Tuesday, 26 Jul 2016

Today's Headlines

Pravastatin Improves Obstetric Outcomes in Anti-Phospholipid Syndrome Patients

Pregnancy complications of anti-phospholipid syndrome (APS) have included recurrent abortions, spontaneous fetal loss, preeclampsia, and premature birth. The etiopathogenesis of these events has been presumed to be placental thrombosis or infarction.

Novel Rise of Combined Dermatology-Rheumatology Clinics

Rheumatology News has a novel online report about combined rheumatology-dermatology clinics.  In the last several years, there have been a few of these in operation (Boston, Chicago, Rhode Island).

RheumNow Week in Review – 22 July 2016

From tofacitinib developmental trials in RA and psoriasis and adherence to T2T in early RA to a rheumatology pearl about dapsone and much more, here are the highlights of what you may have missed on RheumNow.com this week.

FDA Panel Recommends Brodalumab Approval in Psoriasis

Valeant Pharmaceuticals International's experimental drug to treat psoriasis should be approved as long as certain measures are put in place to mitigate the risk of suicide, an advisory committee to the U.S. Food and Drug Administration concluded on Tuesday.

Epigenetic Changes to Inflammasome Found in Autoinflammatory Syndromes

The gene mutations underlying inflammasome activity have been well described, but there appears to be variable penetrance among patients with the same gene mutation, suggesting additional mechanisms may influence disease expression.

Little Evidence Favoring the Health Benefits of Vitamin D

Vitamin D certainly plays a pivotal role in bone health and immune function. However, vitamin D (especially its deficiency) has been casually observed to be associated with numerous conditions (cancer, multiple sclerosis, depression, respiratory tract infections, immune disorders), poor outcomes and bothersome symptoms.

DEXA Still Needed While on Bisphosphonates

Reuters reports that a study of 6629 Canadian women with osteoporosis taking bisphosphonates found that nearly one in five had a decrease in bone density while on medication. (Citation source: http://buff.ly/2afb7nj

The movie Moneyball is a David versus Goliath tale with the A’s (David) struggling to compete with Goliath teams like the Yankees. The movie pits hunch-driven “expertise” (convention) against a mathematic approach to decision making (Moneyball). Would you trust a big Whopper computer printout of next best drug(s) to give to Mrs. Hawking who has psoriatic arthritis and needs to start a DMARD? I believe most of you would huff and scoff at a formulaic or number-driven approach.

Experience is a great teacher. My experience with knee replacement surgery taught me the pivotal importance of the physical therapist in individual outcomes.

You know so much, and they have too much to learn, but limited time and few opportunities make it difficult to share information and fill that gap - especially in a way that will “stick” and be meaningful to the patient. When tempted to give patients 'a piece of my mind', here are some things to consider.

Despite an often fairly characteristic pattern of signs and symptoms, there are significant diagnostic challenges with polymyalgia rheumatica. The reason is that similar clinical features can be also observed in other diseases mimicking PMR, including infectious and malignancies, elderly-onset rheumatoid arthritis, giant cell arteritis, chondrocalcinosis or myositis, to mention some of the most important differential diagnoses.  

How many clues are needed for a rheumatologist to know something is wrong with the therapeutic soup he/she is trying to concoct?  One patient's tale leads to rethinking the RA treatment paradigm.

Nearly half of all available vacation days go unused and over 40% of Americans failed to use any vacation days in 2015. Common sense says that taking more time off (not less) is likely to lead to increased work productivity. Your next vacation is essential to building a better you. Here are some tips to insure you get the most from your time off.

Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.

Dr. Jonathan Kay - Biosimilars at EULAR

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What is the most important advantage of tofacitinib (Xeljanz) in treating RA?