Thursday, 20 Sep 2018

News

Proposed Changes for 2019 Medicare Fee Schedule

On July 12th the Centers for Medicare & Medicaid Services (CMS) released its proposed rule changes for the 2019 Medicare physician fee schedule.  This year, CMS has combined the Medicare physician fee schedule proposed rule with recommendations for the Quality Payment Program (QPP), which will be officially published in the Federal Register on July 27.

Predictors of Methotrexate Non-Response

New research from a UK study suggests that nonresponse to oral or subcutaneous MTX was seen in 43% and is predicted by seronegativity, higher disease activity measures and higher anxiety scores.

Trend Towards Fewer Self-Employed Physicians

 

A nationwide survey study analyzed healthcare provider (HCP) employment type (self-employed, employed by private sector, or employed by government) and annual labor earnings (2001 to 2015) and found that the health care landscape is changing with few self-employed practitioners and more being larger organizations. 

The RheumNow Week in Review –Fateful Outcomes in Rheumatology (7.13.18)

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Fateful outcomes in Rheumatology, what happens to Seronegatives, IL-23 fails, MRI progression, Not all inflammatory back pain becomes SpA:

The Diverse Fate of Seronegative Rheumatoid Arthritis

A Finnish Rheumatology Center followed 435 early, seronegative rheumatoid arthritis (RA) patients for 10-years and found that only 3% became erosive or seropositive RA. They also found that 32% could not be further reclassified, and that the remaining 65% evolve into another diagnosis, led by polymyalgia rheumatica (16%), psoriatic arthritis (11%), spondyloarthritis (9%), and osteoarthritis (10%).  

Defining Refractory RA by Biologic Use

A study from the  British Society for Rheumatology Biologics Register (BSRBR) has shown that biologic refractory disease is seen in at least 6% of patients who have ever received a biologic DMARD (bDMARDs).

Nailfold Capillary Density Predicts Dermatomyositis Lung Involvement

In patients with juvenile dermatomyositis (DM), an association was seen between low nailfold capillary density and pulmonary involvement, European researchers reported.

Liver Disease Increased in Psoriasis

An observational case-control study has shown that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD).

A single center, outpatient dermatology clinic studied 151 patients with psoriasis and 51 control subjects with ultrasonography to diagnose NAFLD.

IL-23 Inhibitor Fails in Ankylosing Spondylitis

A study of the IL-23 risankizumab in active ankylosing spondylitis (AS) patients failed to show efficacy and did not meet primary efficacy endpoints in a 6-month trial.

Systemic Sclerosis: More Common than Expected

Systemic sclerosis is more common in the United Kingdom than previously reported, a nationwide population-based study determined.

Obesity, Hypertension and Diuretics Drive Gout Risk

A recent metanalysis suggests that obesity, hypertension and diuretic use are associated with a two-fold increased risk of incident gout.

From a potential of 9923 articles, researchers analyzed 11 studies with data suitable for the meta-analysis.

Gout was 2.24 times more likely to occur in individuals with body mass index ≥ 30 kg/m2 (adjusted relative risk 2.24 (95% confidence interval) 1.76–2.86).

Hydroxychloroquine Being Over-Dosed with New Guidelines?

Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice. A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).