Wednesday, 21 Nov 2018

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MMWR: Death by Firearms

The CDC's Morbidity and Mortality Weekly Report (MMWR) reports that during 2015–2016 there was a total of 27,394 firearm homicides and 44,955 firearm suicides among US residents, with 12% and 5% of events occuring in children 10–19 years.

CIRT Trial - Methotrexate Fails at Cardiovascular Prevention

Methotrexate has been shown to reduce cardiovascular (CV) deaths in rheumatoid arthritis (RA) patients. Given that inflammation underlies the pathogenesis of atherothrombosis, Dr. Paul Ridker and colleagues studied the value of low dose methotrexate (MTX) in preventing cardiovascular events.

RheumNow Weekly Podcast – 3 Wiseguy Rheumatologists (11.9.18)

Dr Jack Cush reviews the News and Journal reports from the past week on RheumNow.com.  Be sure to check out our upcoming meeting in March 2019 - RheumNow Live.

Intensive Patient Education Does Not Improve Low Back Pain Care

JAMA reports on a randomized clinical trial of 202 adults with acute low back pain showing the addition of intensive patient education failed to improve pain outcomes.

This randomized, placebo-controlled clinical trial recruited patients from general practices in Sydney, Australia, between 2013 - 2015. Patients had to have acute low back pain of fewer than 6 weeks’ duration. 

E/M Guidelines: Right Road, Wrong Direction

Last July, the Centers for Medicare & Medicaid Services (CMS) proposed new E/M guidelines for office visits with physicians. It issued the final guidelines on November 1, with a few tweaks. Implementation was delayed until 2021 (from 2019), possibly due to overwhelming opposition from physicians.

Should Immunoglobulins be Monitored with Rituximab Use?

Boston researchers have found that in a large cohort study of patients receiving rituximab (RTX), most were not being monitored for hypogammaglobulinemia, despite the observed significant increase in severe infections and increased mortality in RTX treated patients.

Musculoskeletal Events with Statin Use

Analysis of the FDA Adverse Event Reporting System data examined the association between statins' musculoskeletal adverse events (MAEs).

Review of the data shows that atorvastatin and rosuvastatin (with strong low‐density lipoprotein cholesterol‐lowering effects) had a higher risk and a faster onset of MAEs when compared with simvastatin.

They could not detect whether concomitant drugs shifted the onset timing of MAEs. 

Guidelines for Patellofemoral Pain

New recommendations have been published in the Journal of Athletic Training on the management of patellofemoral pain (PFP).

IgG4-Related Disease: First Draft Criteria Presented at ACR 2018

As Dr. John Stone, MD, MPH recounted in his presentation regarding the new ACR/EULAR Classification Criteria for IgG4-Related Disease (IgG4-RD), only 15 years prior, IgG4-related disease was an unknown entity in the medical community.

Low Short-Term Risks of NSAIDs in High Risk Patients

JAMA has published a large Canadian claims-based study showing that nonsteroidal anti-inflammatory drug (NSAID) use in patients with hypertension, heart failure, or chronic kidney disease was not associated with a significant safety risk - but this only looked at short-term outcomes (7-37 days of exposure). 

Controversial New Super Opioid Approved by FDA

Amidst a new DEA report demonstrating a record number of opioid overdose deaths (n-72,000 or ~ 200 deaths per day), the FDA has approved a newer and far more potent opioid than those that are currently being abused at alarming rates. The new agent is named Dsuvia.

Late Breaker: Can Tanezumab Be Revived for OA?

The monoclonal antibody tanezumab, which blocks nerve growth factor, showed significant benefits in pain and function among patients with osteoarthritis (OA) of the knee or hip, and rates of severe adverse joint events such as rapidly progressive OA that had plagued earlier studies were low, a researcher reported at the annual meeting of the American College of Rheumatology in Chicago last week.