Tuesday, 20 Aug 2019

TODAY'S HEADLINES

Good Pregnancy Outcomes for DMARD Exposed JIA Patients

A study of pregnancy outcomes in 98 women with juvenile idiopathic arthritis (JIA) who were exposed to DMARDs shows no increased risk of major adverse pregnancy outcomes.

A total of 152 pregnancies in 98 women with JIA and 39 pregnancies involving 21 male patients as partners were reviewed. The majority had a polyarticular JIA (61%). The average age at first pregnancy was 24.1 years, and their mean disease duration was 13.8 years.

Skyrizi Outduels Humira in Psoriasis

A head-to-head trial has shown that risankizumab was significantly superior to adalimumab in providing skin clearance (PASI90) in patients with moderate-to-severe plaque psoriasis, with no difference in safety signals between the two agents.

Upadacitinib (RINVOQ) FDA Approved for Rheumatoid Arthritis

The US Food and Drug Administration (FDA) on Friday, August 16, approved AbbVie JAK1 inhibitor, Rinvoq (upadacitinib) for adults with  rheumatoid arthritis with moderately to severely active disease either not responding to, or intolerant of, methotrexate (MTX). 

RheumNow Podcast – Antibiotics Increase RA Risk (8.16.19)

Dr. Jack Cush reports the news and important journal articles from the past week on RheumNow.com.

Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease

Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results. On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.
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How do you help your patients who are resistant to your medical recommendations when they are receiving biased information from friends, family, and the internet? I wanted to share with you two cases and my approach.
While often seen as demanding, millennial patients have grown accustomed to having direct access to everything and everyone. They tend to be more involved in the clinical evaluation in the office, more concerned about the social aspects of the disease, and are more frustrated with the varying shades of gray in diagnoses and delayed treatment efficacy. What does this mean for you and your practice?
Knowing the names of the agents in today’s armamentarium should be simple. But, the nomenclature is notoriously confusing. The names of monoclonal antibodies can stretch to five syllables which defy easy pronunciation beyond the “mab” at the end. Who comes up with these names anyway?
The House of God is probably more known of than read, with over 3 million copies sold since its release when I was a Chief Medical Resident in the era of its writing. The book itself, according to the author Samuel Schem (aka Steven Bergman, MD, DPhil), a psychiatrist and currently Professor of Humanities at NYU, is a true account of his internship, albeit laden with some liberties of fiction - and it's been quoted for generations. The House of God is cruelly funny and portrays many uncomfortable and dehumanizing aspects of medicine, including substance abuse, bawdy sex (and lots of it), sleeplessness, depression, and suicide to name a few. Taken at face value, it would seem countercultural to our current aspirations of putting patients first, #MeToo and burnout concerns. Is this book merely a humorous anachronistic rant, or a serious work of reflection meritorious of being read and pondered upon?
Riociquat in Scleroderma ILD
OP0183 #EULAR2019
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