Friday, 14 Feb 2020

You are here

RheumNow Podcast- 2019 EULAR RA Guidelines (1.31.20)

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

  1. CORRONA study of ~800 RA patients shows that high and low comorbidity scores and BMI status (obese BMI ≥ 30; n = 356 vs nonobese BMI < 30; n = 449) did not impair or alter the effectiveness of tocilizumab.
  2. Growth differentiation factor-15 (GDF-15) is a myokine is upregulated in myositis, may be a biomarker. 35 pts w/ idiopathic inflammatory myopathy (IIM) had twice the levels of controls (625 vs 326 pg/ml, p = 0.01); also seen in inclusion body myositis
  3. Novel new research shows that Monosodium urate (MSU) crystals activation of inflammatory pathways. MSU activates macrophages and fibroblasts to induced TAK1 (TGF-β-activated kinase 1) leading to amplified IL-1β-induced IL-6, IL-8, and CXCL5
  4. Prospectively study of neuropsychiatric (NP) events in1827 SLE - found that NP-SLE occured in 52%; with 31% directly attributed to SLE. Risk of NP-SLE was highest in the first 2 years (RR 6.16) and mortality risk was higher in NP-SLE pts ((16% vs 7%)
  5. Study of 260 TB patients treated with pyrazinamide or fluoroquinolones showed a higher risk of joint pain (mostly ankles knees) with FQN (29%) vs PZA (17%); median latency was 55 days vs 138 days; half had hyperuricemia.
  6. ENTRACTE trial studied the risk of major adverse CV events (MACE) in 3080 RA pts Rx with tocilizumab (TCZ) vs etanercept (ETN), and found no increased risk of MACE in TCZ patients compared to ETN (HR 1.05 (95% condence interval 0.77–1.43).
  7. Administrative claims study from British Columbia showed the risk of type 2 diabetes is significantly lower in SLE pts taking Plaquenil (HCQ). 1,498 SLE pts (91% F) were followed 4.6 yrs with 140 incident T2DM; lower HR (0.61) for those adherent to HCQ 
  8. New ACR guidelines for OA hip/knee give a conditional recommendation for Balance exercises. A systematic review of 11 studies shows Knee OA pts at risk for falls. Risk factors: impaired balance, weakness, comorbidities, # of joints
  9. 2019 EULAR Recommendations for the Management of Rheumatoid Arthritis  


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

Add new comment

More Like This

Alcohols Net Zero Effect in Rheumatoid Arthritis

A report from The National Databank for Rheumatic Disease addressed the impact of alcohol on disease activity and mortality in rheumatoid arthritis (RA) and found that alcohol use was not associated with changes in disease activity or mortality, after addressing confounders. 

DMARD Inertia by Registry Rheumatologists

A registry study of metric use (primarily RAPID3 and CDAI) in the treatment of rheumatoid arthritis (RA) patients shows that, even in the face of moderate or high disease activity, treatment changes by rheumatologists were relatively low (35.6–54.6%).

Bariatric Weight Loss Fails to Alter RA Risk

Obesity has been shown to be a risk factor for the onset of rheumatoid arthritis (RA) and also shown to affect outcomes by impairing responses to many DMARD therapies. A Swiss study of RA patients undergoing bariatric surgery failed to show that bariatric surgery and weight loss had any effect on the incidence of RA.

Limited Advantage to Very Early vs. Delayed Etanercept in RA

The VEDERA study sought to confirm whether the very early introduction of first-line etanercept+methotrexate (ETN+MTX) was superior to treat-to-target MTX (MTX-TT) in patients with early RA.

Rheumatoid Arthritis Antibodies Linked With COPD

Women who were seropositive for anti-citrullinated protein antibodies (ACPA) and ultimately went on to develop rheumatoid arthritis (RA) were also at increased risk for being diagnosed with chronic obstructive pulmonary disease (COPD), analysis of data from the Nurses' Health Study showed.