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Higher Medical Costs with Corticosteroid Use
Rheumatoid arthritis (RA) health insurance claims database study from Japan shows that RA patients initially treated with glucocorticoids (GCs) and disease-modifying antirheumatic drugs (DMARDs) experienced greater medical costs and healthcare utilization than patients not trea
Combined Therapy in Rheumatoid Arthritis Interstitial Lung Disease
Rheumatoid arthritis interstitial lung disease (RA-ILD) represents a major therapeutic evidence void in our current treatment paradigm. RA-ILD is common, with clinically significant disease seen in 8% of patients. In the past RA-ILD was frequently under-diagnosed, leading to identification of a disproportionate volume of severe cases and subsequently inflating the mortality statistics. However, RA-ILD, particularly in the progressive pulmonary fibrosis phenotype, retains a poor prognosis. I would propose a new framework for RA-ILD treatment.
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Review of cancer-associated myositis (CAM) & assoc myositis-specific or myositis-associated autoantibodies. 2017 meta-analysis 5 studies & 4538 pts w/ DM or PM, the cancer risk (SIR) for DM = 4.66, but PM = 1.75. Cancer risk ^^ w/ Low serum KL-6, TIF1γ, NXP2, HMGCR Abs https://t.co/xsOt4wPIXB
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High cancer risk in myositis patients linked to autoantibodies- TIFF1g, NXP2, HMGCR. https://t.co/CECO78ESHi
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Interstitial lung disease is a group of conditions that cause inflammation and scarring in the lungs.
This JAMA Patient Page describes types and causes of interstitial lung disease as well as its diagnosis, treatment, and prognosis.
https://t.co/WELKKR0SX7 https://t.co/ykzR16ja3L
Links:
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Anti-MDA5 DM is assoc w/ rapidly progr ILD & mortality risk. 26 MD5+ DM pts (age 56.6 yrs; 7/26 male) Sxs: Gottrón’s (81%), ILD (73%), periungual erythema (69%), heliotrope (61%), V-sign (42%), arthritis (42%), weakness (38%), mechanic’s (35%), Raynaud’s (19%). 7/19 RP-ILD died https://t.co/ugbmKlXsBp
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JAMA: Cognitive functional therapy (CFT) is effective in control of chronic low back pain. Study of 500 LBP pts Rx w/ usual care, CFT, or CFT with biofeedback over 3 mos. F/U of ~ 300 pts found that the benefits extended up to 3 years after the intervention. https://t.co/dLv53M7Xkp
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LIVE September 9th, 7PM EST
Join Drs. Sindhu Johnson, Anna-Maria Hoffmann-Vold, Scott Matson & Jack Cush, Moderator, as they review ACR & EULAR #ILD guidelines.
Where are we now? Where are we going?
Don’t miss it!
https://t.co/PVo0dbQLCn
#Rheumatology #ILD https://t.co/gp1qfeEt3S
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Long-term Lab Monitoring in RA is Inefficient
Annals of Internal Medicine has published a retrospective study of long-term routine laboratory toxicity monitoring (lt-RLTM) in patients receiving disease-modifying antirheumatic drug (DMARD) therapy showing that most very abnormal https://t.co/hytyH1qqED
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Might systemic autoimmune Dz related anti-protein arginine methyltransferase 5 (PRMT5). ELISA study of 33 SSc, 87 RA, & 31 controls. Vs controls, anti-PRMT5 Abs seen in SSc (48% vs 0; AUC 0.9) & RA (15% vs 0; AUC 0.768). PRMT5 Abs signif assoc w/ ILD & ANA positivity. https://t.co/svjjtQQsIY
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MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/eu1IpaXGL8
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Wait! FDA approved the Chikungunya Virus Vaccine 2 yrs ago, but just pulled the vaccine, Ixchiq, citing serious safety concerns (specifically CBER reports of >20 serious adverse events, including 21 hospitalizations, 3 deaths, w/ 1 fatality directly linked to vaccine-derived https://t.co/aaC38VX7rF
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Recombinant zoster vaccine effective in #SLE without flare. Retrospective Medicare & commercial claims data on pts given 2 RZV doses, matched 1:4 to unVAX. 3592 pts F?u ~1.5 yrs. Vax effectiveness 70% in Medicare; 54% commercial. SLE flare rates HR 0.91& 0.94. https://t.co/WCBOQhb4Ad
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Primary CNS angiitis - an uncommon vasculitis affecting brain, spinal cord, or leptomeninges, typically B/L, but here are 48 pts w/ unilateral PACNS. Dx is made by imaging, wall imaging (VWI), perfusion, spectroscopy. Histology shows small-to med vessel lymphocytic vasculitis https://t.co/xtD7wBT1J2
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App-based exercise is noninferior to PT supervised exercise, the latter has better adherence. RCT of 68 pts w/ hip/knee OA Rx w/ either PT surpervised exercise BIW x6 wks vs app virtual exercise TIW x 6wks. Pain & Sxs equal betw grps, but Adherence better w/ PT/F2F Rx https://t.co/BTZsi0bzdL
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Osteoporosis in Older Men
JAMA has publish an invited commentary on Screening for Osteoporosis (OP) in Older Men. They point out that a simple screening strategy for older men based on previous fracture history and bone density screening at age 70 or 75 years is a reasonable https://t.co/bpa4N4mdOp
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Ambient Dictation Works and Reduces Burnout
Passive documentation of clinic visits using artificial intelligence (AI)-drafted notes was linked to reduced burnout and improved well-being, a survey study from two academic medical centers suggested.
https://t.co/Tu3sOfZUBI https://t.co/WiC3uJeFEC
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Methotrexate intolerance in rheumatoid arthritis
Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.
https://t.co/aizooTPNTe https://t.co/FZ52bwHBfq
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Lupus Core Dataset for Research
SLE is a complex and potentially life-threatening autoimmune disease. Part of the complexity stems from how it can differ from person to person – giving rise to marked heterogeneity in not only manifestations, but also in disease course and https://t.co/jHD9L3Bc2Y
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RA has lower risk of colorectal cancer (CRC). Korean claims compared 41K RA pts 1:5 vs 204K non-RA. RA had signif. decreased risk for CRC (HR 0.89), main in seroneg RA (HR 0.79) but not seropos RA (HR 0.93). Inverse assoc mainly w/ rectal CA (HR 0.63) & women (HR 0.80). https://t.co/dudG4Is5oj
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