Thursday, 20 Sep 2018

News

Treatments Do Not Increase Infection Risk in Ankylosing Spondylitis

A large Canadian study of the drug use in ankylosing spondylitis (AS) demonstrated no evidence that the risk of serious,  hospitalized infection was influenced by the use of DMARD and/or of tumour necrosis factor inhibitors (TNFi) therapy.

They studied 747 AS patients who initiated TNFI and/or DMARDs between 2001 and 2011 to identify hospitalized infection  coding data and hospital discharge diagnoses.

Outcomes of Systemic Sclerosis Hospitalization

A study of inpatient systemic sclerosis (SSc) hospitalizations using the 2012–13 National Inpatient Sample database finds an inpatient mortality rate of 5%, and that infection was the most common cause of SSc hospitalizations and in-hospital death.

IL-12 and IL-23 Promote Giant Cell Arteritis

It has been postulated that TH1 and TH17 pathways are implicated in the pathogenesis of giant cell arteritis (GCA); this is supported by new research showing that interleukin 12 (IL-12) and interleukin 23 (IL-23) may stimulate inflammatory and proliferative pathways relevant to the pathogenesis of GCA.

Physician Conflicts Overlooked by Physicians

An analysis of Centers for Medicare & Medicaid Services Open Payments Database (OPD) shows a high level of inconsistency for physician self-declared conflicts of interest amongst physicians receiving the highest industry payments. These findings were unrelated to academic rank or productivity and industrial payments.

Dietary Recommendations for Psoriatic Disease

A systematic review by the Medical Board of the National Psoriasis Foundation examined the role of diet in managing adult patients with psoriasis and/or psoriatic arthritis and suggest that dietary interventions to reduce disease severity.

A metanalysis of 55 studies and 4534 patients with psoriasis examined the role of weight loss, gluten-free diets, vitamin supplementation on reducing psoriatic disease activity.

Health Secretary Azar Eyes Rebate Reform

Reuters reports that the U.S. Health and Human Services Secretary Alex Azar had declared his agency has the authority to eliminate rebates on prescription drug purchases, a key element in the administration’s plan to lower prescription medicine costs.

Azar has said rebates created a perverse incentive to continuously raise drug prices.

ACR Meets With HHS Secretary Azar to Discuss Step Therapy Concerns

Yesterday, the American College of Rheumatology (ACR) met with U.S. Department of Health and Human Services Secretary Alex Azar for a productive discussion about the rheumatology community's concerns with a new policy that will allow Medicare Advantage plans to utilize step therapy in Medicare Part B. In the meeting, the ACR expressed concerns that this policy would delay rheumatology patients' access to treatments.

The RheumNow Week in Review – We’re Number One! (8.17.18)

Dr. Cush reviews the articles and news from the last week on RheumNow.com. Information on comorbidities, the downside of steroids, unmet need in psoriatic arthritis, and the top 10 rheumatology programs.

Early Exposure to Passive Smoke May Up Risk for RA Later in Life

Exposure to second-hand smoke during childhood was associated with an increased risk for developing rheumatoid arthritis (RA) later in life, researchers said.

Managing Comorbidity and Poor Drug Responses

Comorbidity is pervasive and complicates medical care in general. It can be a by-product of aging. It may result from drug therapy or an inciting disease process and may be part of the constellation that defines the primary disorder. A growing body of evidence that suggests that comorbidity has a significant dampening effect on drug responsiveness and, adds to poorer outcomes in patients with inflammatory arthritis.

Tumor Necrosis Factor Inhibitors Do Not Increase the Risk of Cancer Recurrence

There is a large body of data that shows tumor necrosis factor inhibitors (TNFi) use in rheumatoid arthritis (RA) confers the same risk as that seen in RA - meaning there is no increase over and above that incurred by inflammation and RA itself.  There are fewer studies about whether it is safe to use a TNFi in someone with a pre-existing history of cancer.

Persistent Osteoporosis Drug Use Pays Off

Among elderly female Medicare patients, persistent use of osteoporosis medications was associated with reduced risk of fracture and significantly lower total health care costs.

Osteoporosis International reports the results of research examining records of 294,369 women >65 years old, on Medicare and taking osteoporosis medicines for the first time at some point between 2009 and 2011. (Citation Source: bit.ly/2vALm98)