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By Jack Cush, MD | 11 October 2019
Dr. Jack Cush delivers select commentary on select news and journal articles from the past week on RheumNow.com.
- Just Dx Pigmented Villonodular synovitis in older male w/ CPPD, new myeloma but chronic monarthritis of knee - Dx by MRI. PVNS is benign, localized synovitis (tenosynovitis) of knee, hip, ankle, elbow, even TMJ! Rx is largely excision. https://t.co/R8EHwOaGU4
- ASBMR meeting presented a study of patients w/ CKD showing that 12 mos romosuzumab improved BMD in lumbar spine, hip, and femoral neck in pts with mild to moderate renal impairment - not enough pts w/ severe CKD to conclude its effects.
- Osteoarthritis Initiative studied 4344 knee OA looking at bulge sign (12.7%) & patellar tap (2%); 3.3% had both. Bulge sign increased risk of freq knee pain (OR 1.31) & TKR [OR 1.47); developing a bulge sign had incr risk of same & Xray worsening (OR 1.67) https://t.co/3HtBrkzAtk
- 225 very early RA in abatacept AVERT study - 44% had high baseline MRI inflammation. With High MRI inflammation, combo ABA+MTX was better than MTX at 12 mos remission by SDAI (45% vs 16%). Pts w/ low baseline MRI inflammation, remission rates did the same https://t.co/A9MRSWaKGB
- Take the Good with the Bad? Study of 179 RA pts achieving remission on TCZ- SC 162 mg qwk randomized to continue qWk or space out to q2Wk -- Weekly Actemra better maintained remission (90% versus 73%; P = 0.004), but then again 73% did well w/ spacing EOW. https://t.co/Tcb2WwCbc2
- Why do we take such crapy care of patients with #gout ? Is it because we have such divergent guidelines? Or we are just overwhelmed? Your take please..- Sacrilegious but true. Every MD thinks they are great-they learned it in med school & as a PGY*. A) most dont treat enuf to be good at it; b) "guidelines are for suckers"; c) colichicine+allopurinol=Voila! Evidence of bad Rx? no monitoring, underRx, colchicine, 300mg allopur. only http://bit.ly/2VyeOZi
- T2T in Lupus Nephritis aims for less proteinuria, Study of 87 pts with class III/IV LN compared goal of urine protein/creat ratio(UPCR) < 0.5 to stringent < 0.15, Latter assoc w/ lower renal flares (HR 0.16), less CKD (HR 0.19), more MMF use (HR = 7.26) https://t.co/0LSXTiUAaV
- N. Zealand study shows their cost of knee OA was $200 million in 2013; and without any changes in the standards of care, this isprojected to increase to $370 million by 2038. (includes an additional 4,000 TKRs per year by 2038). https://t.co/B1awh1ky1B
- Bisphosphonates and the Risk of Osteonecrosis of the Jaw
- Long Delays for Inflammatory Arthritis Patients
- Antibiotics Increase Rheumatoid Risk - Again