Wednesday, 25 Apr 2018

Today's Headlines

Lupus Subgroup Responds to Anti-CD22

The monoclonal antibody epratuzumab showed promise as a B-cell depleting agent in patients with concomitant systemic lupus erythematosus (SLE) and Sjogren's syndrome, a post-hoc analysis of two phase III trials found.

FDA Review: Take Two for Baricitinib

FDA staff remain worried about the safety of baricitinib, an oral JAK inhibitor intended for treatment of rheumatoid arthritis, according to briefing documents prepared for an advisory committee meeting on Monday.

Will Aspirin Cotherapy Undermine Celecoxib’s Safety Effects?

The PRECISION study took 11 years and 24,081 patients (90% OA; 10% RA). It showed that celecoxib had fewer gastrointestinal events, fewer renal events and less ATPC cardiac events compared to ibuprofen - with an 18% reduction in major CV events and a 32% reduction in all-cause mortaility compared to ibuprofen.

The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

Dr. Jack Cush reviews the news and journal reports from the past week on  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

Wear Your Pajamas to Work for Lupus

I suspect that everyone in rheumatology has a special place in their hearts for lupus patients. Their disease is so cruel, and we have so little to offer them, but the young women (and some men) that I treat keep battling on. The longer I have cared for them, the more I wanted to do for them. Managing their illness alone did not seem like enough. 

Tobacco Associated Deaths in the USA

JAMA Internal Medicine reports that in the USA, those who smoke cigar, pipe, or cigarette have a significant overall  mortality risk, and a much highers cancer mortality risk compared to nonsmokers.

The National Longitudinal Mortality Study collected baseline survey data from 1985 through 2011 and included 357,420 participants reporting on their use of cigar, pipes, or cigarettes.


Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub!  This is their light-hearted, gender biased debate on the best patients: Men vs. Women.

A gal with rheumatoid arthritis moved to my town and has transferred her care to me. Despite having RA for 3 years and swollen joints at the last three visits, she has taken surprisingly few effective drugs thus far.

On this visit I declared my concerns for her future health, especially if we didn’t make significant changes in therapy. So I recommended she start a new drug. She asked several good questions, then stated she wanted to go home and think about this further and she would get back to me with her decision.

But wait, that’s what she said at her last visit 2 months ago!  

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so that the therapy you may prescribe can make a difference in their life.

Sasha D just doesn’t like me.  I’ve seen her four times in the clinic, and each visit was a tense battle of misunderstandings, with both of us leaving dissatisfied or worse. The failing wasn’t in the diagnosis, but rather the malalignment of our goals and inability to listen. Despite my efforts, my words, the diagnoses and treatment suggestions haven’t been well received.  

Recently, I was invited to apply for an open seat on the American Board of Internal Medicine (ABIM), the large organization that certifies physicians in the United States. Part of the process is to write a personal statement on my views of the ABIM mission and what I would like to accomplish. 


Dr. Bevra Hahn: Lupus and Physician Burnout
Dr. Bevra Hahn discusses lupus and physician burnout at the 2018 RWCS meeting in Maui.


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23 FDA Approved Biologics for Use in Rheumatology