Friday, 10 Apr 2020

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RheumNow Podcast- Methotrexate Mechanisms (2.28.20)

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

  1. Long term safety of Sarilumab reviewed. 2887 SAR pts on Combo and 471 on SAR mono Rx for up to 7.3 yrs (8188 PYs). SAEs 9.4 & 6.7/100PY; SIE 3.7 &, H zoster (0.5-0.6/100PY), GI perforations < 0.1/100PY & Cancer 0.7-.6. ANC <1000 in 13-15% 
  2. Study of metformin in NON-diabetics w/ inflammatory disease on Pred >20/d shows metformin to to reduce pneumonia, serious infections, markers of carbohydrate/lipid,/liver & bone metabolism (vs PBO) but had no effect on truncal fat 
  3. HIP ATTACK trial assessed if accelerated surgery could reduce mortality & complications. 2970 Pts recv accelerated surgery (6 hr) vs standard care (24hrs). Risk of death (9-10%) & infection was the same; thus accelerated surgery did not lower risk 
  4. The use of cannabis in the past year by adults 65 years and older in the United States increased sharply from 0.4% in 2006 and 2007 to 2.9% in 2015 and 2016   
  5. Brazil Biologics registry studied 1121 RA & 577 SpA pts and found serious infectious adverse events were more common with first TNFi (adjusted IR ratio, 2.96; p < 0.001) & still higher with 2nd TNFi (vs 1st TNFI) (adjusted IR ratio, 1.55)   
  6. Metanalysis of homocysteine (HCY) levels in SLE; 36 articles compared 2919 SLE to 3120 controls. HCY levels were significantly higher in SLE vs healthy controls (P < 0.001), esp w/ age, Dz activity, Dz duration and BMI >23. HCY is important in SLE   
  7. FDA has approved IV meloxicam injection (called Anjeso, from Baudax Bio) for the treatment of moderate to severe pain in adults. Based on two phase 3 efficacy trials and one phase 3 safety study.   
  8. Cross sectional study of 139 RA patients shows that severity of periodontal disease on dental exams was linearly associated with both the presence and levels of anti-CCP antibodies. 
  9. Dr. Bruce Cronstein has a full read review of the MOA of MTX - is it increased adenosine release, NO2 synthase uncoupling, NF-κB effects, or the increased in long intergenic non-coding RNA p21 (lincRNA-p21)? - See his lecture at RheumNow LIVE 
  10. Bariatric Surgery Improves Rheumatoid Activity    
  11. Hyperuricemia Predisposes to Coronary Artery Disease in Men    


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

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