Friday, 14 Feb 2020

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RheumNow Podcast- Best Biologics (2.7.20)

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

  1. Analysis of  30 synovial fluid samples (12 MSU, 18 CPPD); Gout crystals were ID at room temp (92%) & refrigerated (100%) for 7 days;  CPPD crystals were less durable at room temperature (67%) after 7d; w/ less reduction when refrigerated in heparin tubes.   
  2. Study of 75 adult Stills pts looked at flare biomarkers (25 not on TCZ; 6 on TCZ). AOSD flares , ESR/CRP/Ferritin were significantly elevated on TCZ+; but less so in TCZ- pts. WBC & LDH rose regardless of TCZ Rx. Best Biomarkers: WBC, CRP, LDH, Ferritin   
  3. Canadian study of 643 pts triaged for a positive ANA; 41% were seen by a rheumatologist.  1) 24% of ANA+ ps had an ANA assoc rheumatic dz (AARD); 2) 26%no evidence of any disease;  3) 39% other rheum Dx4) 11%  failed to met AARD criteria.   
  4. Claims cohort study looked at serious infection in RA pts Rx w/ tofacitinib vs 7 biologics. Overall risk was 3.12/100PYs. Signif higher SIE in TOFA vs ETN (aHR 1·41), lower vs INFLX (0.81), similar to ABA, GOL, TCZ, ADA. TOFA 2X higher risk of Shingles
  5. Tacrolimus as an option in RA? Metanalysis of 5 studies shows odds of achieving ACR20 was 1.71 (95% CI 1.20-2.42) for 1-2 mg/day and 2.30 (1.79-2.96) for 3 mg/day. Odds of creatinine elevation was 1.95 for 1-2 mg/day and 3.81 for 3mg/day.
  6. Head drop - as a Sx of myopathy? 107 pts reviewed; 53% w/ specific Dx: Inflammatory myositis(n = 16), myopathy w/ rimmed vacuoles (10), radiation(8), nemaline ( 7), myofibrillar (4), facioscapulohumeral ( 3), 2 ea w/ incl. body,mitochondrial, PSS
  7. Danish Registry study of 12,185 Chronic Urticaria patients shows an overrepresentation mastocytosis and anaphylaxis, as well as atopic dermatitis, rheumatoid arthritis, SLE, thyroiditis and vitiligo
  8. MRA vs FDG-PET in newly Dx GCA and Takayasus shows a differences in Sxs & imaging. Carotidynia & arm claudication more common in TAK with evidence of vascular inflammation (PET). GCA lesions by MRA showed more damage than inflammation
  9. Which Biologics are Best in Psoriasis           
  10. Bariatric Weight Loss Fails to Alter RA Risk  


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

Rheumatologists' Comments

Appropriately and well concisely summarized! What a helpful and meaningful podcast it is!

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