Tuesday, 15 Oct 2019

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Stress and the Risk of Incident Inflammatory Arthritis

A prospective analysis of newly diagnosed, inflammatory arthritis (IA) patients suggests that perceived distress (stress) increases the odds of incident IA.

Hydroxychloroquine Blood Levels May Predict Future Retinopathy

A study of 527 patients receiving daily hydroxychloroquine (HCQ) concluded that hydroxychloroquine blood levels may predict future HCQ retinopathy.

This study assessed whether lower HCQ dosing, as recommended by the 2016 American Academy of Ophthalmology (AAO) guidelines (less than 5 mg/kg), would favorably affect retinopathy outcomes.

Juvenile Arthritis at Risk for Coronary Artery Disease

Arthritis Care & Research reports that juvenile arthritis (JA) patients may have a higher risk if coronary artery disease (CAD) in adulthood. 

Data was drawn from the National Health and Nutrition Examination (2007‐2014).  The diagnoses of JA and CAD were self declared by respondents.

RheumNow Podcast – When You’re Hot You’re Hot (10.11.19)

Dr. Jack Cush delivers select commentary on select news and journal articles from the past week on RheumNow.com.

Long Delays for Inflammatory Arthritis Patients

The National Rheumatoid Arthritis Society's (NRAS) annual audit has identified significant treatment delays for patients with suspected early inflammatory arthritis could result in unnecessary harm. 

Sprifermin Benefits Cartilage Loss but not Symptoms in Knee Osteoarthritis

Intra-articular sprifermin given to patients with symptomatic and radiographic knee osteoarthritis has been shown to significantly improve total femorotibial joint cartilage thickness after 2 years, but without significant clinical benefits. Which begs the question, why is there a disconnect between radiographic disease modification (cartilage thickness) and symptomatic improvement?

Declining Trends in Antineutrophil Cytoplasmic Autoantibody–Associated Vasculitis Mortality in the USA

Annals of Internal Medicine reports that age-adjusted mortality rates for antineutrophil cytoplasmic autoantibody–associated vasculitides (AAV) have improved over time - with a decline of nearly 2 percent per year in the United States from 1999 to 2017. Nevertheless, long-term outcomes continue to lag behind mortality rates of the general population.

Bisphosphonates and the Risk of Osteonecrosis of the Jaw

Even though oral bisphosphonates are widely used, there is an inordinate concern over the risk of osteonecrosis of the jaw (ONJ). A new UK study suggests that the risk of ONJ is elevated six fold by the use of biphosphonates.

Biologics Lead the Way in Drug Price Increases

Reuters has reported the results of a recent Institute for Clinical and Economic Review (ICER) analysis showing that biologics, especially Humira and Rituxan, are leading the way in the cost of drugs in the USA. All told, Humira and Rituxan topped a list of seven treatments whose combined 2017 and 2018 price hikes accounted for a $5.1 billion increase in U.S. drug spending. ICER said their analysis points to price hikes that were more than twice the rate of medical inflation and were not warranted by any new clinical evidence.

Serum Interferon Predicts Lupus Flares

Elevated serum levels of interferon-α among patients whose systemic lupus erythematosus (SLE) was in remission helped predict future disease flares, European researchers found.

Among 254 SLE patients who were in remission, 26% had abnormally high serum levels of interferon-α at baseline, according to Alexis Mathian, MD, of Pitié-Salpêtrière Hospital in Paris, and colleagues.

FUTURE 5 - Secukinumab and Less Radiographic Progression in Psoriatic Arthritis

The FUTURE 5 trial studied the effect of secukinumab (SEC) on radiographic progression through 52 weeks in patients with active psoriatic arthritis (PsA) and found that SEC was clinically and radiographically superior to placebo (PBO). Patients received s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. The majority (87%) of patients enrolled at baseline remained in the study for 52 weeks.

Antibiotics Increase Rheumatoid Risk - Again

Another UK study has suggested that prior use of antibiotics increases the risk of developing rheumatoid arthritis (RA).

Rheumatology has published a 15 year case–control study that compared 8482 newly diagnosed RA patients and 22,661 controls from the UK’s Royal College of General Practitioners Research and Surveillance Centre database (between 2006 and 2018).