Wednesday, 21 Aug 2019

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RheumNow Podcast – Scleroderma and the Lung (3.1.19)

Dr. Jack Cush Reviews the news and journal articles from the past week on

  1. The new Shingrix, (nonlive) recombinant zoster vaccine (RZV) is shown to be highly cost effective, even if only one dose is given. 
  2. Population cross sectional study from Israel analyzed 11,782 RA pts and 57,973 controls. Thyroid disease was increased in RA patients vs controls (16.0% v 11.7%, p < 0.001 HypoT4; OR = 1.42, 95% CI 1.34–1.50) and hyperthyroidism (OR = 1.26).   
  3. Key features in distinguishing Adult onset Stills disease from Fever of unknown origin: Arthralgia, rash, sore throat, neutrophilia, ferritin >5xULN, LDH based on comparison study of 69 AOSD & 87 FUO pts. 3 or more fever peaks daily makes AOSD less likely. 
  4. Skin Findings of Dermatomyositis - a few here you may not know about including Holster sign, Psoriasiform changes in scalp, Gottrons sign & papules, heliotrope, Vneck shawl, periungual erythema, facial erythema, erythroderma, calcinosis.   
  5. Metanalysis of 18 studies shows individuals with mult-site pain have a higher future risk for FALLS (OR = 1.74 (95%CI 1.57–1.93)). For high-quality studies, multisite pain pts have double the odds of a future falls. 
  6. Nurses Health Study had 1528 incident #RA cases. Current smoking increased risk of seropositive (not Seronegative) RA (HR 1.47). Smoking cessation >10, >20, >30 yrs ago assoc w/ decreasing risk of seropos. RA, but risk still remains > 30 yrs (HR 1.30)
  7. Prospective cohort study of 93 Systemic sclerosis patients with ILD; 2/3 had diffuse SSc. Half had PH diagnosis w/in 7 yrs of SSc onset, 83% Rx with ILD therapy, 83% Rx for PH. Survival rate for SSc-ILD and PH at 3 years after PH diagnosis was 91%.   
  8. 8.9% of systemic sclerosis pts were ANCA+, denoting a subset with increased risk of ILD (44.8% vs 21.8%, p < 0.001) and pulmonary embolism (8.6% vs 3.0%) in SSc. ANCA should be tested in SSc, as it identifies individuals with worse prognosis  
  9. Among 548 pts referred to academic pain center & treated for back pain, 42% met fibromyalgia criteria. FM+ pts were more likely to be younger, unemployed, w/ greater pain severity, more neuropathic pain, depression, anxiety & lower physical function 
  10. Taiwanese insurance claims data study shows that Sjogrens syndrome patients (n=13398) have increased risk of osteonecrosis of jaw compared to 54K controls (0.08% vs 0.03%, p=0.017) & also bisphosphonate ONJ (adjusted HR=7.9, p<0.001). 
  11. The Johns Hopkins Myositis Center is proud to announce the launch of the Peter Frampton Myositis Research Fund. Join @peterframpton and our Myositis Center team as we work to improve the lives of those impacted by #myositis
  12. Early TNF inhibition in Early Psoriatic Arthritis    
  13. FDA Slaps a Boxed Warning on Febuxostat for CV Risk 
  14. Register to view RheumNow.Live online 
The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

what is the literature citation for the article on Stills Disease?, Can anyone point me to this?
Can you please provide the journal citation for the meta analysis of Adult Stills Disease distinguishing features?

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