Monday, 24 Feb 2020

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RheumNow Podcast - The Elusive Hand OA Problem (12.13.19)

Dr. Jack Cush recaps the news and journal reports from the past week on

  1. Caltech researchers developed a wearable sensor that detects & monitors uric acid levels. Shown to be elevated in both gout patients and normals after purine rich meals. Cool technology thats still a long way from commercial use. 
  2. J Rheum metanalysis of 12 studies & 3,234 SLE pt vs 288,336 control subjects shows a significant association between SLE occurrence and current-smoker (not former) (OR 1.54)
  3. S American study of #SLE compared Latin American (LAM) vs European caucasian SLE pts - LAM had more myositis, hemolytic anemia, nephritis, Sm, Ro, RNP & more disease activity, hospital admissions, but damage index, mortality or co-morbidities
  4. FDA has approved Amgen’s infliximab biosimilar, Avsola (infliximab-axxq),for use in Crohns, UC, RA, AS, PsA and psoriasis, based on a 566 pt trial in RA. This is the 4th infliximab biosimilar in the US, joining Inflectra, Renflexis, and Ixifi.
  5. Biosimilar Tote-Board in Rheumatology: 4 Infliximab biosimilars - Inflectra, Renflexis, Ifixi, Avsola 5 Adalimumab biosimilars - Amjevita, Cyltezo, Hyrimoz, Hadlima, Abrilada 2 Etanercept biosimilars - Erelzi, Enticovo 2 Rituximab biosimilars - Truxima, Ruxience 
  6. 46 #RA pts on DMARDs +/- biologics received 3 part Hepatitis B Vaccination - those on biologics and DMARDs had less seroprotection vs controls (50% vs. 100% [p = 0.02] and 69.7% vs. 100% [p = 0.09], respectively). HBV vaccine well tolerated & without flare 
  7. Those with prior partial knee arthroplasty (AKA medial unicompartmental knee arthroplasty) who undergo total knee replacement have a 3-fold higher risk of revision vs primary TKA. 
  8. Serum Calprotectin levels were higher in the 157 RA pts who relapsed with DMARD withdrawal in the IMPROVED and RETRO Studies   
  9. TB is highly endemic in S. Africa - S. African registry reports 97 TB cases in biologic users w/ TB rate 1240/100000 PYs vs zero in biologic naive pts. 1/3 were extra-pulmonary. TB risk highest w/ TNFi Mabs (1683) vs 861 ETN or 681 other MOAs.
  10. Nurses Health Study - 284 incident #RA cases compared to 849 controls showing Asthma t was strongly assoc w/ ACPA in blood prior to RA Dx (OR 3.6), independent of smoking. (But not assoc w/ RA) Chronic mucosal inflammation may lead to ACPA & RA 
  11. YET another drug fails in erosive hand OA (EHOA). A phase II trial of an IL-1 inhibitor (lutikizumab) vs PBO given to 110 EHOA pts shows not differences in pain outcomes, despite biologic changes in CRP, IL1, neutrophils in those on the IL-1 inhibitor. 
  12. Short-term Benefit with Prednisolone in Hand Osteoarthritis 
  13. FDA Warns 15 CBD Manufacturers  
The author has received compensation as an advisor or consultant on this subject

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