Monday, 22 Jan 2018

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Bone Marrow Edema May be Found in Normals, Athletes and Military Recruits

Rheumatology has published a study demonstrating that bone marrow edema as measured by magnetic resonance imaging (MRI) may be found in healthy people, but that such changes do not change with intense physical activity.

MEASURE 3 Study - Anti-IL17 Benefits Persist in Spine Disease

Patients with ankylosing spondylitis (AS) have shown rapid and sustained responses to secukinumab (Cosentyx) in a third phase III trial that includes a higher dose of this anti-interleukin-17A monoclonal antibody, researchers reported.

New BSR 2017 Gout Guidelines (Best of 2017)

The British Society for Rheumatology/British Health Professionals in Rheumatology first published a guideline for the management of gout in 2007. They have just updated and published their new guideline, largely because of new therapies, an increasing incidence of gout, low penetrance of urate lowering therapies, and the inability to achieve a target serum uric acid level.

Therapeutic Update: 5 Questions on FDA Hearing for Tofacitinib in PsA (Best of 2017)

In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Stroke Risk Highest in the First Year of Lupus (Best of 2017)

Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

Death Rates from Lupus Remain Disproportionately High (Best of 2017)

The Annals of Internal Medicine reports that despite improving trends in mortality, death rates from systematic lupus erythematosus (lupus) remain high compared to those in the general population, and disparities persist between subpopulations and geographic regions. Underreporting of lupus on death certificates may have resulted in underestimates of mortality rates. 

The RheumNow Week in Review - 22 December 2017

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

Allopurinol Dose Escalation is Safe with Severe CKD

Hypertension, nephrolithiasis and chronic kidney disease (CKD) commonly associates with gout.  While there is a clear need to dose adjust NSAIDs and colchicine in those with CKD, there is some debate about the need to dose adjust when using allopurinol with CKD.

Risk of Gout Onset and Flare Linked to Urate Levels

Serum uric acid (SUA) levels are clearly linked to gout. Researchers from Harvard have systemically reviewed the literature to quantify the risk of onset and flare with varying levels of SUA.

Literature review identified 8 eligible articles reporting gout incidence and 18 articles reporting recurrent gout rates in the context of SUA levels.

Cannibis Weakly Effective in Neuropathic Pain

The medical use of cannabis is often extended to management of chronic pain and neuropathic pain.

A metanalysis of 27 chronic pain trials show that there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations.

However, there was little evidence that cannabis can alleviate pain associated with multiple sclerosis, cancer, or rheumatic conditions.  

Cardiac Disturbances Increased in Spondyloarthritis

A prospective Swedish study between 2001–2009 found a higher risk of aortic regurgitation, pacemaker, AV block and atrial fibrillation in SpA, AS, uSpA and PsA patients.

Registry Efficacy of Rituximab in Refractory SLE

Despite large randomized trials failing to show the efficacy of RTX in SLE (LUNAR, EXPLORER), uncontrolled observational data suggests possible efficacy and safety of RTX in refractory SLE.