Friday, 18 Oct 2019

News

Long Delays for Inflammatory Arthritis Patients

The National Rheumatoid Arthritis Society's (NRAS) annual audit has identified significant treatment delays for patients with suspected early inflammatory arthritis could result in unnecessary harm. 

Sprifermin Benefits Cartilage Loss but not Symptoms in Knee Osteoarthritis

Intra-articular sprifermin given to patients with symptomatic and radiographic knee osteoarthritis has been shown to significantly improve total femorotibial joint cartilage thickness after 2 years, but without significant clinical benefits. Which begs the question, why is there a disconnect between radiographic disease modification (cartilage thickness) and symptomatic improvement?

Declining Trends in Antineutrophil Cytoplasmic Autoantibody–Associated Vasculitis Mortality in the USA

Annals of Internal Medicine reports that age-adjusted mortality rates for antineutrophil cytoplasmic autoantibody–associated vasculitides (AAV) have improved over time - with a decline of nearly 2 percent per year in the United States from 1999 to 2017. Nevertheless, long-term outcomes continue to lag behind mortality rates of the general population.

Bisphosphonates and the Risk of Osteonecrosis of the Jaw

Even though oral bisphosphonates are widely used, there is an inordinate concern over the risk of osteonecrosis of the jaw (ONJ). A new UK study suggests that the risk of ONJ is elevated six fold by the use of biphosphonates.

Biologics Lead the Way in Drug Price Increases

Reuters has reported the results of a recent Institute for Clinical and Economic Review (ICER) analysis showing that biologics, especially Humira and Rituxan, are leading the way in the cost of drugs in the USA. All told, Humira and Rituxan topped a list of seven treatments whose combined 2017 and 2018 price hikes accounted for a $5.1 billion increase in U.S. drug spending. ICER said their analysis points to price hikes that were more than twice the rate of medical inflation and were not warranted by any new clinical evidence.

Serum Interferon Predicts Lupus Flares

Elevated serum levels of interferon-α among patients whose systemic lupus erythematosus (SLE) was in remission helped predict future disease flares, European researchers found.

Among 254 SLE patients who were in remission, 26% had abnormally high serum levels of interferon-α at baseline, according to Alexis Mathian, MD, of Pitié-Salpêtrière Hospital in Paris, and colleagues.

FUTURE 5 - Secukinumab and Less Radiographic Progression in Psoriatic Arthritis

The FUTURE 5 trial studied the effect of secukinumab (SEC) on radiographic progression through 52 weeks in patients with active psoriatic arthritis (PsA) and found that SEC was clinically and radiographically superior to placebo (PBO). Patients received s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. The majority (87%) of patients enrolled at baseline remained in the study for 52 weeks.

Antibiotics Increase Rheumatoid Risk - Again

Another UK study has suggested that prior use of antibiotics increases the risk of developing rheumatoid arthritis (RA).

Rheumatology has published a 15 year case–control study that compared 8482 newly diagnosed RA patients and 22,661 controls from the UK’s Royal College of General Practitioners Research and Surveillance Centre database (between 2006 and 2018).

ILD Patients At Risk for Autoimmune Disease

Patients diagnosed with interstitial pneumonia with autoimmune features (IPAF) are at an increased risk of developing a systemic autoimmune rheumatic disease (ARD).

A retrospective study of interstitial lung disease (ILD) patients from the Columbia University Irving Medical Center (2009 to 2017) looked for those who did or did not meet IPAF criteria.

RheumNow Podcast – Women Take Over Rheumatology (10.4.19)

Dr. Jack Cush reviews the News and Journal Reports from this week on RheumNow.com.

ASBMR Recommendations on Secondary Fracture Prevention

The American Society for Bone and Mineral Research has developed multistakeholder consensus clinical recommendations for the prevention of secondary fractures for those aged 65 years and older after an initial hip or vertebral fracture.

Overall they have promoted 13 recommendations (7 primary and 6 secondary) strongly supported medical evidence.

Highlights include recommendations for:

Increasingly Women are Choosing Subspecialty Careers

JAMA Internal Medicine has an analysis of the growing trend of more women enrolling in medical schools in the last few decades, such that more than half of US Med school matriculants in 2017 were women.  Also in 2017, 42% of residents in internal medicine were women.  The reported analysis looked at internal medicine subspecialty choices by women and men between 1991 to 2016.