Thursday, 23 Jan 2020

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RheumNow Podcast- Knee Pain Knockout (1.10.20)

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

  1. UK study of 2701 Early arthritis pts Dx in 3 different eras finds that from those dx in 2010, 59% were estimated to reach low disease activity compared with 48% with diagnosis in 2002 and 32% with diagnosis in 1990. 
  2. Study of 1054 adults with septic bone, joint, prosthetic infections shows that 6 weeks of oral antibiotic therapy cost less and was noninferior to IV antibiotic therapy (success rate ~85% at 1 year) while being >20% cheaper
  3. Misuse and abuse of Gabapentin in US? Between 2003-2016 there were 260 million gabapentinoid visits. Annual use nearly quadrupled from 2003 to 2016 (mostly PCPs 46%). Nearly half w/ concurrent opioids (32.9%) or benzodiazepines (15.3%).
  4. Systematic literature of biologic Rx of dactylitis & enthesitis in Psoriatic arthritis. 18 trials, 6981 patients showed that TNF inhib & ustekinumab, secukinumab, ixekizumab were 2-3 fold significantly better than PBO at resolution of dactylitis by Wk 24.
  5. 301 fibromyalgia #FM pts randomized to receive active‐TENS or placebo‐TENS or no‐TENS to use at home 2h/day for 4 wks. Active TENS had greater reduction in pain & fatigue vs placeboAND better global improvement (70% vs. 31%, p<0.0001)
  6. CORRONA registry 880 RA pts developed a solid cancer. 42% taking bDMARD/tsDMARD; 5% switched biologics w/in 36 mos & 10% started a new biologic- w/ most changing to a TNFi (53%). ACR guidelines say to Rx regardless of solid tumor
  7. high-dose trivalent inactivated influenza vaccine (HD-TIV) was studied in 696 RA patients compared to standard-dose quadrivalent flu vaccine - Seroconversion was 3 fold higher w/ HD-TIV, no differences in side effects and no increase in RA flares
  8. Claims data from RA patients (n = 12,182), shows that screening for hyperlipidemia was suboptimal (compared to Diabetes pts), Those seeing a PCP and Rheum were 36% more likely to be screened.
  9. Genicular Artery Embolization to Treat Osteoarthritis Knee Pain   
  10. Taltz Shines in Non-Radiographic Axial Spondyloarthritis  
  11. ACR-Arthritis Foundation Treatment Guidelines for Osteoarthritis  
  12. RheumNow.Live – March 13-15, 2020


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