Monday, 18 Feb 2019

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RheumNow Podcast – FDA Panels Meet on Gout & OP (1.18.19)

Dr. Jack Cush reviews the news, articles and FDA Panel discussions from the past week.

  1. Contraceptive surveys of 164 arthritis pts(138 Rheumatoid;26 Psoriatic) finds one-third (32-35%) using highly effective contraception; 31% using effective methods; but ineffective methods in 35.5% RA & 11.5% PsA and no contraception in 1.5% RA & 23.1% PsA
  2. Who thought this was possible? Numbers suggest this is rare. Tis wrong to use this to forge ahead with an unlikely PMR dx in the face of a normal CRP/ESR; but will you go so far as to order the expensive FDG-PET?
  3. National registry of lupus nephritis pts w/ ESRD (n=20,974) between 1995-2014 showed that mortality declined from 11.1 to 6.7/100PY; Mortality declined for whites (HR 0.68), blacks (0.67) and Hispanics (0.51) and declined for CVD and infx by 44% & 63%
  4. Combined study of Danbio (Denmark) and ARTIS (Sweden) RA registries showed that in 8987 treatment courses of abatacept, rituximab or tocilizumab there was no difference in Serious infection rates - ranging from 4.7-8.1 SIE/100 Pt Yrs. 
  5. CDC report 5 Jan 2019: 7 million cases of influenza w/ an estimated 69,000 to 84,000 hospitalized for flu-related illness. H1N1 is the most common strain. Flu activity is widespread in 30 states
  6. FDA Panel Backs Approval of Romosuzumab for Osteoporosis  
  7. Febuxostat Gets Reprieve from FDA Advisory Panel  
  8. Anakinra for Acute Crystal-Induced Arthritis  
  9. Early Predictive Factors for Scleroderma Renal Crisis 


The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

The occurrence of GCA with normal acute phase reactants has been described, so I guess the same could happen with PMR. In our specialty, things are not always what they seem. Moreover, the only rule is that "there are no rules".

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