Friday, 20 Oct 2017

News

Tofacitinib Scores in TNF inhibitor Resistant Psoriatic Arthritis

Mease et al has reported in the NEJM the results of a phase 3 trial showing tofacitinib (Tofa) to be significantly more effective than placebo in active psoriatic arthritis (PsA) patients who previously failed to respond to tumor necrosis factor inhibitor (TNFi) therapies. 

Rheumatologists are Slow to Change DMARDs

The paradigm of rheumatoid arthritis (RA) therapy mandates early diagnosis and aggressive treatment.  Yet a recent cohort study has shown that RA patients with moderate to high disease activity (MHDAS) were met with infrequent DMARD adjustments; with median time to DMARD adjustment being 5 months and median time to low disease activity (LDAS) was roughly 10 months. 

Gout Increases Risk of Stroke Moreso than MI

Gout coassociates with many of the disorders within the metabolic syndrome - diabetes, hypertension, hyperlipidemia and obesity.  Not surprisingly, gout is a risk factor for cardiovascular disease, but the risk magnitude for  myocardial infarction (MI), and stroke are unclear.

Stelara FDA Approved for Use in Adolescent Psoriasis

Johnson & Johnson has announced that they have received an expanded FDA approval for the use of ustekinumab (Stelara) in treating adolescent patients, aged 12 and over, with moderate to severe plaque psoriais.

High Drug Discontinuations and Nonadherence in Fibromyalgia

Compliance and adherence was shown to be quite poor in fibromyalgia (FM) patients, with high rates of drug discontinuation and greater than 60% demonstrated low adherence.

Spinal X-ray Inhibition in Ankylosing Spondylitis Best Achieved by Control of Activity

Although tumour necrosis factor inhibitors (TNFi) are highly effective (on clinical grounds) in ankylosing spondylitis (AS), proof that they may alter the course of spinal radiographic progression has been scant. That's primarily because of the insidisous nature of the disease, comparatively slow progression and difficulties in imaging and scoring the sacroiliac and axial joints. 

13 October 2017 The RheumNow Week in Review

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses a novel antiviral drug or the use of stem cell therapy for scleroderma, rituximab in HSP, when to withdraw NSAIDS in RA, and congrats to PAs and NPs!

The Big Need - NPs and PAs

Despite being one of the most satisfying of medical subspecialties, the number of U.S. rheumatologists is about to sharply decline.  These data were presented at the 2016 ACR meeting, where it was shown that the estimated total number of U.S. rheumatologists in in 2015 was 4,933 and is projected decrease to 3,645 by 2025. During this declining clinical supply, there will be a 138% increase in demand from 6,155 to 8,184 by 2030.

Novel Gel Drug Delivery Developed for Rheumatoid Arthritis

Scientists at the Institute for Basic Science have invented a hydrogel capable of delivering drug at sites of inflammation in disorders such as rheumatoid arthritis. Published in Advanced Materials, this jelly-like material could be used to absorb extra fluids in swelling joints and release drugs wherever nitric oxide is produced in abundance.

Arthritis Burden over $303 Billion Annually in U.S.

Arthritis of all types in the U.S. carried an economic burden of $303.5 billion in 2013, nearly 1% of the gross domestic product that year, according to a CDC analysis.

BSR Guidelines on Lupus Management

In the UK, NICE has accredited the British Society of Rheumatology (BSR) to develop a guidance document on the management of systemic lupus erythematosus in adults.  The last published guidelines for lupus were published in 2008 by EULAR and in 2012 by the ACR.

Zilretta - a New Drug FDA Approved for Osteoarthritis of the Knee

Flexion Therapeutics announced friday that the U.S. Food and Drug Administration (FDA) has approved its osteoarthritis (OA) of the knee injectable steroid drug Zilretta with the indication of moderate-to-severe knee pain.

Zilretta is the commonly used triamcinolon acetonide combined with a drug delivery system designed to provide extended pain relief over three months.