Friday, 18 Jan 2019

News

RheumNow Podcast – FDA Panels Meet on Gout & OP (1.18.19)

Dr Jack Cush Reviews the news, articles and FDA Panel discussions from the past week

Does Methotrexate Work in Giant Cell Arteritis?

There seems to be both hope and uncertainty regarding the use of weekly methotrexate (MTX) in giant cell arteritis (GCA) patients whom need to limit their glucocorticoid use. While well done clinical trials have shown no certain efficacy, data suggesting MTX benefits comes from small trials, anecdotes and clinical experience. 

FDA Panel Backs Approval of Romosuzumab for Osteoporosis

The US Food and Drug Administration’s advisory committee on Bone, Reproductive and Urologic Drugs voted Wednesday in favor of approving Amgen’s osteoporosis anti-sclerostin drug, romosozumab (Evenity) for use women with postmenopausal osteoporosis. 

Reuters reports that the panel voted 16-1 in favor of the monthly injection developed jointly by UCB.

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.