Friday, 16 Nov 2018

News

The Great Debate: Plaquenil - Choosing Safety over Efficacy?

I am usually thrilled to offer Plaquenil as one of the safer  therapy options to my patients with lupus and other autoimmune conditions. Unfortunately, on many occasions, once we go into detailed discussion of the potential side effects with the patient,  the issue of hydroxychloroquine eye toxicity casts a cloud over  overall optimistic view of Plaquenil.

ICI-Induced Inflammatory Arthritis and Shared Epitope Alleles

Immune checkpoint inhibitors (ICI) have changed the hematology/oncology world. However, their AEs from a rheumatologic standpoint are still being evaluated and at this time, genetic risk factors for inflammatory arthritis due to ICI are not well understood. Dr. Cappelli et al evaluated a possible connection with HLA typing at their institution.

Walking the Tightrope of Treat to Target in Psoriatic Arthritis

In the last few years, new studies have been published examining if early intervention and tight control (TC) of psoriatic arthritis (PsA) disease activity will have the same beneficial outcomes as it does for rheumatoid arthritis (RA).  

Nurse Led Gout Management Highly Effective

UK researchers have shown that nurse-led gout management, using a treat-to-target urate-lowering strategy, is efficacious and cost-effective compared with usual physicain care. The results are published in the recent Lancet edition.

Worldwide, gout management is suboptimal. In the UK only 40% of gout patients receive urate-lowering therapy, and fewer ever achieve a target serum urate (< 6mg/d) concentration.

RheumNow Week in Review – ACR Preview Edition (10.19.18)

Dr. Jack Cush summarizes the news and reports from RheumNow.Com this past week and previews RheumNow activities at the upcoming ACR 2018 meeting in Chicago.

It's the Genes, Not the Diet that Raises Urate

Researchers from New Zealand find that in contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.

NEJM Debate on Medical Marijuana for Chronic Pain

This week’s NEJM features a case discussion and debate over whether medical marijuana should be used to treat chronic pain. The debate focuses on a 31-year-old woman with long-standing complex regional pain syndrome in her leg and foot. CRPS followed a sports related hairline fracture in the right fibula. Her pain has been intractable since.

Update on Immune Checkpoint Inhibitor Toxicity

JAMA has a 2018 update/review of the safety issues seen with mmune checkpoint inhibitors (ICIs) - important new cancer therapies, with 14 cancer indications, that have significantly improved survival in several. ICIs are monoclonal antibodies that block inhibitors of T-cell activation and function.

Apremilast Succeeds in Scalp Psoriasis

Celgene has announced results from the phase 3 STYLE study, showing apremilast yielding significant improvement in moderate-to-severe scalp psoriasis. STYLE is a phase 3, multicenter, randomized, placebo-controlled, double-blind study evaluating the efficacy and safety of apremilast in subjects with moderate to severe plaque psoriasis of the scalp. The study enrolled 303 people who were randomized 2:1 to receive apremilast 30 mg twice daily or placebo for the first 16 weeks.

IL-6 for Adult Still's: A New Option?

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.

Hip and Knee Replacements Monitored by Smart Watch

Reuters reports that patients with hip or knee replacements will now be followed for progress using their Apple watches.

A multi-site study involving medical facilities from Massachusetts, California, Colorado and Michigan will receive stats including heart rate, steps taken and standing hours from patients waiting for or recovering from hip and knee replacement surgery.

RheumNow Week in Review – Four Fingers are Best (10.12.18)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. New info on scleroderma-SLE overlap, nailfold capillaroscopy, Women with SpA, acute gout management and lupus patient in pain who visit the ED.