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RheumNow Podcast – Fight or Switching (DMARDs) (10.18.19)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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Joint Injections: Are They Worth the Risk?

d RheumNow

Intra-articular injections of corticosteroids for relief of the pain of hip or knee osteoarthritis (OA) may have adverse long-term consequences, researchers suggested.

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Protective Effects of ASA and Vasodilators in Systemic Sclerosis

d Jack Cush, MD

A large cohort study suggests that the use of vasodilators and aspirin (ASA) in systemic sclerosis (SSc) may yield favorable  cardiovascular outcomes.

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High Dose Statins Increase Odds of Osteoporosis

d Jack Cush, MD

It is unknown if inhibiting cholesterol synthesis (with statins) might influence sex-hormone production and therefore, the risk of osteoporosis. A new study shows that, in statin-treated individuals, the development of osteoporosis is statin dose-dependent.

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Comorbidity Worsens Axial Spondyloarthritis

d Jack Cush, MD

Comorbidities are common in patients with axial spondyloarthropathy (axSpA), and a recent study has shown that multimorbidity, the coexistence of 2 or more conditions, is associated with more severe disease than those without comorbidities.

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RheumNow Podcast is up! The week in review - on statins, Comorbidities, ANA specificity, APL Ab effects, PsA surgery & more. Watch it here>> https://t.co/c0EPyvKNWD or listen to the podcast in your car (Android Auto, Apple Car play) or here>> https://t.co/xZWQTszGn9

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Risk of uveitis in JIA - study 2294 JIA pts in the UK JIA registries finds that uveitis occured in 27/943 MTX, 16/1047, and only 1 of 304 adalimumab/infliximab Rx pts. No difference w/ MTX & etanercept, but much less with adalimumab https://t.co/rO13LznMmm

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Dr. John Cush RheumNow ( View Tweet)

RheumNow survey for Rheumatologists – When treating GCA, when do you add a steroid sparing agent? https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

Study of RA complications from National Inpatient Sample data (2005-14) show #RA higher risk for MI (OR 1.03), COPD (1.67), CVA ( 2.2), renal Dz (1.42), EtOH abuse (2.73). Mortality trend increased significantly for CHF (P = 0.025) & AFib (P = 0.042) https://t.co/NzKPWsyKgA

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RHEUMATOLOGISTS - In what percentage of your GCA patients do you use a steroid-sparing agent? Few, Some, Many? RHEUMNOW Live Vote: Rheums Click here>> https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

NEJM Case: 4-year-old girl with juvenile dermatomyositis refractory to multiple therapies has active rash, weakness & extensive calcification and strongly positive for anti–NXP-2 . Improved w/ infliximab, thalidomide, aluminum hydroxide. https://t.co/Wbb6JEMtrh

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Dr. John Cush RheumNow ( View Tweet)

Survey for RHEUMATOLOGISTS - When choosing drug therapy for GCA, what mechanism are you targeting? IL-1, IL-6, TNF, or inflammation in general? Please vote at RheumNow >> https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

LIVE VOTE Survey: When treating a patient for GCA, when might you add a steroid-sparing agent?? If youre a RHEUMATOLOGIST - please vote in our RheumNow quick 4Q survey https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

The risks of pulmonary embolism after 6 types of surgery assessed using 60703 patients in a French national database. PE risk elevated for 12 weeks, highest in 6wks Pos-Op.

Dr. John Cush RheumNow ( View Tweet)

UK population study of 6591incident RA patients shows comorbidity increased all-cause mortality (aHR 1.26; 1-1.6). Joint destruction had no effect, but COPD was associated with significantly more mortality (COPD HR 2.84; 1.13-7.12). https://t.co/6ULPvq34qh

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Dr. John Cush RheumNow ( View Tweet)

RHEUMATOLOGIST SURVEY - In what percentage of your GCA patients do you use a steroid-sparing agent? Few, Some, Many? RHEUMNOW Live Vote: Rheums Click here>> https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

LIVE VOTE RheumNow survey for Rheumatologists – When do you add a steroid sparing agent? https://t.co/qhpOxYhsYV

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Dr. John Cush RheumNow ( View Tweet)

Evaluation of ANA testing in sytemic autoimmune dz (AID) finds low titers have low PPV. Highest PPV was for centromere pattern in PSS, w/ a PPV of 29% (1:160), 42% (1:32), 77% (1:640) & 82% (1:1280). Speckled PPV was low unti 1:1280 (PPV 71% for AID) https://t.co/JbDDXAOxOu

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Dr. John Cush RheumNow ( View Tweet)

REcent trial results from the Dermatology Meeting EADV in Madrid —shows rituximab superior to mycophenolate in Pemphigus Vulgaris; RTX 40% vs MMF 9.5% attained complete remission of pemphigus vulgaris, without steroids for > 16 weeks https://t.co/PU9CbQSHJV

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Dr. John Cush RheumNow ( View Tweet)

Single center study of anti-PhosphoLipd Abs in 149 Bx proven lupus nephritis pts 36% had APL Abs (18.8% IgG, 18.1% IgM, 10.7% B2GlyP, 8.1% LAC). F/U of 156 mos - APL+ had lower 10 yr survival (91 vs 99%). lower GFR, more thrombotic events & miscarriage https://t.co/U5ra02wMmX

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Dr. John Cush RheumNow ( View Tweet)

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