Monday, 25 Mar 2019

News

Smoking Doesn't Influence Rituximab Responses in Rheumatoid Arthritis

Alcohol, smoking and obesity have all been shown to influence the risk and activity of rheumatoid arthritis (RA) and may also influence response to therapy. This study assesssed whether smoking would influence response to rituximab (RTX) in RA. 

U.S. Gout Rates Remain Steady, but Substantial

Using data from 5,467 adults in the US in the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2016, researchers found that the prevalence of gout and hyperuricemia has remained at 3.9%, having doubled from the 1960s to the 1990s, corresponding to an estimated 9.2 million adults with gout in 2015-2016.

Malar Rash and Polyarthritis

58-year-old woman with a history of hypothyroidism presents with a 2-week history of joint pain and swelling in her right knee, which became migratory and later affected the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of her fingers; this followed a series of others being sick in the household.

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.