Wednesday, 14 Nov 2018

News

Nurse Led Gout Management Highly Effective

UK researchers have shown that nurse-led gout management, using a treat-to-target urate-lowering strategy, is efficacious and cost-effective compared with usual physicain care. The results are published in the recent Lancet edition.

Worldwide, gout management is suboptimal. In the UK only 40% of gout patients receive urate-lowering therapy, and fewer ever achieve a target serum urate (< 6mg/d) concentration.

RheumNow Week in Review – ACR Preview Edition (10.19.18)

Dr. Jack Cush summarizes the news and reports from RheumNow.Com this past week and previews RheumNow activities at the upcoming ACR 2018 meeting in Chicago.

It's the Genes, Not the Diet that Raises Urate

Researchers from New Zealand find that in contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.

NEJM Debate on Medical Marijuana for Chronic Pain

This week’s NEJM features a case discussion and debate over whether medical marijuana should be used to treat chronic pain. The debate focuses on a 31-year-old woman with long-standing complex regional pain syndrome in her leg and foot. CRPS followed a sports related hairline fracture in the right fibula. Her pain has been intractable since.

Update on Immune Checkpoint Inhibitor Toxicity

JAMA has a 2018 update/review of the safety issues seen with mmune checkpoint inhibitors (ICIs) - important new cancer therapies, with 14 cancer indications, that have significantly improved survival in several. ICIs are monoclonal antibodies that block inhibitors of T-cell activation and function.

Apremilast Succeeds in Scalp Psoriasis

Celgene has announced results from the phase 3 STYLE study, showing apremilast yielding significant improvement in moderate-to-severe scalp psoriasis. STYLE is a phase 3, multicenter, randomized, placebo-controlled, double-blind study evaluating the efficacy and safety of apremilast in subjects with moderate to severe plaque psoriasis of the scalp. The study enrolled 303 people who were randomized 2:1 to receive apremilast 30 mg twice daily or placebo for the first 16 weeks.

IL-6 for Adult Still's: A New Option?

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.

Hip and Knee Replacements Monitored by Smart Watch

Reuters reports that patients with hip or knee replacements will now be followed for progress using their Apple watches.

A multi-site study involving medical facilities from Massachusetts, California, Colorado and Michigan will receive stats including heart rate, steps taken and standing hours from patients waiting for or recovering from hip and knee replacement surgery.

RheumNow Week in Review – Four Fingers are Best (10.12.18)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. New info on scleroderma-SLE overlap, nailfold capillaroscopy, Women with SpA, acute gout management and lupus patient in pain who visit the ED.

Teenage Obesity Increases Lupus Risk

Analysis of the Black Women's Health Study shows that obesity as a teenager may be associated with increased risk of systemic lupus erythematous (SLE) in adulthood.

The relationship between obesity and SLE risk is unclear. Past studies have predominantly assessed white women, while black women have higher prevalence of both obesity and SLE.

SLE-Scleroderma Overlap Outcomes

Overlap of autoimmune disorders represents a significant diagnostic and management challenge to the rheumatologist. A novel cohort analysis of overlap between systemic sclerosis (SSc) and systemic lupus erythematous (SLE) suggests such patients tend to be younger, more frequently have PAH, but less cutaneous manifestations of SSc.

NSAIDs OK for Certain High-Risk Groups?

Some patients typically contraindicated for prescription nonsteroidal anti-inflammatory drug (NSAID) use may be able to take them with no increased risk of harm, according to a large observational study.