Tuesday, 19 Mar 2019

News

Senate Drills Drug Makers Over Price

Reuters reported that today, the US Senate Finance Committee met to question the executives from seven US pharmaceutical companies on the rising price drugs in America. 

Does Smoking Cessation Reduce RA Risk?

Individuals who quit smoking and maintained their nonsmoking status over a long duration of time had a decreased risk of developing seropositive rheumatoid arthritis (RA), an analysis of two large prospective cohorts found. 

Canadian Vaccination Guidelines for the Immunosuppressed

A multidisciplinary Canadian task force has developed guidelines for vaccination in patients receiving immunosuppressive therapies, based on the evidence that immunosuppressive use in immune-mediated disease may be  associated with an elevated risk of infections. 

FDA Slaps a Boxed Warning on Febuxostat for CV Risk

The U.S. Food and Drug Administration (FDA) has reviewed data from the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial and concluded there is an increased risk of death with Uloric (febuxostat) compared with allopurinol, and has added this as a boxed warning to the drug’s product label.

The Risk of Tuberculosis with TNF Inhibitors

A study from Turkey shows that among 2117 patients treated with a TNF inhibitor (TNFi) the risk of developing TB was 6 fold higher in those treated with a TNFi compared to non-users.

This retrospective cohort study included patients with rheumatoid arthritis (RA), ankylosing spondylitis, juvenile idiopathic arthritis or psoriatic arthritis (PsA) that treated with or without TNFI. The calculated the 2-year RR of TB after TNFi.

RheumNow Podcast - Death and Surgery (2-22-19)

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

Lupus Microbiome May Drive Disease Activity

Silverman and colleagues have published their study of the fecal microbiome of systemic lupus erythematosus (SLE) patients and found roughly five times more gut bacteria known as Ruminococcus gnavus, and that these abnormalities in microbiota can correlate with measures of disease severity in SLE.

Impressive Survival of Interleukin-1 Inhibitors in Systemic Juvenile Idiopathic Arthritis

The drug retention rate of interleukin-1 inhibitors (IL-1) used to treat systemic juvenile idiopathic arthritis (JIA) appears to be quite high according to a new study. 

Safety Warnings for Higher Dose Tofacitinib

Pfizer has issued a press release regarding the safety of tofacitinib, citing higher rates of pulmonary embolism and death associated with the use of higher dose tofacitinib 10mg bid in rheumatoid arthritis (RA) patients treated in a long-term safety trial.  

Remission Unlikely in RA

Dr. Marwan Bukhari (editor of Rheumatology) has written an editorial wherein he suggests that true remission is hard to achieve. He notes that "remission as a target is a noble objective that we should all aspire to but we should not chastise our practice if we do not achieve it, as more and more evidence suggests that we should consider it the ideal but not the norm."

TKR - One or Two at a Time?

His would-be surgeon tried mightily to talk him out of a bilateral knee replacement. At 340 pounds, the patient's BMI -- above 43 -- was a significant contraindication. 

But the patient -- Nick Yphantides, MD, chief medical officer for California's San Diego County -- told MedPage Today he "aggressively" insisted, threatening to find another surgeon if he had to.

Older Men Less Likely to be Assessed and Treated for Osteoporosis

A study from the University of Washington in Seattle find that men with osteoporosis were less likely to be assessed by dual-energy X-ray absorptiometry (DXA); vitamin D measurements and were less like to receive calcium/vitamin D and bisphosphonate prescriptions.