David Liew

Melbourne

Co-Host at Australian Prescriber Podcast

Rheumatologist and clinical pharmacologist, world traveller pretences back on track, and even sometimes journal podcast host. All opinions my own

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Articles

What would it take for JAKs to ROCK the boat?

1 week ago | rheumnow.com | David Liew

JAK inhibitors have taken a beating over the last three years. The excitement and potential has been tempered by mounting cardiovascular safety concerns, but specifically in at-risk patients, compared to TNF inhibitors. Once the suggestion is made, though, the concern is powerful. I am sure I am not the only one who has had to have difficult conversations navigating nuance in explaining situations where I think the risk is more than manageable. The fear of cardiovascular events can be hard to shake.
Secukinumab promise in PMR is real

2 weeks ago | rheumnow.com | David Liew

GCA is getting steroid-sparing therapy choices, and PMR doesn’t want to miss out. Most PMR patients with current therapy approaches incur multiple grams of cumulative prednisolone exposure, even though they’re often exactly the kind of patients we would rather keep away from steroids altogether. Yet we only recently got our first steroid-sparing choice in PMR, sarilumab, and conventional registration studies seem hard to run.
Will the Robots Save Ultrasound?

Dec 3, 2024 | rheumnow.com | David Liew

Ultrasound has a lot going for it in rheumatoid arthritis and psoriatic arthritis. It is free of ionizing radiation, yet can deliver helpful insights to the bedside, educating our patients along the way. As we seek to prognosticate more and delineate better, ultrasound should be our friend. That is not news.
Ozempic will change rheumatology

Nov 29, 2024 | rheumnow.com | David Liew

Ozempic is everywhere. Even all the way in Australia, where we have highly constrained supply that makes headlines and substantial limits on direct-to-consumer advertising, somehow I know the jingle from the American ad for Ozempic. I have no special interest or personal gain to be made, but so pervasive is its cultural significance that its ubiquitous brand recognition should come as no surprise. Our rheumatology patients are no different.
JAK inhibitors in GCA?

Nov 17, 2024 | rheumnow.com | David Liew

It’s been eight years, and here we are again. The ACR annual meeting was last in Washington DC in 2016, and there’s probably a lot about ACR 2024 in DC that seems familiar. Maybe for some, it’s the half-smoke hot dogs that DC is famous for, maybe for others it’s something else (as an Australian, who am I to say). Sometimes ACR Convergence can have little overtones of Groundhog Day, living the same story over and over.
The path to new technologies in rheumatology must be beset with caution

Jun 20, 2024 | rheumnow.com | David Liew

Sometimes it feels like we live in an antiquated bubble. We examine from the right side of the patient’s bed and we use Latin abbreviations to give critical instructions about our medicines, for no strong reason apart from the reason that we hav always done it that way. It served our rheumatological forefathers well, and as the rightful torchbearers of the legacy of Osler and Heberden, we look at our whole craft built around this and see no good reason to dispose of this.
Choices in GCA | RheumNow

Jun 17, 2024 | rheumnow.com | David Liew

It has been easy over time to presume that all advanced therapies in a disease area will work as well as each other. We have been so used to the idea that all b/tsDMARDs in rheumatoid arthritis are as effective as each other, given enough time, and that they all modify the disease to prevent the disability that we had become used to. It’s hard to change our thinking to be any different. Similarly, in psoriatic arthritis, the arthritis scores have been hard to separate between the different agents.
The art of talking about risks with our patients

Jun 11, 2024 | rheumnow.com | David Liew

On the first day of EULAR 2024, I am debating Janet Pope. To make it more challenging, it’s about JAK inhibitor safety, and I have been allocated to argue against the regulatory safety warning and the randomised controlled trial that supports it. It’s a challenge, but one that has really given me an opportunity to reflect more broadly. There are many things which are problematic about the regulatory safety warning, a number of which I didn’t put together fluently in my mind prior to this.
Better than bemoaning regulation, we can tackle risk with our words

Jun 11, 2024 | rheumnow.com | David Liew

On the first day of EULAR 2024, I am debating Janet Pope. To make it more challenging, it’s about JAK inhibitor safety, and I have been allocated to argue against the regulatory safety warning and the randomised controlled trial that supports it. It’s a challenge, but one that has really given me an opportunity to reflect more broadly. There are many things which are problematic about the regulatory safety warning, a number of which I didn’t put together fluently in my mind prior to this.
Clinical evaluation is critical for the implementation of artificial intelligence in healthcare: comment on the article by Mickley et al.

Feb 6, 2024 | acrjournals.onlinelibrary.wiley.com | Alix Bird |Christopher McMaster |David Liew |Alix Bird MBBS

Christopher McMaster FRACP, MBBS Department of Rheumatology, Austin Health, Victoria, Melbourne, Australia Department of Clinical Pharmacology and Therapeutic, Austin Health, Victoria, Melbourne, Australia Centre for Digital Transformation of Health and School of Computing and Information Systems, University of Melbourne, Victoria, Melbourne, AustraliaSearch for more papers by this author