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Anti-Rheumatic Rx

RECIPE Study: Non-opioid Analgesics following Total Hip Arthroplasty

Patients undergoing total hip arthroplasty using a combination of paracetamol, ibuprofen, and dexamethasone, had optimal responses with the lowest morphine consumption, and fewer adverse events.

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Pharmacologic Efficacy in Still's Disease

A systematic review of the effectiveness and safety of pharmacological treatments for adult-onset Still’s disease (AOSD) supports the use of either IL-1 or IL-6 inhibitors.

A metanalysis was performed using databases, trial

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Imaging-Only Diagnosis of Giant Cell Arteritis Is Feasible

Medpage Today

Positive findings with color Doppler ultrasound were enough to diagnose giant cell arteritis (GCA) accurately without need for confirmation with temporal artery biopsy (TAB), a prospective study indicated.

Out of 165 older patients in whom GCA was strongly suspected, 73 (44%) had the

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Featured BSR Abstracts (5.2.2024)

Dr. Jack Cush muses on the news, journal reports, FDA announcements and the 2024 BSR abstracts just released.

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ARCTIC Rewind: Can You Taper DMARDs with Remission? https://t.co/5Mkdyt4DIK https://t.co/0Z2gVpjIgX
Dr. John Cush @RheumNow( View Tweet )

Lower Limb Muscle Mass Influences Osteoarthritis Risk

The Rotterdam study shows that weight-bearing recreational physical activity caused more incident knee osteoarthritis (KOA), but mainly when there was low muscle mass. KOA risk is traditionally linked to either obesity or injury. This study assesses whether muscle mass may influence

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Methotrexate Does Not Increase ILD Risk in Dermatomyositis

A cohort analysis of dermatomyositis (DM) patients starting immunomodulators finds that methotrexate use was not associated with an increased risk of interstitial lung disease (ILD).

ILD affects ~23% of DM patients and the oft used MTX is has a low risk of pneumonitis and pulmonary

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Systemic Inflammation and Mortality in RA-ILD

Analysis of the German RABBIT registry shows that systemic inflammation, more so than disease activity, strongly influences all-cause mortality in patients with rheumatoid arthritis and prevalent interstitial lung disease (RA-ILD).

RA-ILD patients from the biologics register Rheumatoid

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Biomarker Predictors of Osteoarthritis

Science Advances has reported that Duke University researchers have validated a biomarkers of osteoarthritis that may be identified 2 years before the appearance of radiographic OA.  Six peptides (biomarker) demonstrated an AUC 77% probability of successfully predicting knee

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ARCTIC Rewind: Can You Taper DMARDs with Remission?

In an open-label, randomized, non-inferiority trial, rheumatoid arthritis patients in remission were subject to tapering of disease-modifying antirheumatic drugs (DMARDs), and while maintenance of remission was seen in some, many DMARD tapering patients did flare and were unable to maintain

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TLR Antagonist in Lupus

Medpage Today

An investigational Toll-like receptor (TLR) antagonist was effective in reducing biomarkers and clinical symptoms of systemic lupus erythematosus (SLE) in a pilot trial, evidence that the innate immune system may hold the key to lupus pathophysiology.

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Rheum Chapter Notes (4.26.2024)

Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.

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Predicting Infection in Lupus Nephritis

Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN. 

This study analyzed 111 non-infected LN patients, 72 infected LN patients, and 206 healthy controls (HCs), looking at patient

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Predicting CKD Outcomes in Lupus Nephritis

An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.

A multicentre observational study of patients with biopsy-proven LN; either proliferative (PLN) or membranous (MLN) lupus nephritis were compared regarding

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Self Acupressure in Knee Osteoarthritis

A clinical trial has shown that self-administered acupressure (SAA) is effective in relieving knee osteoarthritis (KOA) patients.

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High risk medications for pregnancy: MTX- 40% pregnancy loss, 6-10% birth defects MMF/CYC - 40% pregnancy loss, 25% birth defects Recommend 2 forms contraception on MMF Change meds slowly to safe Rx and monitor disease activity at least 3 mos before pregnancy #RNL2024 @RheumNow

Dr. John Cush @RheumNow( View Tweet )

Canary in a Coal Mine (4.19.2024)

Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.

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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes

A population-based cohort has demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients with type 2 diabetes (T2D). 

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Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
Dr. John Cush @RheumNow( View Tweet )
This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs In AC&R https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
ACR_Journals @ACR_Journals( View Tweet )
Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
Dr. John Cush @RheumNow( View Tweet )

Burnout or Retire (4.12.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?

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World Congress on OP, OA & MSK Disorders

EurekAlert!

Bone and musculoskeletal disease researchers and physicians from around the world will meet today in London, UK for the opening of the largest scientific event in the field, the World Congress on Osteoporosis, Osteoarthritis and

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Neuropsychiatric SLE - 2/3 Improved at 12 Months

The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data. 

A retrospective cohort study identified 350 NPSLE events (between 1999-2015) defined by ACR definitions and categorized as being:

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JAMA: SLE Review

Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.

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