Wednesday, 22 May 2019

RA/Inflammatory arthritis

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20 May 2019 ACR Video RheumNow Live Preview with Dr. Michael Weinblatt (MTX: Who Would've Predicted Its Impact in RA?)
18 May 2019 Social Smartphone pictures (taken by patients) can be very helpful. One study in 40 Pediatric dermatology patients showed an 89% concordance between clinic visit and virtual picture diagnosis.
18 May 2019 Social 100 pts with oligoarticular inflam arthritis in India: Causes= periph SpA(n 37), axial SpA(11),TB (19), brucella (6), septic arthritis (6), gout (5), RA(5), NTMycobacteria (2), SLE (2), chikungunya (2), 1 Ea. w/ ALL, sarcoid, pachydermoperiostosis
17 May 2019 News Opioids, SSRIs and Steroids Increase Fracture Risk in RA
16 May 2019 Social Discontinuing TNFi before wk 20 is feasible in RA and JIA pregnancy with well- controlled Dz. OTIS study of 490 women compared 25% who D/C TNFi before wk 20 vs 41% taking TNFi after wk 20. D/C TNF not assoc w/ clinical worsening in the 3rd trimester.
16 May 2019 Social Literature review - 23 studies on Natural dietary supplement (NDS) use finds that worldwide 47% of RA pts use NDS, did not differ by geographic region, 47% found NDS to be effective, 13% had adverse side effects, & 30% informed their physicians.
15 May 2019 Social Reactivation of latent CMV infection is rare in Rheum Pts. 14 pts described w/ febrile illness, on steroids (13), with coinfections (8), 4 died during hospitalization, tend to have longer hospitalizations (47 vs. 7 days), more coinfections (67% vs. 17%)
13 May 2019 Social Studies argue about MTX efficacy in GCA; many calling for new RCTs at higher doses. A new real world study compared 83 GCA pts on MTX (13.5mg/wk) vs 83 controls showing signif. lower relapse rates with MTX (0.32; 0.24–0.41), but no change in steroid use
10 May 2019 Social The RheumNow Podcast is up! Watch it here or listen to the podcast on iTunes or SoundCloud
07 May 2019 Social Danish population study of 55,037 found 210 men (37.6% RF+) & 456 women (41% RF+) RA pts; In women, body fat%, waist size, & obesity was assoc. w/ higher risk of RA. (10% higher for each 5% body fat, 5% for each 5- cm in waist, & 50% higher for obese)
07 May 2019 Social Claims comparison of venous thromboembolic events (VTE) in treated RA pts finds a nonsignificant, but numerically higher rate of VTE in TOFA vs TNFi pts (0.60/100PY vs 0.34/100PY) (1.12/100PY vs 0.92/100PY), respectively. HR 1.33 (95% CI 0.78–2.24).
07 May 2019 Social In first-degree relatives of RA patients, comparing ACPA pos and neg FDR finds all moderate to severe periodontitis was significantly more prevalent in ACPA+ FDR (91%) compared to ACPA neg FDR (40%). From the Journal of Clinical Periodontology
06 May 2019 ACR Video RheumNow Live Preview with Dr. Philip Seo (Mimics of Vasculitis)
06 May 2019 Social Study of 281 Italian pts with temporal artery Bx-proven Giant cell arteritis shows increased mortality w/ large vessel involvement (HR 5.14) at diagnosis, and reduced mortality with PMR onset (HR 0.57) & adventitial inflammation (HR 0.31) on TABx.
06 May 2019 News Denosumab Protects Against RA Erosions
03 May 2019 Social Analysis of new drug registration trials in RA (1998-2018) shows an increase in placebo responses (significant for ACR50 & ACR70); yet with significant reductions in Disease duration, SJCand DAS28-ESR. Changes in RA? RCTs? expectation bias?
02 May 2019 Social DESIRABLE study from JAPAN Rx 654 (relatively) early, MTX tx RA pts with PBO, or Prolia given q3 or q6 mos. Denosumab lead to significant reductions in Erosion scores, total Xray (not JSN) and increased BMD (vs PBO); no effect on ACR20/50/70.
02 May 2019 Social Study of 213 RApatients starting MTX. After mean F/U 4.3 yrs and 6288 ALT tests, 7% had ALT elevation; 21% of these were ALT>1.5×ULN. Strongest predictor was a pre‐treatment elevation of ALT (OR 6). 3% permanently stopped MTX due to ALT elevation.
01 May 2019 ACR Video RheumNow Live Preview with Dr. Carol Langford (Dx, Mgmt & Monitoring of GPA)
01 May 2019 Social 8/171 ANCA-Assoc Vasculitis pts had Uncommon manifestations - often seen in PR3+, very young or very old w/ delay in Dx (~12 mos); includes Pancreatitis, unusual pulmonary dz (cystic lung disease; usual interstitial pneumonia) or splenic infarcts