Monday, 24 Feb 2020

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RheumNow Podcast- The Down Side of Steroids (1.17.20)

IDr. Jack Cush reviews the journal reports and news from RheumNow.comBe sure to register for RheumNow Live 3/13/2020 in Fort Worth

  1. Study of 224 pregnancies (133 women) w/ UCTD, ANA+, <45 yrs. The outcomes: live births 79%, 20% miscarriages, 0.9% stillbirths and 2.7% intrauterine growth restriction. Miscarriages & stillbirths strongly associated with aPL and ENA antibodies (P < 0.05).
  2. CMAJ Same-day discharge arthroplasty (usually w/in 4-8 hrs after surgery) may be a feasible, made possible by \minimally invasive surgery, tranexamic acid & multimodal analgesia. CMAJ review contraindications: Age >80yrs, cirrhosis, CKD, bleeding disorders
  3. Dr Kevin Winthrop has published claims analyses showing nontuberculous mycobacterial infections are increasing- from 3.13 to 4.73/100,000PY & prevalence from 6.78 to 11.7/100,000PYs (from 2008 to 2015), esp in women & elderly
  4. 128 pts w/ Breast Cancer were evaluated for rheumatic complaints. Ultimately 1/3 developed an inflammatory rheumatic disease; most common being RA (8%), Sjogrens (6%) & PsA (5%). Arthralgias were more common with aromatase inhibitor use.
  5. Study of 100 pts w/ Granulomatosis with polyangiitis finds 56% had elevated d-dimer levels and that d-dimer are associated with disease activity and inflammation rather than with the risk of venous thromboembolism. 23 had VTE not predicted by d-dimer
  6. @KDAO2011 asked me does DIC or sepsis cause false positives APL Abs? I didnt know but Dr Erkan did @DorukErkanMD who provided this paper showing over half (52%) of critically ill had prolonged aPTT, none had bleeding,thromboembolic complications.
  7. MIRROR OL study shows that when pegloticase is co-administered with methotrexate, a high rate of response is seen (79% or 11/14 pts), achieved a complete response (sUA < 6 mg/dL) at Month 6. Topline results announced by Horizon.
  8. Diabetics using SGLT2 Inhibitors have a lower Gout Risk
  9. TULIP2 - Anifrolumab Succeeds in Lupus
  10. Steroids Up the Risk of Organ Damage in SLE


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

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