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8 September 2017: The RheumNow Week in Review

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from This week's report includes trends in MTX use and outcomes, fibromyalgia as an inflammatory disorder, drugs that stop psoriasis pruritus, drugs that don't cause TB, cardiovascular risk and what Rheums think of ACR/EULAR criteria.

  1. 192 Chronic fatigue patient show high TGF-B,low resistin, 17 cytokines correlate with activity(CXCL*, GF, IL-4, IL5, IL7, IL13, IL17F, several growth factors. 
  2. Between 2004-2014, MTX use increased (40% to 64%) and biologic use increased (from to1.7% to 27%), but the rate of ortho hip and knee surgery dropped (72 to 51/1000pts in 2014)
  3. Optimal MTX dosing in early #RA patients (≥10mg/wk w/in 3 mos and ≥20mg/wk @6mo) improves clinical & functional but not Xray outcomes
  4. A review of 230 SLE patients, 95 had both abnormal protein-creatinine ratio (PCR) AND a 24 Hr Protein measures; serial assessments showed PCR had insufficient accuracy vs 24hr-Prot measures
  5. Base on claims data, prevalence of RA increased over 10 yr period; RA found in 1.28-1.36 million adults (or roughly 0.5%) by 2014
  6. Psoriasis pruritus seen in >80%; metaanalysis 13 trials shows Anti Il-17, JAK inhib, ADA, apremilast reduce pruritus 
  7. Despite the FDA requiring TB testing for IL-17 inhibitors; no reported TB cases in 1st Yr RCTs and in vitro studies show no mTB reactivation with IL17inhibition
  8. 167 RA patients that were serially assessed over 2 yrs; only BMD loss by DXA predicted Xray damage @ 12 & 24 mos; NOT DAS, RF, CCP, or ESR
  9. Study of 153K RA patients, 23% had Anemia,and review of their drugs found that anemia was only improved by tocilizumab, not with Tofa, DMARDs, other biologics.
  10. New Recommendations on Biosimilar Use   
  11. Rheumatoid Arthritis Augments Cardiovascular Risk   
  12. Increasing Deaths and Breaking Bad with Fentanyl   
  13. Do Rheumatologists Use ACR/EULAR Guidance on Rheumatoid Arthritis? “Live Vote” Results   
  14. Hugo E. Jasin, MD (1933-2017)   
The author has received compensation as an advisor or consultant on this subject

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