The RheumNow Podcast – Heartbreak of Methotrexate (11.16.18) Save

Dr. Jack Cush reviews the news from the past week at RheumNow.com.

1. The definition of POLYPHARMACY? Mine is when the med list requires 2 pages or when the patient cannot remember Rx names/dose due to #Drugs. Another is "many different medicines used concurrently to treat a single disease or coexisting diseases." Polypharmacy comes with high Risk
2. CCP+ RA patient starts out with 8 tender, 6 swollen and DAS=5.1. Put on MTX and TNFi and quickly goes into remission (0 joints) at month 6, 12, 18. At next visit what do you do w/ meds?
3. Analysis of disease activity in 354 patients with ANCA associated vasculitis (AAV) enrolled in 4 trials shows 13% with ESRD and 19% died. Disease activity at 3 & 6 mos predicted later ESRD or death https://t.co/NZu1kJuFF2
4. Large database study of incident gout (n = 41,446) shows chronic kidney dz (CKD stage ≥ 3) was nearly doubled in gout patients (adj HR 1.78 95% CI 1.70, 1.85) and that urate lowering therapy lowered CKD risk by 40% (HR 1.31) https://t.co/5kM1TigSIf
5. Metanalysis of 28 studies, 52,520 psoriasis cases shows high prevalence of sexual dysfunction (40-56%) and erectile dysfunction (34-81%), with strong associations with anxiety, depression, genital psoriasis and increasing age. https://t.co/2myhgWEW1a
6. Anticoagulation (AC) advice from #ACR18 - Stony Brook study of Temp artery bx found 20/27 pts on AC prior to procedure - Data from 16pts showed continuing AC found only 3/16 with minor bleeding adverse events - Abst #2782 https://t.co/TDsdfO27J9.
7. Metanalysis of 10 studies and 204 RA patients suggests that during pregnancy disease activity improved in 60% of patients but flared post-partum in nearly half (47%). https://t.co/DHeY4rgKu1
8. Pilot Data on Rituximab in Henoch-Schonlein Purpura 
9. Scleroderma Expert Treatment Preferences  
10. CIRT Trial - Methotrexate Fails at Cardiovascular Prevention