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The RheumNow Week in Review –Fateful Outcomes in Rheumatology (7.13.18)

Dr. Jack Cush reviews the news and journal articles from the past week on  Fateful outcomes in Rheumatology, what happens to Seronegatives, IL-23 fails, MRI progression, Not all inflammatory back pain becomes SpA:

  1. Canadian population studies shows that hyperlipidemia monitoring (mostly by PCPs) was poor for 5587 RA and 5613 controls; Lipids were measured in 56.6 and 59.5%, respectively     
  2. Metanalysis shows autoimmune disease significantly co-associated with psychosis (OR 1.26) - positive assoc w/ pernicious anemia (1.91), pemphigoid (1.90), psoriasis (1.70), celiac (1.53) & Graves Dz (1.33); but neg assoc for AS (0.72) & RA (0.65)
  3. Early Arthritis Clinic in Australia (2008-15) shows significant delays: from symptom onset to rheumatology review = 26.4 wks. Patient delay (8.7 wks) was the longest delay-predicted overall delay. GP  delays associated with lower disease severity & those at a socioeconomic disadvantage   
  4. 76/156 early RA pts in remission at 1 year were studied (including MRI) at baseline and at 12 months. Despite clinical remission a majority had MRI inflammation (43% synovitis, 39% BM edema, 9% tenosynovitis), and 33% showed MRI progression of bone erosions.
  5. Claims data study of GPA pts (214 children & 5,352 adults) showed hospitalizations 30% higher in children w/ GPA; who also had 2-3 fold higher rates of leukopenia (RR = 2.6), neutropenia (RR = 2.2) & hypogammaglobulinemia (RR = 3.7)
  6. NIH Rochester Epidemiology Project enrolled adults w/ LBP from 99-03 From 5304 pts with back pain, only 124 patients had new‐onset Inflam LBP (IBP). After 13.2 yrs, only 31% of IBP progressed to SpA; That IBP often resolves may explain difference betw prevalence of IBP (3–6%) & the prev of SpA (0.4–1.3%)   
  7. Testosterone use in USA tripled from 2001 - 2011, mostly men without clear indication. In late 2013 2 studies reported increased MI & CVA risk associated with testosterone use and since decreased 50%.
  8. The Diverse Fate of Seronegative Rheumatoid Arthritis  
  9. Defining Refractory RA by Biologic Use     
  10. IL-23 Inhibitor Fails in Ankylosing Spondylitis    
  11. Hydroxychloroquine Being Over-Dosed with New Guidelines?   
  12. Prescription Drugs and the Effect on Access to Biosimilars in the US   
  13. Upcoming ARTHROS Regional Meetings in Chicago, Nashville, Boston and Washington, DC  


The author has received compensation as an advisor or consultant on this subject

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