Tuesday, 17 Sep 2019

News

Anakinra Shows Benefits in Cytokine Storm

The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.

 

ACR Survey Shows Half of Patients Cannot Afford Treatments

Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.

Medical Use of Cannabis in 2019

JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.

Prior Authorizations Delay Care in Rheumatology

Physicians who believe their patients' health is negatively affected by insurers' demands for prior authorization, and the delays that often result, will find that opinion vindicated by a new study of rheumatology care: when permission had to be sought from insurers to provide intravenous drugs, average time to begin treatment was longer and patients had twice the corticosteroid exposure, a single-center analysis found.

RheumNow Podcast – The End of Arthritis (9.13.19)

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

Two vs. Four Weeks of Antibiotic Therapy in Septic Arthritis

A prospective trial has shown that 2 weeks of antibiotic therapy is as effective as 4 weeks of antibiotic therapy, with similar outcomes but shorter hospital stays.

This Swiss study was a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. 

Bimekizumab Add-on Therapy in Rheumatoid Arthritis

Bimekizumab is a dual inhibitor of IL-17A and IL-17F that has been shown to be effective in psoriasis and psoriatic arthritis. A proof-of-concept study shows that giving bimekizumab to rheumatoid arthritis patients not adequately controlled by certolizumab pegol resulted in a rapid decrease in disease activity achieved after 12 weeks of treatment. These findings are novel as anti-IL-17 monoclonal antibody therapy has previously been shown to be ineffective in RA.

74 Percent of Rheumatoid Arthritis Patients Dissatisfied with Treatment

CreakyJoints has completed a 258 patient survey showing that nearly three-fourths of people with rheumatoid arthritis (RA) have expressed dissatisfaction with their treatments, including conventional (csDMARDs) and biologic Disease Modifying Antirheumatic Drugs (bDMARDs).

Steroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis

Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.

Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement

JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.

Riociguat Fails in Systemic Sclerosis-Associated Digital Ulcers

Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.

Anti-IL-23 Beats IL-17 in Plaque Psoriasis

Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).