Monday, 16 Sep 2019

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RheumNow Podcast – Do’s and Don’ts in Spondylitis (9.5.19)

Dr. Jack Cush reviews the news and important research published in the last two weeks on RheumNow.com.

  1. Study of 89 patients with unclassified mono or oligoarthritis shows that the addition of dual energy CT (DECT) scans add little to the diagnosis of those having gout. https://buff.ly/2MWB25t 
  2. Study of 1/2 billion Europeans shows a significant increase in mortality with 2 drinks or more per day of sugar- and artificially sweetened soft drinks; sweetened with digestive deaths (HR 1.59); artifically sweetened with circulatory deaths (HR 1.52). https://t.co/P0JRgaz7oJ 
  3. Cochrane review shows there are very few studies addressing whether smoking cessation leads to improvement in RA or inflammatory arthritis. 2 identified studies (57 pts only) failed to examine if smoking cessation intervention reduced disease activity https://t.co/TAJuGD0acc 
  4. A prospecitve cohort study of 278 axSpA patients, grouped them into alcohol drinkers and non-drinkers. Alcohol was associated with spinal progression (mSASSS changes ≥ 2 units over 2 yrs) (60.7% vs 29.2%, P < 0.001, compared with  nondrinkers). 1st time finding. https://t.co/XdPrAWPQVG 
  5. Observational study of 601 systemic sclerosis patients; 448 Rx with vasodilators (CCB, ACEi, ARBs) & 153 did not. 1) vasodilator therapy was assoc w/ lower risk of vent, arrhythmias (p=.03); 2) low-dose ASA had fewer cardiac blocks & pacemakers (p=.02) https://t.co/mgOcW1Bidd 
  6. Drug use by SLE patients during 376 pregnancies (284 women) was studied. HCQ was used in 24.2%, but was discontinued 17% in the year prior, 30% in 1st trimester, 10% in 2nd trimester & 26% in 3rd trimester. Education on utility of HCQ during Pred needed! https://t.co/SxQW8vpjVO 
  7. Anifrolumab (anti-IFNa) was shown to be effective in its 2nd phase III trial in SLE - meeting its primary (BiCLA) endpoint at week 52, according to an Astra-Zeneca press release. Full data to be presented at an upcoming medical meeting. https://t.co/SLaQHJS6WY   
  8. Positive safety and efficacy results for subcutaneous infliximab biosimilar, CT-P13 (Remsima), was presented at EULAR 2019. In 48 RA pts, efficacy (DAS28,, ACR20) of CT-P13 SC was comparable to CT-P13-IV up to Week 54. https://t.co/84ismy7ci2   
  9. Tocilizumab Shows No Increase in Cardiovascular Risk  
  10. Taltz FDA Approved for Ankylosing Spondylitis (Radiographic Axial SpA) 
  11. ACR/SPARTAN Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis
Disclosures: 
The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

Dear Dr. Cush, As regarding to stopping smoking and the effect of it on RA disease activity, we have published an article in a large Swedish RA cohort of 1460 RA patients, of which 127 patients stopped smoking. The patients who stopped smoking had a poorer prognosis. The study was a retrospective cohort study. Please see: Andersson ML, Bergman S, Söderlin MK. The effect of stopping smoking on disease activity in RA. Data from BARFOT, a multicenter study in RA. Open Rheumatology J. 2012;6:303-9. The article is open access. Yours sincerely, Maria Söderlin, MD, PhD
According to literatures in a multi-cohort study revealed that smoking by ACPA leads to joint damage .Comparison of radiological progression in cohorts of RA patients ( with according to smoking status never, past and current as well as ACPA status) detected progression remarkably more severe joint damage in smokers .Ann Rheum Dis. 2014;73:1384-1387.

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