Friday, 25 May 2018

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The RheumNow Week in Review – 12 May 2017

Dr. Jack Cush highlights the big stories, news and articles from this week at

  1. Prevalence of PsA is increasing in Denmark (7.3 in 1997 to 27.3/100k PY 2010), higher in women, ages 50-59yrs,  also more DMARD and biologic use
  2. Minocycline can be a potential Rx option for Calcinosis related digital ulcers in Scleroderma.
  3. CAMERA Study: tis better to add 10mg pred to MTX than not: less Biologic use (30vs50%), less erosions, same safety
  4. World Lupus Day was 5/10 - Lupus must be managed as one person, one disease; not as a patient wth 4 organ systems affected, each requiring  a specialist to weigh in
  5. Stroke is uncommon in RA 3.2/1000 PY;3 fold higher after a serious adverse event.  Risks higher with age, smoking hyperlipidemia and H. Zoster!
  6. Adalimumab Effective in Pediatric Plaque Psoriasis  
  7. 2017 Medscape review shows Avg Rheumatologist Salary = $235K, 25%  have a networth >$2million, 17% paying school loans, 11% claim financial losses from practice
  8. EUSTAR Study: Scleroderma patients with anti-RNA polymerase III Abs have higher risk of cancer (OR 7.38), especially with higher  age & more skin involvement.
  9. ACP Guideline Recommends Generic Bisphosphonates But Limits DEXA Use
  10. NSAIDs Increase Risk of Acute Myocardial Infarction  
  11. CDC Shows a 40% Lifetime Risk of Symptomatic Hand Osteoarthritis
  12. OARSI has submitted 103pg white paper to FDA declaring OA is a "serious dz with no current satisfactory treatments"
  13. HUMOR Study - Humira shown to have no effect in hand OA. 43pt crossover RCT #OARSI mtg.


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

Rheumatologists' Comments

I can't help but wonder if the reported increase in heart disease associated with active RA is really due to increased inflammation affecting plaque formation or the effects of NSAIDs that have been widely used in the past as background therapy for DMARDs. Another condition for whuch we have little therapy and is possibly related to inflammatory OA is CPPD disease. All we really have is steroids for pseudogout even though colchicine and DMARDs are used in desperation, not to mention Plaquenil. I appreciate your concise reports.
David, thanks for the thoughts. OA needs a big push from all of us. RA and CVD I believe is largely driven by both inflammation and preclinical pathology that may be related to ACPA and other factors we link with bad RA, those just happen to be proatherogenic too! - Jack

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