Friday, 20 Jul 2018

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Vedolizumab Implicated in Exacerbations of SpA in IBD Patients

Beloved by gastroenterologist for treatment of inflammatory bowel disease (IBD), α4β7 integrin receptor vedolizumab (VDZ) has probably caught attention of many rheumatologist since the time it entered the market; largely for what it won't do for inflammatory arthritis.

JAK Inhibition in Autoinflammatory Syndromes Interferonopathies

While many autoinflammatory syndromes are driven and managed with select inhibition of IL-1, IL-18 or IL-6, a subset are driven by type I interferon and are referred to as interferonopathies. These monogenic IFN–mediated disorders present in infancy with fevers, systemic inflammation, an IFN response gene signature, inflammatory organ damage, and high mortality.

TNF Inhibitors Don't Increase Cancer Risk in Children

While the risk of neoplasia with tumour necrosis factor inhibitor (TNFi) use has been largely nullified in most inflammatory disorders, this risk in children is less certain. However a recent study shows no risk of increased cancer in children treated with TNFi for juvenile idiopathic arthritis (JIA), pediatric inflammatory bowel disease (pIBD) and pediatric plaque psoriasis (pPsO).

The Microbiome and Lupus Connection Reviewed

In the current issue of the New England Journal of Medicine, Drs. James Rosenbaum and Gregg Silverstein review the pathogenesis of systemic lupus erythematosus (SLE) from the viewpoint of a dysbiolsis.

The complexity of the trillions of organisms that constitute our microbiome underscores its multiplicity of functions, including nutrient, metabolic and immune shaping functions.

Risk of Psoriasis Complicating TNF Inhibitor Therapy

A population-based study of claims data from Korea shows that among inflammatory bowel disease (IBD) patients receiving tumour necrosis factor inhibitors (TNFi) there is a 3.7 per 100 patient-year risk of paradoxically developing psoriasis - a rate that is roughly 3-fold higher than risk in TNFi-naive IBD patients.

Canada Closer to Marijuana Approval

Reuters reports that Canada’s Senate on Thursday voted to legalize recreational marijuana, clearing a major hurdle that puts the country on track to become the first Group of Seven nation to permit national use of the drug.

Now the law and amendments go to the House of Commons who will need to decide on before the law can be passed.

The RheumNow Week in Review – Baricitinib Splash (6.7.18)

Dr. Jack Cush discusses the past week's news and journal articles featured on RheumNow.com - including reports on advance practice clinicians, baricitinib, gout, disease activity, hypomagnesemia and upadacitinib.

Advance Practice Clinicians Proliferating in Specialty Practices

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

SPAR Predicts ILD Progression in Systemic Sclerosis

The development and progression of interstitial lung disease in systemic sclerosis can be an ominous finding. A new analysis of two independent clinical trial cohorts shows that oxygen saturation (SpO2) < 94% after 6 minute walk time (6MWT) and the presence of arthritis predicted the development of ILD in SSc.

Blacks Suffer When Pain is Poorly Defined

Racial discrimination was a key feature at a 2-day summit on pain management and the opioid crisis, hosted by the National Institutes of Health on Thursday and Friday.

Asheley Cockrell Skinner, PhD, of the Duke Clinical Research Institute in Durham, North Carolina, provided a broad overview of racial bias in opioid prescribing.

Prescription Drug Monitoring Programs Fail to Deter Opiate Abuse

A systematic review of prescription drug monitoring programs (PDMPs), advocated in the president's Prescription Drug Abuse Prevention Plan, fails to show evidence of efficacy in preventing nonfatal and fatal overdoses.

Low Disease Activity in Lupus Limits Damage

Patients with systemic lupus erythematosus (SLE) who were assessed as being in a low disease activity state during more than half of clinical visits had a decrease in organ damage events of approximately 50%, a retrospective study found.