Tuesday, 20 Aug 2019

News

RA Disease Activity Drives Lung Complications

A longitudinal study from the BRASS registry shows that increase rheumatoid arthritis disease activity increases the risk of RA-associated interstitial lung disease (RA-ILD). RA patients without RA-ILD at baseline, enrolled in the Brigham RA Sequential Study (BRASS, 2003–2016), were followed from 2003-2016 with serial clinical, DAS28, serologic and imaging assessments.

RheumNow Podcast – Tricked Up Lupus Criteria (8.9.19)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including new SLE criteria, ULT in gout and MSU reductions, IVIG in ANCA vasculitis and non-TNF biologics outperform the TNF inhibitors.

NSAIDs Mediate Cardiovascular Risk in OA

NSAIDs have been linked to an increased risk of cardiovascular disease, but does this also hold for osteoarthritis (OA) patients.

Vitamin D Supplements Fail to Prevent Type 2 Diabetes - DUH!

A NEJM report shows that the use of vitamin D3 supplementation (4000 IU per day) in those without diabetes or vitamin D deficiency failed to significantly lower risk of type 2 diabetes (compared to placebo).

The rational for this report included observational data showing an association between a low blood 25-hydroxyvitamin D level and the risk of type 2 diabetes.

Increasing Lung Disease in Systemic JIA

A single-center cohort analysis shows that lung disease is increasingly seen in children with systemic juvenile idiopathic arthritis (SJIA), especially those complicated by macrophage activation syndrome. Prior to 2013, reports of pulmonary disease in SJIA were rare, but since there have been increasing reports of alveolar hypertension, interstitial lung disease and pulmonary alveolar proteinosis; often with a high mortality rate. As such, since 2014, the Cincinnati Children’s Hospital Medical Center has seen an increase in lung disease and severe lung disease in SJIA.

Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA

A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.

anti–cyclic citrullinated protein–positive at-risk individuals (CCP+ at-risk) compared with a healthy control group and patients with early rheumatoid arthritis (RA)? 

New EULAR/ACR Classification Criteria for SLE

The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.

War on RA - Part 3: Useless Drugs

We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.

Are Non-TNF Biologics Superior to TNF inhibitors?

Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis. An analysis from the Swedish Rheumatology Register shows that the non-TNFi biologic DMARDs (bDMARDs), in particular tocilizumab and rituximab, are more effective than TNFi. 

EULAR Recommendations on Large Vessel Vasculitis

Th European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) was originally published in 2009. Since then there have been new randomised clinical trials and cohort analyses leading to an update the original recommendations.

Sjogren's Syndrome at Risk for Psychiatric Disorders

A population-based claims study from Taiwan shows significantly increased incidences of depressive disorder, anxiety disorder, and sleep disorder in patients with primary Sjögren’s syndrome (pSS). 

RheumNow Podcast – More Than a Spot of Tea (8.2.19)

Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com: MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.