Friday, 03 Apr 2020

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A Rheumatologist’s Tips: Telemedicine in 6 Easy Steps

Ready for telemedicine/telerheumatology? Once you and your patient agree on a virtual visit, the following suggestions may help facilitate the interaction. If you have the ability and the capacity, record the visit.

The COVID-19 Global Rheumatology Registry

As the highly virulent SARS-CoV-2 spreads over the world, uncertainty and fear for our patients with rheumatic diseases mount.  

As of March 17, 2020 over 183,000* cases of Coronavirus disease 2019 (COVID-19) have been recorded, with the majority in China and Europe, but that may be the tip of the iceberg. Many more cases likely exist that are undetected due to shortages in testing supplies.   

Rheumatic Disease Drugs and COVID-19

We are in the early stages of trying to limit the morbid and mortal consequences of the corona virus pandemic of 2020. Not surprisingly, the recommendations designed to limit exposure and damage continually highlight the fact that the elderly and immunosuppressed may be amongst the most severely affected should they become infected with this virus. This has led to a great deal of uncertainty by patients and providers about how rheumatic diseases and their treatments need to be specifically addressed.

In Vasculitis, Beware of Infection

Risks of infection were strikingly high among patients with antineutrophil cytoplasmic antibody-associated (ANCA) vasculitis, which may relate to both the disease and its treatment, Scottish researchers found.

RheumNow Podcast- Corona Increases RA Risk (3.13.20)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

Earlier Anakinra Initiation Warranted in Still's Disease

An Italian study examined the outcomes in adult onset Still's disease (AOSD) based on whether they received early or delayed treatment with anakinra (ANK). 

A total of 141 AOSD patients were retrospectively studied.

Overall, they found no differences in efficacy if ANK was started within 6 (or 12 mos) vs. thereafter.  

Switching Biologics in JIA

While there are numerous agents approved for use in juvenile idiopathic arthritis, little is know about actual use biological disease-modifying antirheumatic drug (DMARD) use or switching in the biologic era. A cohort comparison study has shown that after an unsuccessful trial of a first biologic, changing to a second TNFi is as effective as switching to a non-TNFi biologic.

Malignancies with Giant Cell Arteritis

The Journal of Rheumatology reports the findings of a Swedish population-based cohort study of biopsy-proven giant cell arteritis (GCA) patients showing that the overall risk for cancer was not increased; yet there appears to be an increased risk for leukemia and a decreased risk for breast and upper gastrointestinal tract cancers.   

EMA Final Recommendations on VTE Risk with Tofacitinib

On 14 November 2019 the European Medicines Agency (EMA) concluded that Xeljanz (tofacitinib) could increase the risk of blood clots in the lungs and in deep veins in patients who are already at high risk.  These recommendations have been formally published and are intended for EU nations utilizing tofacitinib.

Hospitalized GPA - Higher morbidity, Mortality and Cost

Rheumatology reports on a study of patients with granulomatosis with polyangiitis (GPA) showing worse outcomes and higher costs when hospitalized with GPA.

GPA patients were identified from the Nationwide Inpatient Sample (NIS) and were compared to those without GPA with regard to demographics, procedures, length of stay, mortality, morbidity and total hospitalization charges (between 2005–2014).

Diabetes in OA: Pain Is Worse

Among patients with knee osteoarthritis (OA), pain was greater for those with coexisting diabetes mellitus (DM), and this association was independent of obesity and radiographic severity, European researchers found. 

RheumNow Podcast - Despite Corona (3.6.20)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.