Friday, 15 Feb 2019

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Anakinra for Acute Crystal-Induced Arthritis

A retrospective analysis of hospitalized patients who also had a gout and pseudogout attack shows that injections of anakinra (interleukin-1 receptor antagonist) were highly effective and safe in nearly three-quarters of patients.  

Through a medical records search they found 100 patients and 115 episodes between 2014-2017 who were treated with anakinra for crystal arthritis. 

Febuxostat Gets Reprieve from FDA Advisory Panel

On January 11, 2019 the FDA convened two advisory panels (the Arthritis Advisory Committee [AAC] and the Drug Safety and Risk Management Advisory Committee [DSaRM]) to consider the cardiovascular safety of febuxostat (Uloric) based on the 2018 “Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) study. 

The Vote

IL-6 Blocker Succeeds in Real-World Vasculitis

Tocilizumab (Actemra) was effective for refractory giant cell arteritis (GCA) in real-world practice, although serious infections occurred relatively frequently, Spanish investigators reported.

Assessing the Performance of Aging Physicians

A JAMA Viewpoint article examines the performance of aging surgeons and notes that the effects of aging affects physicians variably and that physician competency should be based on functional age (and abilities) rather than chronologic age. This argues against a mandatory retirement age for surgeons.

Early Predictive Factors for Scleroderma Renal Crisis

It has been historically said that risk factors for scleroderma renal crisis (SRC) includes include cold exposure, steroid use, dehydration, rapid progression of skin disease, tendon friction rubs, anti-RNA polymerase III antibodies and pregnancy.  A new study examines risk factor for SRC at the onset and diagnosis in systemic sclerosis patients. 

Diet and Weight Loss Improves Psoriatic Arthritis

Short-term intervention with the very low energy diet (VLED) in psoriatic arthritis (PsA) with obesity (body mass index BMI ≥ 33 kg/m2) showed that weight loss was associated with significant positive benefits on weight and disease activity in joints, entheses and skin. 

Only One-Third of Gout Patients Receive Urate-Lowering Drugs

The most recent analysis of National Health and Nutrition Examination Survey [NHANES] 2007-2016) data shows the prevalence of gout to be 9.3 million in the USA.

Data from 5,467 participants from NHANES 2015-2016, finds gout in 3.9% or  9.2 million US adults.  This includes 5.2% [5.9 million] of men and 2.7% [3.3 million] of  women with gout.

RheumNow Podcast – Gout Spot Light (1.11.19)

Dr. Jack Cush discusses the highlights from the past week on RheumNow.com:

Heberden’s Nodes Predict Knee OA Progression

Hand and knee osteoarthritis are considered to be clinically and pathogenically different and distinct, but a new study suggests that Heberden's nodes (HNs) can predict MRI‐based knee osteoarthritis (OA) progression.

An NIH study of 575 subjects included clinical examination with evaluation of HNs at baseline and knee MRI at baseline and 24‐month.

NEJM Review - Glucocorticoid-Induced Osteoporosis

Lenore Buckley and Mary Humphrey have published a nice review of glucocorticoid-induced osteoporosis (GIOP) in the NEJM.

Price of Drug Promotion Skyrockets

JAMA reports that health care advertising costs in the U.S. have almost doubled over the past two decades, surging from $17.7 billion in 1997 to at least $29.9 billion in 2016. (Citation source: https://buff.ly/2Rk8a9Q)

Combo RA Treatment May Boost Risk for Serious Adverse Events

A current meta-analysis of safety and efficacy of combination bDMARD treatment in RA patients shows that combination treatments increase serious advese event (SAE) risks, and the risk for serious infections in particular.