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RheumNow Week in Review – 16 December 2016

Dr. Jack Cush reviews highlights from this week on

  1. US Life expectancy fell from 78.9 in 2014 to 78.8 in 2015. This is the first drop in 22 yrs; due to rises in 8/10 leading causes of death
  2. Reports on Overuse of medical care doubled in last Yr. Overuse of specialty referrals, hospitalizations, narcotics overuse, testosterone use
  3. JAMA Internal Medicine reports 1/6 Americans used a psychiatric drug in 2013; higher in older people, women and whites.
  4. Among 618 PsA patients; 1/2 Rx with a TNFi and 1/2 Rx with DMARDs. Found subsequent Cancer event rates (0.52 vs 1.0/100PY) were significantly lower with the TNFi
  5. PPP Syndrome: Pancreatitis, Panniculitis & Polyarthritis is rare & occurs with pancreatic CA or pancreatitis; Biopsies show panniculitis +/- fat necrosis
  6. 40 Scleroderma patients reported with either very large pericardial effusions (1/3) or pericardial tamponade (2/3); Fluid was exudative. Treatment included. Steroids 50% or surgery 32%
  7. How to ask the Alopecia question Correct: "Is there hair on the pillow in the morning". Less Correct/Specific: "is there hair on the brush or in the shower"
  8. PNAS report of 21 patients with chronic mucocutaneous Candidiasis due to autosomal recessive IL-17RA deficiency, starts infancy with Staph & Candida infections
  9. IL-33 could be a biomarker for RTX responses – when RA pts are RF+ or CCP+; and have detectable serum IL-33 levels & High IgG levels a 100% EULAR response was seen.
  10. Study of 219 pregnant IBD pts shows TNF inhibitor use during Pregnancy was not associated with adverse pregnancy or fetal outcomes
  11. Over 1000 RA patients with resolved HBV (HBsAg -/HBcAb+) infection it was shown that the reactivation rate was 1.9 per 100Pt-Yrs; and not higher with MT or DMARD use
  12. Rituximab May Reduce Mortality Risk in Rheumatoid Lung Disease
  13. Lupus May Be at Increased Risk for Dementia
  14. Random Drug Levels and Anti-Drug Antibodies Predict Rheumatoid Outcomes 
  15. EULAR 2016 Recommendations on Early Arthritis
The author has received research/grant financial support on this subject
The author has received compensation as an advisor or consultant on this subject

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