Tuesday, 19 Mar 2019

News

Combo RA Treatment May Boost Risk for Serious Adverse Events

A current meta-analysis of safety and efficacy of combination bDMARD treatment in RA patients shows that combination treatments increase serious advese event (SAE) risks, and the risk for serious infections in particular.

Opioids Double Rates of Suicides and Overdoses

An article in the New England Journal of Medicine reports that the rates of suicide and drug overdoses has doubled in the last 17 years, and that opioids are largely to blame.

Using data from the Centers for Disease Control and Prevention databases, researchers show that the sheer number of deaths from suicides and unintentional overdoses together rose from 41,364 in the year 2000 to 110,749 in 2017.

BMS Buyout of Celgene for $74 Billion

Reuters reports that Bristol-Myers Squibb (BMS) has announced its intention to buy Celgene Corp for nearly $74 billion in a cash-and-stock deal.

Celgene shareholders will receive one BMS share and $50 in cash per share (or $102.43 per share), and a premium of 53.7 percent to Celgene’s Wednesday close.

RheumNow Podcast – A Grand New Year (1.4.19)

Dr. Jack Cush reviews the news and journals for the beginning of 2019. All from RheumNow.com. Best wishes for a charmed 2019! My advice: 1. Just show up. 2. If you can, then you must do. 3. Live each day as if it twas your 1st day/last day/make or break day. 4. Teach.

2018 Rheumatology Year In Review

This annual appraisal of hallmark moments, news and research articles from 2018 are gleaned from that published in RheumNow during the last year and filtered by other news sources and literature review.  The top 10 list herein is rooted in what rheumatologists should know and what will likely change their standards and practice in the future, if not 2019. 

Uncertain Long Term Efficacy in Trials of Knee Osteoarthritis

A systematic review and network meta-analysis of 47 randomized clinical trials in knee osteoarthritis finds uncertainty around estimates of effect size for pain scores thereby casting uncertainty over the long-term efficacy of medications for knee osteoarthritis.

Sleep Apnea Increases Gout Risk

Both Gout and obstructive sleep apnea (OSA) comingle with a wide range of serious comorbidities. A matched retrospective cohort study from the UK Clinical Practice Research database shows those with OSA are at a higher risk of developing gout.

This report compared 15,879 patients with OSA versus 63,296 without; median follow‐up was 5.8 years.

Severe Cutaneous Sarcoid Treated with Tofacitinib

Researchers from Yale have taken a novel approach and shown benefits when using tofacitinib in severe cutaneous sarcoidosis.

A report in the NEJM describes a 48-year-old female woman who was previously unresponsive to multiple medications and had not received systemic glucocorticoids. She was treated with tofacitinib 10 mg twice-daily and clinically responded with near disappearance of her skin lesions..

Best of 2018: The Safety of Paternal Exposure to DMARDs and Biologics

Pregnancy and drug safety is a complex issue, often with limited information about maternal drug exposure on the offspring. Greater uncertainty exists when considering whether paternal exposure may also influence fetal outcomes.

A systematic review examined the effect of disease modifying anti-rheumatic drugs (DMARDs) on male fertility and if peri-conception (within 3 months) paternal exposure was detrimental to fetal outcomes.

Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices

An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

Best of 2018: Hydroxychloroquine Being Over-Dosed with New Guidelines?

Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice. A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).

Best of 2018: U.S. News 2018-19 Rheumatology Rankings

The Annual U.S. News and World Report Rankings of Hospitals has listed the top contenders in the field of rheumatology. The U.S. News Review rates hospitals nationwide in 16 specialties – including rheumatology. Of the 4,500 hospitals covered by U.S. News that were analyzed, 158 were classified nationally in at least one specialty area.