Friday, 25 May 2018

Today's Headlines

Measures of Opioid Misuse Predict Future Opioid Overdose and Death

The current issue of Annals of Internal Medicine examines patterns of potential opioid misuse that are associated with subsequent adverse outcomes nationally.

Researchers analyzed a 5% sample of Medicare beneficiaries who had an opioid prescription, without a cancer diagnosis.  Specifically the sought to correlate a diagnosis of opioid overdose with other measures of opioid misuse including:

MPO Antibodies Predict Relapses in MPO-ANCA-Associated Vasculitis

A study of MPO-ANCA positive patients followed serially over 2 years shows that reappearance of MPO‐ANCA may predict  relapse in patients with MPO‐ANCA positive AAV and that routine MPO‐ANCA monitoring is warranted. 

This study aimed to establish a potential link between myeloperoxidase (MPO)‐antineutrophil cytoplasmic antibody (ANCA) and relapse in those with ANCA‐associated vasculitis (AAV). 

FDA Approves Denosumab for Glucocorticoid-Induced Osteoporosis

Amgen announced that the U.S. Food and Drug Administration (FDA) has approved the use of Prolia® (denosumab) for the treatment of glucocorticoid-induced osteoporosis (GIOP) in men and women at high risk of fracture, defined as a history of osteoporotic fracture, multiple risk factors for fracture, or patients who have failed or are intolerant to other available osteoporosis therapy.

ACR Leaders Lobby Capitol Hill for Help on Rising Costs and Access Barriers in Arthritis Care

Rheumatologists and rheumatology health professionals convened on Capitol Hill this week to urge legislative action on pressing policy issues affecting rheumatology care during the American College of Rheumatology’s Advocacy Leadership Conference, held May 16 -17, 2018 in Washington, D.C.

Autoinflammatory Syndromes Show Dramatic Response to Canakinumab

The New England Journal of Medicine reports that the anti-interleukin (IL)-1β monoclonal antibody canakinumab (Ilaris) was effective in the treatment of three distinct autoinflammatory recurrent fever syndromes (FMF, TRAPS, HIDS) with responses that were far superior to what was seen with placebo on almost every outcome measure, a randomized study found.

The RheumNow Week in Review – Modifiable Behavior (5.18.18)

Dr. Jack Cush reviews the news and journal articles from the past week on  He discusses opioids, new approval for polyarticular JIA, running and osteoarthritis, and modifiable behaviors that influence outcomes. 


Leadership positions in medicine are disproportionately filled by men. Although the enrollment of medical schools are equal male: female or even some have more women, 40% of American medical institutions lack programs for recruiting women, or for retention and promotion of female faculty.

This may also be true in rheumatology, which is now attracting more women than men as trainees. I recently wrote an article in the Lancet about mentoring women in medicine and suggested ideas for improving the gender gap in leadership.  

Just because it’s busted, it doesn’t mean you have to fix it.  At some point, it’s important to know when to leave “good-enough” alone. Such is the story of the "busted valise" and what to do about it.

Three years ago we published our first edition of RheumNow. We have something - and someone - to celebrate. Surprise, Dr. Jack Cush - this one’s for you! 

Everyone wonders how he does it. Vision. Drive. Determination. Unwavering resolve. Strength of purpose. Commitment - day in, day out. Willing to take risks. Unwilling to settle. All these, yes, but also this: passion, heart and soul.

In celebration, we asked a few of his colleagues to share their remarks about this important milestone. Without further ado…

The introduction of a guest or speaker should be simple, functional and respectful. In the least, it should go something like, “I have the honor of introducing our speaker, Dr. John Brown, who comes to us from Brown University, where he is the Chief of Internal Medicine. Today he’s going to lecture on “the right way to lecture”. 

However, no one does this. Instead most try to do more, usually with knowledge gaps, and end up delivering incomplete, awkward or bad introductions.   

Introductions tend to either be awkward or great.  

I tell my patient’s that I empathize with them. I understand that they do not want a rheumatologic condition, nor do they want to take our medications and are disheartened when I tell them that we have no cures. But, if we flip that proverbial coin over, my goal for their care is to improve their quality of life.

In rheumatology, we have many ways to accomplish that goal for our patients; from medication management to advocacy and support groups for patients and loved ones. But what are you doing at work or home to improve YOUR quality of life and the lives of those around you?

Dr. Uma Mahadevan: Gastroenterology Update
Dr. Uma Mahadevan discusses gastroenterology pearls at the 2018 RWCS meeting in Maui.


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Rare Risk of Colitis with IL-17 Inhibitors