Monday, 25 Mar 2019

News

Severe Cutaneous Sarcoid Treated with Tofacitinib

Researchers from Yale have taken a novel approach and shown benefits when using tofacitinib in severe cutaneous sarcoidosis.

A report in the NEJM describes a 48-year-old female woman who was previously unresponsive to multiple medications and had not received systemic glucocorticoids. She was treated with tofacitinib 10 mg twice-daily and clinically responded with near disappearance of her skin lesions..

Best of 2018: The Safety of Paternal Exposure to DMARDs and Biologics

Pregnancy and drug safety is a complex issue, often with limited information about maternal drug exposure on the offspring. Greater uncertainty exists when considering whether paternal exposure may also influence fetal outcomes.

A systematic review examined the effect of disease modifying anti-rheumatic drugs (DMARDs) on male fertility and if peri-conception (within 3 months) paternal exposure was detrimental to fetal outcomes.

Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

Best of 2018: 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).

Best of 2018: U.S. News 2018-19 Rheumatology Rankings

The Annual U.S. News and World Report Rankings of Hospitals has listed the top contenders in the field of rheumatology. The U.S. News Review rates hospitals nationwide in 16 specialties – including rheumatology. Of the 4,500 hospitals covered by U.S. News that were analyzed, 158 were classified nationally in at least one specialty area.

Best of 2018: Patients May Not Fill Your Prescription

A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics. 

Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib.

Best of 2018: Ustekinumab May be Effective in Lupus

Ronald F van Vollenhoven and colleagues have reported in Lancet that ustekinumab (UST), an interleukin-12 and -23 inhibitor, when added to usual therapy in systemic lupus erythematosus (SLE) patients, was shown to be superior to placebo at improving clinical efficacy and laboratory parameters after 6 months of therapy.

Best of 2018: Unproven But Profitable Stem Cell Clinics

Stem cell clinics are popular and proliferating as they are largely a cash business and fall outside of FDA regulatory control. In lieu of scientific proof, most advocates use patient testimonials and the placebo effect to back up their claims.

Mourning the Loss of NIAMS Director Stephen Katz, MD, PhD

The following tribute to the late Dr. Steven Katz appeared on the NIH website. 

RheumNow Podcast – Rheumatologist Salaries (12.21.18)

Dr. Jack Cush reviews the news from RheumNow for the week ending 12/21/18.

Zolendronate Protects Against Fracture in Osteopenia

The NEJM reports that the use of zoledronate significantly reduces the risk of nonvertebral or vertebral fragility fractures in women with osteopenia.

While it is known that bisphonates have beneficial effects in osteoporosis, their impact in osteopenia has not been shown. 

Reassuring VTE Data for Tofacitinib

No significant differences in risk for venous thromboembolism (VTE) were seen in patients with rheumatoid arthritis (RA) treated with tofacitinib (Xeljanz) and those receiving tumor necrosis factor (TNF) inhibitors, analysis of administrative data showed.