Tuesday, 20 Aug 2019

News

War on RA - Part 1: Walk on the Moon

It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.

Partial or Total Knee Replacement for Osteoarthritis?

Lancet has reported on a clinical trial comparing total knee replacement (TKR) and partial knee replacement (PKR) in late-stage isolated medial compartment knee osteoarthritis patients finding that both TKR and PKR are equally effective, PKR should be considered the first, because of lower costs and better cost-effectiveness.

FDA Approves Apremilast for Behcet's Oral Ulcers

The US Food and Drug Administration (FDA) has approved apremilast (Otezla) for the treatment of oral ulcers associated with Behçet’s Disease, a rare chronic multisystem inflammatory disease that affects about 5 in 100,000 persons in the USA.

RheumNow Podcast – Don’t Take My Advice (7.19.19)

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

Fatigue is Driven by Inflammation, Pain, and Chronicity in Psoriatic Arthritis

Correlates with fatigue were assessed in psoriatic arthritis (PsA) patients in the DANBIO registry and found to be associated with  clinical inflammatory factors, disease duration, and chronic pain.

A toital of 2062 PsA patients in the Danish nationwide registry DANBIO were studied by cross-sectional survey from December 2013 to June 2014.

Intraarticular Capsaicin in Knee Osteoarthritis

A novel compound, synthetic trans‐capsaicin (CNTX‐4975), has been studied as an intraarticular injection and shown to significantly reduce pain in patients with chronic moderate‐to‐severe osteoarthritis of the knee. A phase II, multicenter, double‐blind study enrolled 172 knee OA patients between the ages of 45–80 years. Patients were randomized to receive either intraarticular placebo, or a high‐purity synthetic trans‐capsaicin CNTX‐4975 0.5 mg, or CNTX‐4975 1.0 mg.

Increased Risk of Cardiovascular Death in Hip and Knee Osteoarthritis

Hip and knee osteoarthritis patients have been shown to have increased mortality rates from cardiovascular events when compared to the general population.

The study included patients in the Skåne Healthcare Register from southern Sweden who were 45–84 years old and seen over 2004-2014. Overall, there were 15,901 such patients in the study.

A Potential Biomarker for Chronic Fatigue Syndrome Patients

Myalgic encephalomyelitis/chronic fatigue syndrome affects at least 2 million people in the United States and bears tremendous overlap with fibromyalgia - both being difficult to diagnosis because the symptom complex is often unrecognized and these conditions have no biomarker test. 

Upadacitinib Superior to Adalimumab in Methotrexate Refractory RA

Upadacitinib, a JAK1-selective inhibitor, was studied head to head against adalimumab and placebo in rheumatoid arthritis after an inadequate response to methotrexate, and shown to be superior to ADA and PBO in ACR20 and DAS remission level responses.

Cardiovascular Disease Increased in Hospitalized Lupus Patients

Systemic lupus erythematosus (SLE) patients who are hospitalized have an increased prevalence of atherosclerotic cardiovascular disease (ASCVD) and its individual phenotypes of coronary artery disease (CAD), peripheral artery disease (PAD), and cerebrovascular disease. 

Rituximab Safety Concerns when Used in anti-TNF Refractory RA

The SUNSTONE study evaluated the long‐term safety of rituximab in rheumatoid arthritis (RA) previously exposed to ≥1 anti–tumor necrosis factor inhibitors (TNFi) and showed a stable, but high, rate of serious infections, opportunistic infections and an overall higher mortality rate.

Rituximab Superior to Cyclosporine for Membranous Nephropathy

The NEJM has reported that rituximab (RTX) and cyclosporine (CYA) was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months.