Wednesday, 17 Oct 2018

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Update on Immune Checkpoint Inhibitor Toxicity

JAMA has a 2018 update/review of the safety issues seen with mmune checkpoint inhibitors (ICIs) - important new cancer therapies, with 14 cancer indications, that have significantly improved survival in several. ICIs are monoclonal antibodies that block inhibitors of T-cell activation and function.

Apremilast Succeeds in Scalp Psoriasis

Celgene has announced results from the phase 3 STYLE study, showing apremilast yielding significant improvement in moderate-to-severe scalp psoriasis. STYLE is a phase 3, multicenter, randomized, placebo-controlled, double-blind study evaluating the efficacy and safety of apremilast in subjects with moderate to severe plaque psoriasis of the scalp. The study enrolled 303 people who were randomized 2:1 to receive apremilast 30 mg twice daily or placebo for the first 16 weeks.

IL-6 for Adult Still's: A New Option?

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.

Hip and Knee Replacements Monitored by Smart Watch

Reuters reports that patients with hip or knee replacements will now be followed for progress using their Apple watches.

A multi-site study involving medical facilities from Massachusetts, California, Colorado and Michigan will receive stats including heart rate, steps taken and standing hours from patients waiting for or recovering from hip and knee replacement surgery.

RheumNow Week in Review – Four Fingers are Best (10.12.18)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. New info on scleroderma-SLE overlap, nailfold capillaroscopy, Women with SpA, acute gout management and lupus patient in pain who visit the ED.

Teenage Obesity Increases Lupus Risk

Analysis of the Black Women's Health Study shows that obesity as a teenager may be associated with increased risk of systemic lupus erythematous (SLE) in adulthood.

The relationship between obesity and SLE risk is unclear. Past studies have predominantly assessed white women, while black women have higher prevalence of both obesity and SLE.

SLE-Scleroderma Overlap Outcomes

Overlap of autoimmune disorders represents a significant diagnostic and management challenge to the rheumatologist. A novel cohort analysis of overlap between systemic sclerosis (SSc) and systemic lupus erythematous (SLE) suggests such patients tend to be younger, more frequently have PAH, but less cutaneous manifestations of SSc.

NSAIDs OK for Certain High-Risk Groups?

Some patients typically contraindicated for prescription nonsteroidal anti-inflammatory drug (NSAID) use may be able to take them with no increased risk of harm, according to a large observational study.

Complex Pain Syndromes in the Emergency Room

Emergency physician Chris Hahn, MD, doesn't have any trouble conjuring a simple definition of fibromyalgia. "Just think about the most annoying chief complaints you can imagine. That's the diagnostic criteria."

Physical Therapy Equals Arthroscopic Surgery in Meniscal Tears

Several new trials suggest that conservative management may be as efficacious as arthroscopic surgery in patients with meniscal tears, thus contributing to the trend of fewer arthroscopic surgeries. A new trial of patients with nonobstructive meniscal tears shows no significant difference in 2 year outcomes between physical therapy and early arthroscopic partial meniscectomy.

Allopurinol Shown to be Renal Protective

Neogi and colleagues have shown that standard doses of allopurinol (300 mg/day) were associated with a 13% lower risk of renal function deterioration in chronic gout patients - thus, allopurinol does not appear to impair renal function over time.

Carpal Tunnel Syndrome - a Leading Cause of Work Related Disability

MMWR reports that workers’ compensation claims for carpal tunnel syndrome (CTS) in California during 2007–2014 were 6.3 per 10,000 full-time equivalent workers, with female workers and workers in industries that manufacture apparel, process food, and perform administrative work being at highest risk for CTS.