Friday, 20 Oct 2017

News

Joint Pain Linked to Increasing Temperature, Not Rainfall

Every rheumatologist knows and every rheumatic patient woes about the havoc weather inflicts on joint pains. Yet, research on this issue has seldom confirmed these impressions.  A novel new look has shown by linking online search terms with published weather conditions that increasing climate temperatures increased rates of hip and knee pain (searches), while precipitation had no effect.

Criteria for Early Referrals from Primary Care

Early diagnosis and early intervention has been the mantra of all who manage musculoskeletal (MSK) diseases for decades. While the rules for referral may be clear to some, the lack of uniformity and promotion amongst primary care providers is less certain.

JIA Worsens Quality of Life Long into Adulthood

Adult patients with a history of juvenile idiopathic arthritis (JIA) showed poorer health-related quality of life decades later, compared with individuals who were healthy as children -- even if they were in clinical remission, reported researchers in Norway.

Mycophenolate and Steroids in Neuropsychiatric Lupus

Beyond diagnosis, management of neuropsychiatric lupus (NPSLE) can be challenging. Moreover, there are scant studies addressing optimal management. In this issue of Clinical Rheumatology, researchers show the efficacy of mycophenolate mofetil (MMF) and deflazacort in NPSLE.

Therapeutic Update: 5 Questions on Sirukumab FDA Hearing

Drs. Cush and Gibofsky answer 5 questions about the August 2, 2017 FDA Arthritis Advisory Committee meeting that reviewed the NDA for sirukumab use in rheumatoid arthritis. The panel voted against (1-12) the approval of sirukumab.

MSK Ultrasound Now Standard for Rheumatology Training

In the United States, musculoskeletal ultrasound (MSUS) in rheumatology has grown significantly in the last few decades. Ten years ago, more than half of rheumatology fellows had training or exposure to MSUS. A current survey of training programs shows that 94% provide MSUS training.

H1N1 Vaccination Triggers TLR Activation and Autoantibody Production in DMARD-naïve pSS

Increased morbidity and mortality from infectious causes in patients with autoimmune disorders has led to the overall consensus that vaccination of such patients is important and should be widely promoted in clinical practice. However, the autoimmune-biased immune system of the patient with rheumatic disease and use of immunosuppressive drugs tend to affect response to vaccination.

FDA Arthritis Advisory Panel Endorses Tofacitinib Approval for Psoriatic Arthritis

On Thursday, August 3, the FDA Arthritis Advisory Committee (AAC) met to consider tofacitinib for use in patients with psoriatic arthritis. The panel voted 10-1 in favor of approval.

The RheumNow Week in Review – 4 August 2017

Dr. Jack Cush reviews new FDA decisions on sirukumab and tofacitinib as well as other news items from the past week on RheumNow.com. 

Arthritis Advisory Panel Votes Down Sirukumab

On Wednesday, August 2, the FDA convened the Arthritis Advisory Committee (AAC) to evaluate the safety and efficacy of Janssen’s anti-IL-6 monoclonal antibody, sirukumab. The panel included over 13 voting members that included adult and pediatric rheumatologists, statisticians, pharmacologists and patient representatives.

Pediatric Consensus on Comorbidity Assessments

Comorbidity is a serious consequence or confounder in patients with inflammatory diseases. This has been well described in both psoriatic and rheumatoid disease.  JAMA Dermatology has published the recommendations of a pediatric multispecialty group regarding the screening for comorbid disease. (Citation source https://buff.ly/2u4pi3J)

No Increase in Malformations with Etanercept Use During Pregnancy

While there are several reports detailing uncontrolled, observational results of biologic use during pregnancy, most are hampered by low numbers, incomplete data and too small a sample to make reliable judgements regarding the teratogenicity.  A company sponsored claims data analysis has shown that etanercept exposure during pregnancy was not associated with an increase in major congenital malformations (MCMs).