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Sensitivity of Temporal Artery Biopsy
Metanalysis shows that temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) has a sensitivity of 77%, similar to results seen with temporal artery imaging. These data suggest clinicians may be willing to accept a GCA diagnosis without proof by TAB.
Read ArticleFDA Grants Breakthrough Status for Potential Lupus Nephritis Drug
Obinutuzumab (Gazyva) has been granted Breakthrough Therapy Designation (BTD) by the U.S. Food and Drug Administration (FDA) for use in adults with lupus nephritis (LN). The drug made by Genentech, is going forward based on the Phase II NOBILITY study in adult patients with proliferative lupus nephritis (LN). Currently, there are no FDA-approved medicines for lupus nephritis.
Read ArticleLow Dose IL-2 Effective in Lupus
A double-blind, placebo-controlled clinical trial of low-dose IL-2 in patients with systemic lupus erythematosus (SLE) has shown that low-dose IL-2 induced was clinically effective while expandng regulatory T cells and NK cells, which may benefit immune homeostasis in SLE patients.
Read ArticleAnakinra Shows Benefits in Cytokine Storm
The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.
Read ArticleACR Survey Shows Half of Patients Cannot Afford Treatments
Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.
Read ArticleMedical Use of Cannabis in 2019
JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.
Read ArticlePrior Authorizations Delay Care in Rheumatology
Physicians who believe their patients' health is negatively affected by insurers' demands for prior authorization, and the delays that often result, will find that opinion vindicated by a new study of rheumatology care: when permission had to be sought from insurers to provide intravenous drugs,
Read ArticleRheumNow Podcast – The End of Arthritis (9.13.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
Read ArticleTwo vs. Four Weeks of Antibiotic Therapy in Septic Arthritis
A prospective trial has shown that 2 weeks of antibiotic therapy is as effective as 4 weeks of antibiotic therapy, with similar outcomes but shorter hospital stays.
Read ArticleBimekizumab Add-on Therapy in Rheumatoid Arthritis
Bimekizumab is a dual inhibitor of IL-17A and IL-17F that has been shown to be effective in psoriasis and psoriatic arthritis. A proof-of-concept study shows that giving bimekizumab to rheumatoid arthritis patients not adequately controlled by certolizumab pegol resulted in a rapid decrease in disease activity achieved after 12 weeks of treatment. These findings are novel as anti-IL-17 monoclonal antibody therapy has previously been shown to be ineffective in RA.
Read Article74 Percent of Rheumatoid Arthritis Patients Dissatisfied with Treatment
CreakyJoints has completed a 258 patient survey showing that nearly three-fourths of people with rheumatoid arthritis (RA) have expressed dissatisfaction with their treatments, including conventional (csDMARDs) and biologic Disease Modifying Antirheumatic Drugs (bDMARDs).
Read ArticleSteroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis
Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.
Read ArticleNeed for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement
JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.
Read ArticleRiociguat Fails in Systemic Sclerosis-Associated Digital Ulcers
Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.
Read ArticleMetanalysis of 16 studyes Systemic Sclerosis pregnancies have a higher risk of miscarriages (OR 1.6), IUGR (OR 3.2), preterm births (OR 2.4) and low birth weight (OR 3.8). SSc pts have 2.8 fold higher rate of gestational HTN & 2.3x more C- sections. https://t.co/FuM0DZFR4k
Dr. John Cush RheumNow ( View Tweet)
Faculty Spotlight: Sherine Gabriel, MD, MSc is a rheumatologist, current president of Rush University, and Chief Academic Officer of @RushMedical will speak on the panel “How Far We Have Come” at the @WIMSummit- see her session Sept 21st! #WIMstrongertogether https://t.co/pdzXbUcHV9
Nucala (mepolizumab) was approved in 2015 for severe eosinophilic asthma, and in 2017 for EGPA (Churg Strauss). The FDA has now approved it for use in Six to 11-Year-Old Children with Severe Eosinophilic Asthma https://t.co/orAaFCkR92
Dr. John Cush RheumNow ( View Tweet)
Novartis announced 16 wk results from the PREVENT trial - secukinumab shown to have superior ASAS40 responses in active non-radiographic axial spondyloarthritis (nr-axSpA). They estimate there are 1.7 million with nr-axSpA in the EU and US. https://t.co/IamZNN7Itc
Dr. John Cush RheumNow ( View Tweet)
Rates of "indeterminate" results on quantiferon-IT assays were found to be significantly higher in systemic vasculitis (21%) than nonvasculitis pts and controls (7-7.5%). Indeterminate predictors were Syst vasculitis (OR 9.64), high NLR (OR 1.70). https://t.co/QqL2efsF7V
Dr. John Cush RheumNow ( View Tweet)
Do your state have a pediatric rheumatologist? @ACRheum @ACRSimpleTasks #Act4Arthritis #rdam https://t.co/ZGvopF75lb