Tuesday, 24 May 2016

Today's Headlines

ORBIT Study Shows Rituximab and TNF inhibitor Equivalence

The initial choice of biologic is crucial to long-term success. Yet there are few studies evaluating head-to-head differences in some of our most popular therapies.

RheumNow Week in Review - 19 May 2016

Dr. Jack Cush reviews this week's news and research highlights from RheumNow.com.

FDA Delays Ruling on Generic Labeling

The New York Times reports that the FDA has delayed its much anticipated ruling on generics until sometime in 2017. 

Musculoskeletal Complications of Hematologic Disorders Reviewed

Morais and colleagues have published an informative review of rheumatologic and musculoskeletal (MSK) disorders that may potentially befall those with benign or malignant blood disorders. It is important to be aware of these associations. In some instances, the MSK manifestation may be the first sign of a hematological disorder. 

GWAS Reveals Shared Susceptibility Locus Between RA and SLE

While the phenotypes of RA and SLE are quite different, genome-wide association studies (GWAS) performed in the past have shown a genetic overlap between both.

Gene expression studies have revealed common molecular mechanisms involved in the pathogenesis of these two conditions, which may explain a phenomenon of RA/SLE overlap, commonly known as rhupus.

Risk Factors for Bisphosphonate Bone Complications

Rare reports of bisphosphonate associated atypical femoral fractures (AFF) and osteonecrosis of the jaw (ONJ) have raised concerns about the chronic use of bisphosphonates. The risk of AFF and ONJ was assessed in an analysis of the Swedish national database.  

Reports Call for More Gout Education

Two recent surveys show that gout patients are often uninformed, undertreated, improperly monitored and frequently stigmatized by their gout.

The Gout & Uric Acid Education Society (GUAES) has done an online survey of 1000 Americans and 103 gout patients and shown that nearly 90% of patients view gout as a "major inconvenience" and worrisome.


What do you call it when you say one thing and the listener hears something else?

What are the questions patients should ask their doctors about biologics? Are there rules for starting and stopping biologics? Patients need to educate themselves about their condition and their medications, and know that the best education on biologics should not be television ads, 4-page pharmacy printouts or the multi-folded, microprint package insert. 

Upon reading the title of a recent news item - 'Medical error is the third leading cause of death in the US' - a feeling of apprehension and dread arose. Very quickly, my worst fears were realized.

Biologics are big. Their popularity is reflected in their growing use since being introduced in 1998. Biologics have been used by more than 3 million patients worldwide. In 2013, Enbrel, Remicade and Humira accounted for nearly $30 billion in worldwide sales. In the USA, it is estimated that we will spend $220 billion on biologics by 2017. 

Rheumatology is fortunate to have many "key opinion leaders" (KOLs) to teach, study, synthesize and pave the advances in our discipline.  Who are these KOLs and how can we tell them apart? 

Why do we use TNF inhibitors as our first biologic choice?  Is it the evidence of efficacy, access, safety, and drug retention, or is it a prescriber habit that merits critique?  

Dr. Jack Cush provides a perspective on the first year anniversary of RheumNow.com - a site dedicated to delivering the wisdom, art and science of Rheumatology. 

Dr. Rafid Asfar: Granulomatosis with polyangiitis presenting as an eye mass
Dr. Arthur Kavanaugh interviews Dr. Rafid Asfar about his abstract on granulomatosis with polyangiitis presenting as an eye mass as presented at the 2016 Rheumatology Winter Clinical Symposium.

Daily Download

Patient Guide to Biologics

Overview of Biologics for patients - how they work, side effects, how given, etc


Which of the following CME Rheumatology meetings (other than the ACR annual meeting) do you prefer to attend?