Friday, 20 Oct 2017

You are here

The RheumNow Week in Review – 21 April 2017

Dr. Jack Cush reviews highlights from the past week on RheumNow.com:

  1. Long term followup of RA pts on Norfolk registry demonstrate better SURVIVAL when DMARDs are started early (<6 mos) https://t.co/Wy2OVFuw7l
  2. How Pfizer makes most of its $52.8 billion in 2016 - Surprisingly most from Prevnar 13 at $5.7 bill/year! https://t.co/bSy2GjLlj9
  3. Neutrophil to Lymphocyte ratio useful in assessing SLE w/ lympho/leukopenia from Rx or SLE? High (>2) w/ Dz activity https://t.co/NrbQaQ2xtA
  4. Acute Arthritis study shows ultrasound gout findings show sensitivity/specificity for 1) double contour 42/92%, 2) Intraarticular aggregates 58/92%, and 3) tophi 40/100.; all with a PPV 88-100% https://t.co/pf2T3JBAeU
  5. In animal models, high fat, high carbohydrate diet (junk food) promotes cartilage damage and osteoarthritis. https://t.co/70KgIrzh74
  6. Corrona study 1,567 PsA shows patients w/ dactylitis or enthesitis had more Dz activity, Pain, Fatigue, low work,HAQ https://t.co/2UcTOZKhYf
  7. Osteoarthritis Initiative 4367 pts shows 15% w/ recurrent falls, increased by 22-25% w/ opioid or antidepressant use https://t.co/LiIEANObvj
  8. Lyme disease hits 2016 record high in Maine; 1464 cases, up by 21% from 2015. Most increased Penobscot Co since 201… https://t.co/3LPj5wdisM
  9. Data from OP/OA mtg in Italy says Knee Osteoarthritis is associated wth a 13% higher risk of developing hypertension (P=.03) https://t.co/pEKJH0R7wj
  10. Norway population study shows self-reported dx of RA & AS highly inaccurate, 19% RA, 16% AS verified by hosp records https://t.co/zc2zIb1ZZY
  11. FDA Delays Baricitinib Decision
  12. The Cost of Not Taking Medicine
  13. Anti-IL-23 Therapy Effective in Crohn's Disease
  14. Paradoxical Toxicities with TNF Inhibitors
Disclosures: 
The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

I am working in locum in Wisconsin and note that the EHR frequently lists a "problem" (not diagnosis) of Lyme disease. The majority of such patients have poorly documented disease manifestations with non-confirmatory serologies upon repeat or Western Blot. The majority are "diagnosed" and empirically treated in the ER or urgent care setting by a primary care doc based on non-specific complaints (when I started practice in 1978 such patients were labeled "chronic brucellosis", now they are labeled "chronic Lyme disease). Hence I am slow to accept any "reports" regarding the incidence of Lyme disease. More likely its the incidence of mis-dagnosis of Lyme disease. A + PPD does not equate to active TB (only exposure), and +serolgy for Lyme does not equate to active disease, only expoure to B. Bergdorfi.

More Like This

The RheumNow Week in Review - 20 October 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses presentations from APLAR 2017 in Dubai, Catastrophic APS, safety of low-dose prednisone, frequency of psoriatic arthritis and a new drug for PsA and a hepatitis A outbreak in San Diego.

13 October 2017 The RheumNow Week in Review

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses a novel antiviral drug or the use of stem cell therapy for scleroderma, rituximab in HSP, when to withdraw NSAIDS in RA, and congrats to PAs and NPs!

The Big Need - NPs and PAs

Despite being one of the most satisfying of medical subspecialties, the number of U.S. rheumatologists is about to sharply decline.  These data were presented at the 2016 ACR meeting, where it was shown that the estimated total number of U.S. rheumatologists in in 2015 was 4,933 and is projected decrease to 3,645 by 2025. During this declining clinical supply, there will be a 138% increase in demand from 6,155 to 8,184 by 2030.

Arthritis Burden over $303 Billion Annually in U.S.

Arthritis of all types in the U.S. carried an economic burden of $303.5 billion in 2013, nearly 1% of the gross domestic product that year, according to a CDC analysis.

The RheumNow Week in Review - 6 October 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses when to hold the biologic, lymphoma risk with tofacitinib, early clues to the diagnosis of RA, biologic use in pregnancy, what's killing psoriasis patients and the 2016 top 5, best selling drugs in rheumatology.