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The RheumNow Week in Review – 3 February 2017

Dr. Jack Cush reviews this week's highlights from RheumNow.

  1. Infliximab given < 4 wks before TKA or THA did not increase risk of hospitalized or post-op joint infections
  2. Chemokine CXCL10 highly correlates w/ DAS28, CDAI, SJC, CRP & ESR in pts w/ early untreated RA. Potential Biomarker?
  3. Sarilumab (anti-IL-6) "Kevzara" approved by Health Canada for the Rx of RA. Dose 200 mg sc EOW. Let IL6 Wars begin!
  4. Risk of incident gout 70 fold higher w/ SUA >10; Risk of recurrent gout is 5 fold higher if SUA >9;
  5. A study of 1305 pts shows Psoriatic Arthritis has a 43% higher risk of diabetes. Risk linked to tender Jts and ESR.
  6. NHS: Post-Menopausal women have a 2fold higher risk of seronegative RA (vs. Post-menopause). Menopause before age 44yrs HR= 2.4
  7. 1 million Americans will have hip or knee replacement; but 1/12 hosp w/ complications, and theres no predictive tool
  8. Psoriasis and Psoriatic arthritis pts have a 2 fold increased risk of fracture (including vertebral Fx).
  9. After 1st yr RA pts switch from Remicade to CT-P13 (Inflectra) had same ACR 20/50/70, anti-Drug Abs INTERCHANGEABLE!
  10. Metanalysis of lupus & Rx adherence shows 43-75%, of patients are non-adherent, & 1/3 stop theray after 5 yrs.
  11. Study of Pregnant Psoriatic arthritis women shows skin tends to do well, but joint may worsen in upto 40%.
  12. Recent review of Humira safety in >15k pts shows only 3 congenital anomalies (~4%) that was less than controls (~5%)
  13. Among 103 SLE pts ~10% had "Rhupus" polyarthritis; they had less renal, but more joints, erosions, hi ESR/CRP levels
  14. Gout is Undermanaged 
  15. Limited Efficacy of NSAIDs in Spondyloarthritis 
  16. Is the Jury Still Out on Triple Therapy vs. MTX + TNF inhibitor?
  17. Uncertain efficacy of Pneumococcal vaccine 
The author has received compensation as an advisor or consultant on this subject

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