Friday, 15 Nov 2019

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The RheumNow Week in Review – 7 April 2017

Dr. Jack Cush reviews highlights from this week's meeting at the Cleveland Clinic Foundation - Biologics Summit VII; and of course a few other tweets and journal articles:

  1. Dr Ritchlin Risk factors for PsA: obesity, nail dystrophy, smoking, severe psoriasis, nail dystrophy, trauma, Fam Hx PsA, Rubella vaccination
  2. Dr. Ritchlin-30% psoriasis pts develop PsA, mechanisms unknown. enthesitis driven by biomechanical factors, arthritis involves IL-17, IL-23
  3. Psoriatic Genetics: Dr Chris Ritchlin shows HLA- C*0602 seen in 57% of Psoriasis patients, but only 28% of Psoriatic arthritis. #CCFSummit
  4. FDA approves 23andme to market genetic tests for Alzheimers,Parkinsons, celiac, dystonia, Gaucher, hemochromatosis
  5. Dr Torgerson Complement deficiency in SLE: C2 40% homozytotes get lupus GN; C4 - 75% get GN; C1q/r/s def 90% get SLE or GN, usually young
  6. Dr Troy Togerson humans make 100 billion PMNs qd, live ~6.5 hrs, removed by complement and phagocytes. "Neutrophils live fast and die hard" 
  7. Dr Holers Mucosal evidence: IgA autoAb present, airway dz in ACPA+ FDR, IgA plasmablasts, dysbiosis (gut, periodontal) in At risk individuals
  8. Dr. Holers - Stopping smoking will reduced risk but data from Nurses Health Study says you need to be off for 20yrs…
  9. Dr M Holers shows 1st Degree relatives (FDR) about 16% are RF or CCP positive, increased by smoking @CCF Biologics Summit VII
  10. Dr McInnes -"RA synovium in inflammation tells us much, but the synovium in remission is likely to tell us more"
  11. Dr McInnes - in #RA the immune system dynamics change as the disease evolves; yet our therapies/approach unchanged and not keenly targeted
  12. Dr Iain McInnes "One of the major lessons in the last decade is that we are bad at choosing the right target" CCF Biologic Therapies Summit
  13. Statin Necrotizing myopathy review 100 pts, 65yrs, CK 6853, 100% HMG-CoA reductase Ab+, most on DMARDs
  14. FDA grants "breakthrough status" (expedited review) for Rituximab in Pemphigus Vulgaris based on recent Lancet study
  15. Abbvie announces that Humira is now FDA approved for use in severe finger nail psoriasis.
  16. FDAs Oncology Advisory Committee votes 11-0 approve subcutaneous rituximab for lymphoma & CLL. Given in minutes not hours
  17. Auranofin repurposed for use in cancer, resistant bacterial, fungal & parasitic infections
  18. Healthy Bones Formed During Adolescence 
  19.  Abatacept Use During Surgery
  20. The Great Masquerader. 
The author has received compensation as an advisor or consultant on this subject

Rheumatologists' Comments

A lot of time and money is wasted chasing ghosts associated with FMS. Another problem is when FMS coexists with bonafide disease including RA, SLE etc. More chasing ghosts. If anything improves with a prednisone challenge, the FMS must be set aside and the evaluation of symptoms must proceed in spite of the FMS.

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