Friday, 15 Dec 2017

News

SLE Clinical Trial Design and Outcome Measures

Clinical trials remain a challenge in SLE and a number of outcome measures have been used with varying success.

Two abstracts in this session sought to address novel ways to assess responses in SLE trials.

Tech Tools for Rheumatologists Version 3.0

On Monday November 11th, Dr. Suleman Bhana, presented Tech Tools for Rheumatologists Version 3.0. 
 
Dr.

Low-dose Bactrim Safe with Methotrexate in AAV

A high proportion of GPA patients receive pneumocystis prophylaxis, usually with TMP-SMX (Bactrim), and drug interactions are always a concern.  

Large Vessel Vasculitis: Giant Cell Arteritis and Takayasu Arteritis

Prof Weyland started by explaining that giant cell arteritis (GCA) and Takayasu Arteritis (TA) are granulomatous forms of arteritis. The age of onset is usually >60 years in GCA and < 40 years in TA, the group in the middle may be a different form of vasculitis based on gene expression studies.

Gut-derived TNF: Connection Between Crohn’s and SpA and Sacroiliitis

The pathogenesis between microscopic gut inflammation leading to the development of Crohn’s disease and sacroiliitis has been poorly understood. Dr. Debusschere, et al sought to understand this important link between IBD and axial SpA. The group looked at the in situ expression of gut biopsy derived TNF, TNFR1 and TNFR2 from known SpA patients.

Co-morbid Fibromyalgia

Rheumatoid Arthritis and SLE can be quite challenging to manage in clinical practice, but our arsenal of medications to tone down inflammation is becoming quite broad.

Sustenance Inspector’s 2017 Annual ACR report

There are two things I learned in rheumatology fellowship.

  1. Never burn any bridges because everyone in rheumatology knows each other

  2. Rheumatologists like their food

Podcast of ACR Day 1

Check out this compilation of our ACR Day 1 videocasts merged into one 59 minute podcast !

https://soundcloud.com/rheumnow/rheumnow-acr-2017-san-diego-day-1

You can follow RheumNow podcasts on Soundhound.com and iTunes.

ACR 2017 - Day 1 Highlights

Curtis and colleagues presented a plenary session that analyzed the duration of drug holidays and the risk of subsequent fractures (FX) in women starting bisphosphonates (BP). They looked at 156,236 women taking BP for 3 years (median 2.1 yrs.) and then discontinuing BP.  20% stopped BP for > 6 mos. and 12.7% restarted BP and 11% died. For those off BP for >2 yrs. there was a 40% increased risk of Hip Fx.

RA and Cardiac Co-Morbidities

We know that cardiovascular disease (CVD) is the leading cause of death in RA and that traditional risk factors do not fully account for increased risk. It is also recognised that RA patients have fewer warning symptoms prior to major event and also have a higher case fatality rates for stroke and cardiac events. 

Complementopathies: Redefining Old Diseases

From Dr. Michelle Petri’s lecture on Antiphospholipid Syndrome Updates at ACR17 Review Course on Saturday, I learned that there is now a new class of diseases called the complementopathies.  This was the first time I heard of this term; how many patients did I misdiagnose who really had this and what are the ICD10 codes?!

The Red Eye in the Rheumatology Patient

Professor Rosenbaum is well known for his expertise in rheumatic eye disease and he gave a great summary of how to approach your patient having a red eye.

The differential diagnosis for the red eye includes conjunctivitis, keratitis, acute anterior uveitis, episcleritis, scleritis and acute closed angle glaucoma.