Friday, 14 Jun 2019

You are here

RheumNow Podcast – Vasculitis and Strange Bedfellows (12.14.18)

Dr. Jack Cush reviews the news from the past week on 

  1. Comparison of pediatric (214) and adult (5348) GPA pts shows Pediatric GPA to have 30% more hospitalizations and 2-3 fold more leukopenia, neutropenia, hypogamma than adults. No diff in severe infections, major relapse, ESRD.
  2. No differences seen in the rates of major adverse CV events (MACE) between RA, axial SpA or PsA pts, suggesting inflammation, rather than a disease, drives CV risk. Data from a Swiss mixed retrospective/prospective cohort study
  3. 27yoF w/ chronic 4 mos b/l knee effusions (SF WBC=22K, -C/S), MRI synovitis only, Labs normal but with +ANA 1:160, neg Parvo, B27, RF, CCP, RPR, HCV/HBV, ESR and CRP. No resp to NSAIDs or IA steroids. DX?  
  4. Statin Safety review from the American Heart Assn says 1 in 4 adults > 40yrs takes a statin; lowering LDL by 55-60%. Statin-induced rhabdomyolysis is <0.1%, and serious hepatotoxicity is ≈0.001%. The risk of statin-induced new diabetes is ≈0.2%/Year
  5. Vasculitis may complicate autoinflammatory Dz - in FMF (IgA vasculitis, PAN), vasculitis may occur w/ CAPS, TRAPS, HIDS, DIRA, PAPA & Behcets syndromes. Vasculitis is part of DAD2 deficiency (STING-assoc vasculopathy w/ onset in infancy-SAVI (PAN-like)
  6. Systematic review of 41 papers shows that polymyalgia rheumatica is associated with comorbidities - CVA, CAD, peripheral arterial disease, diverticular disease, hypothyroidism, but there is disagreement as to an association betw PMR and cancer.
  7. Registry studies of systemic sclerosis shows that early severe GI involvement (9% at 2yrs) is associated with increase risk of inflammatory myositis (OR 4.68), telangiectasias (OR 2.45), skin progression and a >2-fold risk of death (HR 2.27)
  8. Psoriatic Arthritis Does Not Add to Pregnancy Problems
  9. No End in Sight for the Shingrix Vaccine Shortage
  10. Genetic Diagnosis for Previously Undiagnosed Disorders  
  11. Patients Don't Always Tell the Truth
  12. Too often doctors think their job is to know the answer and fix the problem. All too often, strangely and surprisingly, that isnt what the patient wants or needs. They need someone who cares, doesnt judge behaviors and displays a pulse and personality 
  13. RNL 3/22-24 2019 in Ft Worth, 16hrs CME, all the big names, all the big companies


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

Add new comment

More Like This

Ultrasound Reveals Which Anti-CCP Positive Patients Progress to Arthritis 

Power Doppler signal on baseline ultrasound exam may well help stratify anti-CCP positive patients with musculoskeletal symptoms but no clinical synovitis, according to data from the Leeds Institute of Rheumatic and Musculoskeletal Medicine presented at EULAR 2019.

EULAR 2019 – Day 3 Report

The third day of EULAR 2019 started with novel biologics, the efficacy of secukinumab in axial psoriatic arthritis, neurologic events with TNF inhibitors from the DANBIO database (OP0261), and neuropathy in SLE (OP0252), but above all this was a big poster day. Here are selected highlights from day 3 EULAR in Madrid.

RheumNow Podcast – EULAR 2019 Streamin' - (6.14.19)

Dr. Jack Cush reports from Madrid on several novel presentations from EULAR 2019.

1. Genovese Vagal nerve stimulator in RA

2. Low dose steroids in Hand OA

EULAR 2019 Report – Day 2

It was a full and lively 2nd day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day 2 EULAR in Madrid 

Be ‘on point’: Guidelines for rheumatic complications of immunotherapy

At EULAR 2019, Madrid, several recommendations including RA, SLE, and Sjogren’s syndrome have been developed.