who were treated with rituximab (Rituxan), remission or partial responses at 1 year were observed

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Sustained Remission Off Therapy Unlikely in GPA

Oct 08, 2020

A French Vasculitis Study Group analysis of their granulomatosis with polyangiitis (GPA) reveals that after 10 years, only 7% of GPA patients achieved sustained remission off therapy (SROT) and have never relapsed.

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Study of 193 Axial SpA pts with TNF inhibitor switching shows, using stringent outcome measures (ASDAS-ID) shows odds of responding to 2nd TNFi best w/ secondary TNFi failure (OR 7.3) or adverse events (OR 9.1), compared to primary TNFi failure.

Dr. John Cush RheumNow ( View Tweet)

Oct 08, 2020
Study of 222 RA pts on MTX given anti-GMCSF (otilimab) 22·5 mg, 45 mg, 90 mg, 135 mg, 180 mg, or PBO weekly x 5 wks, then EOW. @wk 24 DAS28-CRP <2·6 5%, 16%. 19%, 14%, 14% respectively and 3% in PBO. Otilimab failed to meet primary endpoint.

Dr. John Cush RheumNow ( View Tweet)

Oct 08, 2020

IL-1 Inhibition Alters Arthroplasty Rates

Oct 07, 2020

A subanalysis of the CANTOS trial suggests that inhibition of interleukin-1β (IL-1β) can reduce rates of incident hip or knee replacement (THR/TKR) surgeries.

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Fractures from Delays in Denosumab Reinfusions

Oct 07, 2020

Denosumab is effective in osteoporosis when used on schedue, but research suggests that discontinuation leads to rapid reversal of effect; a new observational study has shown that delays in denosumab administration of more than 16 weeks results in an increased vertebral fracture risk,

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Incredible lecture on the highest of therapeutics for rheumatoid arthritis by @BrighamWomens Dr Michael Weinblatt. Love this screen shot of A to Z for therapies prior to the methotrexate era. Z=Zero therapy (do nothing). Incredible advances since then!
Jeff Sparks jeffsparks ( View Tweet)
Oct 06, 2020

Systemic Steroids Reduce Mortality in COVID-19

Oct 06, 2020

JAMA Internal Medicine reports an analysis of COVID-19 clinical trials showing that critically ill patients with COVID-19 treated with systemic corticosteroids have an overall lower mortality rate.

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Swedish population study of psoriasis pts Rx w/ secukinumab (848) or ustekinumab (1107) showed slightly more respiratory infx & UTI (HR 1.22), w/ no difference in hospital treated severe respiratory, UTI (HR 0.96) or candidiasis (HR 1.80) https://t.co/yIRubED6VX

Dr. John Cush RheumNow ( View Tweet)

Oct 06, 2020
Utilization study of 1031 tofacitinib vs 17,803 biologic DMARD Rx-patients shows 14% higher discontinuations w/ TOFA (HR 1.14), but pts who switched to tofacitinib from a bDMARD had longer persistence than pts switched to another bDMARD (HR 0.90) https://t.co/5cqloT

Dr. John Cush RheumNow ( View Tweet)

Oct 05, 2020
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