Friday, 25 May 2018

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The RheumNow Week in Review - Nonadherence and Astronomic Costs (5.11.18)

Dr. Jack Cush reviews highlights, news and journal articles from the past week on RheumNow.com.

  1. Australian RCT treated Trochanteric bursitis (glueal tendinopathy) w/ either education + exercise (EDX), steroid injx or "wait & see". EDX wins w/ better pain and global scores at wk 8 and better global scores at wk 52 (still less pain) https://t.co/eNky3xc9fW https://t.co/v6U8HRfqe0
  2. In an animal model of induced large vessel vasculitis, in vivo Rx w/ tofacitinib reduced JAK2 & JAK 2 cytokine signaling and suppressed tissue-resident memory T cells and vasculitic pathology. https://t.co/7JIMbryFxo
  3. AbbVie Submits Biologics License Application to FDA for Risankizumab (IL-23 Mab) for Moderate to Severe Plaque Psoriasis https://t.co/4lq3xKc6T1
  4. FDA has approved 9 biosimilars in the USA> Zarxio, Inflectra, Erelzi, Amjevita, Renflexis, Cyltezo, Ixifi; Mvasi (Avastin), Ogivri (Herceptin). There are 5 more biosimilars (of either filgrastim or herceptin) in front of FDA w/ upcoming PDUFA dates https://t.co/jeQoGJmygF
  5. The FDA may be getting into the EHR business; FDA has requested $100 million in FY2019 for an EHR initiative to evaluate the safety of regulated products. THis would connect patient safety and outcomes directly to the FDA. https://t.co/DuNorLFKr4
  6. UK study of 1207 male ex-footballers & 4085 control pop. men shows knee osteoarthritis outcomes (knee pain, RKOA TKR) 2-3 times higher in male ex-footballers compared with men in the general population group https://t.co/FJQ34Dm84a
  7. Patients May Not Fill Your Prescription   
  8. Severity of Lupus Nephritis is Declining over Time  
  9. 60 Minutes Drills Acthar - A Financially Crippling Drug   
  10. "Not all symptoms merit a diagnosis or disease, some are just evidence of human imperfection" - J Cush, MD
  11. "I'm addicted to placebos. I'd give them up, but it wouldn't make any difference."  - Steven Wright

 

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

Rheumatologists' Comments

Jack-I will re-try sending this. Your comment "Not all symptoms merit a diagnosis or disease, some are just evidence of human imperfection" - J Cush, MD- strikes a chord with me as I work 6 months a year in locums to keep my skills up. I see many people who have been labeled as inflammatory arthritis, SNRA, UCTD, etc dutifully treated with multiple DMARDs and biologics. Over time, their rheumatologists change but the EHR continues to represent a label as a diagnosis. Subsequent rheumatology providers choose to continue the treatments with dangerous and expensive meds without re-visiting the diagnosis. They take the easy way out and run the patient thru rather than re-invent the wheel or upset the patient who usually doesn't have a clue (especially if underprivileged). No critical thinking or intellectual honesty-just get 'em in and get 'em out and look good on paper (screen of EHR). Very worrisome and a real trap for those who are taking care of he EHR more than the patient. The treatment decisions seem permanent and are not re-evaluated over time for many patients in this uncertain diagnosis category. After FMS, SNRA is a vexing diagnostic label.-David

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