Tuesday, 17 Jul 2018

Today's Headlines

Trend Towards Fewer Self-Employed Physicians

 

A nationwide survey study analyzed healthcare provider (HCP) employment type (self-employed, employed by private sector, or employed by government) and annual labor earnings (2001 to 2015) and found that the health care landscape is changing with few self-employed practitioners and more being larger organizations. 

The RheumNow Week in Review –Fateful Outcomes in Rheumatology (7.13.18)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Fateful outcomes in Rheumatology, what happens to Seronegatives, IL-23 fails, MRI progression, Not all inflammatory back pain becomes SpA:

The Diverse Fate of Seronegative Rheumatoid Arthritis

A Finnish Rheumatology Center followed 435 early, seronegative rheumatoid arthritis (RA) patients for 10-years and found that only 3% became erosive or seropositive RA. They also found that 32% could not be further reclassified, and that the remaining 65% evolve into another diagnosis, led by polymyalgia rheumatica (16%), psoriatic arthritis (11%), spondyloarthritis (9%), and osteoarthritis (10%).  

Defining Refractory RA by Biologic Use

A study from the  British Society for Rheumatology Biologics Register (BSRBR) has shown that biologic refractory disease is seen in at least 6% of patients who have ever received a biologic DMARD (bDMARDs).

Nailfold Capillary Density Predicts Dermatomyositis Lung Involvement

In patients with juvenile dermatomyositis (DM), an association was seen between low nailfold capillary density and pulmonary involvement, European researchers reported.

Liver Disease Increased in Psoriasis

An observational case-control study has shown that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD).

A single center, outpatient dermatology clinic studied 151 patients with psoriasis and 51 control subjects with ultrasonography to diagnose NAFLD.

A video matrix of the best moments and findings from our coverage of EULAR 2018 in Amsterdam
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The word “access” is thrown around a lot these days, particularly regarding health care and specifically, prescription medications. Access to medications essentially revolves around two things: availability and affordability. Immediately, pharmaceutical manufacturers come to mind, as they are responsible for production and setting the list price. However, ultimate availability and affordability of medications is shared with another entity. The final arbiter of access is the Pharmacy Benefit Manager. Their power resides in the fact that they control the formulary and determine the “preferred drugs” list. How does this relate to the uptake of biosimilars?

The antiphospholipid syndrome (APS) is a common disorder affecting patients with and without autoimmune disease. Despite wider recognition of APS among physicians as well as the expanding research collaborations, many clinical questions are still encountered in clinical practice, which require further evidence-based studies. In this “Across the Table” edition, Drs. Cush and Erkan discuss some of these APS-related questions. Our guest expert, Dr. Doruk Erkan offers up his approach to diagnosis and management of APS.

A new patient came in today; he noted that he made an appointment with me after reading a favorab

Everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.

Just last week, I went to a doctor’s retirement party. It was festive, with honors and ribbing for the lucky one, but there was an asterisk to his milestone. Retirement was not anticipated or planned for. What is your retirement plan?
Which cytokine do you think is most important in the pathogenesis of Still's Disease (SJIA)?
Dr. Olga Petryna at EULAR 2018 - Biologics Don't Affect Infection with Arthroplasty
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