RheumNow Week in Review – I Wanna New Drug (9.28.18) Save

Dr. Jack Cush reviews the news from the past week on RheumNow.com, including news on inappropriate opioids, pre-clinical RA treatment, DMARDs in Gout, the decline of arthroscopy and a pain in the mouth.

1. Horizon announces a new trial to evaluate the efficacy of MTX in prolonging efficacy and preventing anti-PEG antibodies in refractory gout patients treated with Pegloticase IV http://bit.ly/2xUsJxa
2. Study from the UT Southwestern Cutaneous Lupus Registry; 129 pts w/ Cutaneous Lupus had 18% risk of other autoimmune disease - including 5% w/ autoimmune thyroid disease. ~3-5x Higher risk if white, never smokers, +FHx autoimmune Dz, +ANA https://t.co/mA9y7qLEQe
3. Systematic review examined 10 studies, 1156 patients with undifferentiated (UA) or arthralgia & showed that DMARD/steroids did not reduce the risk of RA in arthralgia only pts, but use in UA significantly reduced the risk (OR 0.73; 95% CI 0.56 to 0.97) https://t.co/ZImmumitD2
4. BMS - Burning Mouth Syndrome - a variant of chronic pain. Affects 4% in Sweden, mostly middle-aged & elderly women. Pts present with severe burning or stinging, usually the tongue, dysgeusia, xerostomia and skin disorders. https://t.co/4HSnlxLxAh
5. Analysis of Veteran's Affairs RA data from 2006 to 2012, looked at escalating from MTX to MTX‐TNFi or triple therapy shows nonpersistence with triple Rx is related to AE from SSZ use. https://t.co/MBGMrnwKj0 
6. Large EMR study of 8,879 fibromyalgias patients found 34 suicide attempts and 96 suicidal ideation events; predicted by obesity & drug dependance but prevented with more frequent outpatient engagement https://t.co/j0Psi5As4g
7. Mylan and Fujifilm have won a European Commission approval to market their Humira biosimilar called Hulio. That makes for 5 such adalimumab biosimilars (others from Amgen, Sandoz, Samsung Bioepis, Boehringer Ingelheim) https://t.co/KlgPjxhU6I
8. Annals Int Med - analysis of adults prescribed opioids between 2006-2015 shows 31943 Rx visits for opioids - 5% for cancer pain, 66% for noncancer pain &  28.5% an Opioid was Rx without a pain Dx. https://t.co/6vKQbwEdkR
9. Lancet ARRIVE study: PBO vs aspirin in primary prevention in >12K pts w/ moderate CV risk. No difference in fatality rate, no signif difference in combined CV endpoint (MI, CVA etc) but event rate was very low. ASA assoc w/ 2 fold increase in GI events https://t.co/Er6PI1yInp
10. Knee Arthroscopic Surgeries on the Decline 
11. Ustekinumab May be Effective in Lupus