Friday, 23 Mar 2018


Two Types of Osteoarthritis Based on Cartilage Studies

A report from Annals of Rheumatic Diseases suggests that osteoarthritis (OA) may be two distinct diseases based on genetic studies of articular cartilage. (Citation source:

RNA sequencing of knee cartilage from 44 OA patients undergoing total knee replacement was compared to 6 additional patients with OA and 10 control patients with non-OA.

Prevention of HBV Infection: How Are We Doing?

In 2016 the WHO set out to eliminate HBV infection as a public health threat by 2030. So far, we are far from this goal as vaccine implementation has been suboptimal in a number of important patient populations, including patients with rheumatologic diseases, as well as other immunocompromising diseases like HIV.

Rheumatology Physician Burnout and Depression

The 2018 Medscape Physician Burnout and Depression report shows that 42% of physician respondents report "burnout" and up to 15% experience some sort of depression. In a survey of 15,543 doctors from 29 specialties, they found highest burnout rates in critical care and neurologists (48%), family medicine (47%), ob/gyns and internists (46%). Lowest rates were seen in pathology and dermatology (32%), and plastic surgery (23%). 

What did rheumatologists report?

IL-1 and IL-6 Inhibition Preferred in Systemic JIA

Since 2000, the German Biologics register (BiKeR) has prospectively enrolled children with juvenile idiopathic arthritis to assess outcomes with biologic therapies.  A new report evaluates the efficacy and safety of etanercept (ETA), tocilizumab (TOC) and the interleukin-1 inhibitors (anakinra and canakinumab) (IL-1i) in those with systemic onset juvenile idiopathic arthritis JIA (sJIA).

Salt Drives Gut-Brain Connection via IL-17

A study from Nature Neuroscience shows that a high salt diet may mediate neurovascular disease by altering microbiome and the expansion of TH17 cells in the small intestine, thereby increasing plasma interleukin-17 (IL-17) and its subsequent effects on endothelium in the brain.

Laparoscopic Gastric Sleeve Compared to Bypass Bariatric Surgery

JAMA reports the results of a 5 year Finnish study comparing the results of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass and shows that gastric bypass yielded greater weight loss at 5 years, the difference was not statistically significant, in patients with morbid obesity. 

New Rise in Hip Fractures Amongst Women

Reuters reports that the incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients.

Stroke Risk Confirmed in SLE

The most common cerebrovascular events (CVEs) seen among a large cohort of patients with systemic lupus erythematosus (SLE) were stroke and transient ischemia, and the majority of these events were attributable to the disease itself, a multinational study determined.

The RheumNow Week in Review - 12 January 2018

Dr. Jack Cush reviews a dozen highlights from the past week on

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

Ibuprofen’s Anti-androgenic Effect May Result in Hypogonadism in Males

PNAS reports use of ibuprofen by males may result in antiandrogen effects that may contribute to adult male reproductive problems.

40% of Arthritis Patients Fail to Receive Exercise Guidance

The latest issue of CDC’s MMWR reports that exercise counseling among arthritis patients increased from 52% to 61% (2002 to 2014); hence ~40% do not receive health care provider counseling, suggesting the need for provider education and training in exercise counseling, and improved electronic medical record reminders.