The ACR and the Vasculitis Foundation have published their evidence-based recommendations and expert guidance for the management of GCA and Takayasu arteritis. These recommendations address a variety of clinical questions and scenarios including diagnostic testing, imaging, treatments, and surgical interventions. Recommendations for GCA and TAK include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of glucocorticoids as initial therapy.
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Mease and colleagues have shown that psoriatic arthritis (PsA) patients with nail involvement have worse disease and outcomes than those without nail psoriasis.
Study of 33 RCTs, 4544 pts Rx w/ either IL-17 or TNF inhibitors finds lower risk of UVEITIS with anti-TNF mAb (vs PBO OR = 0.46; vs IL-17i OR = 0.34. IL-17 inhibitors are not protective against uveitis https://t.co/AIxgI2qhq9
Study of 647 RA pts wanting to get pregnant finds only 3.9% SSA+ & 1.1% SSB+ (higher in RF+ pts); ~1/2 had SSA titre of >240 units/mL - but No cases of neonatal lupus or heart block seen. In a French register, SSA related CHB was 1.5% https://t.co/FmZzPpmB7D
Can you refuse to see unvaccinated pts? NY Times letter reviews options for “vaccine hesitant” or “vaccine refusing”
1. Ask if vaccinated
2. Offer telehealth
3. Require masks & distancing
4. Minimize contact betw vax & no-vax pts
5. Address pt concerns
https://t.co/LEJLDMIDyF https://t.co/stoUpzzK02
Botanical extract, Chrysanthemum zawadskii var. latilobum (GCWB) studied in 112 w/ mild-mod. knee OA. Randomized, double-blind, placebo-controlled study finds GCQB signif better than placebo in WOMAC total & function scores https://t.co/xyKlrL2CG7
Sweets Syndrome (Acute Febrile Neutrophilic Dermatosis) in NEJM. A 46-year-old woman with erythematous painful raised lesions on her thumb, arms and other areas. https://t.co/Tggz1lLULR
Do Women or Men make the best doctors? https://t.co/HTtZd9GHRH+
Carpal Tunnel Syndrome has an annual incidence of 0.4%. Population based study shows more likely in women, 50-59 years, w/ obesity, gout, rheumatoid arthritis or a prior hx of wrist injury. https://t.co/X7U5yh0R3l
Impact of Nail Psoriasis on Psoriatic Arthritis
Mease and colleagues have shown that psoriatic arthritis (PsA) patients with nail involvement have worse disease and outcomes than those without nail psoriasis.
https://t.co/fOiso0EGAK https://t.co/6YREBE2mHg
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Potential Birth Defects with Hydroxychloroquine
HCQ is one of the safest meds used in rheumatology, but there is new claims data suggesting a small increase in the risk of malformations associated with first-trimester HCQ use.
https://t.co/IHNKjHVXaU https://t.co/Oay2ayVr9m
ICYMI: News: EULAR Guidelines on Intraarticular Therapy
EULAR has published evidence-based recommendations on the use of intra-articular therapies (IAT) based on the literature review and recommendations of a multidisciplinary international task force.
https://t.co/Z6vC0x9zY1 https://t.co/dKpjpo50YT
ICYMI: Hands-Down Rheumatology - Sarcoidosis usually presents as a monarthritis or oligoarthritis. Late sarcoid arthritis affects knees, ankles, fingers (dactylitis). Bony lesions show honeycomb trabecular pattern).
https://t.co/lmXBbJz6ts https://t.co/qqSEmm4lNI
Rheums--Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/wzNmOzH4VE https://t.co/kKoBTHWX6z
ICYMI: New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate
https://t.co/J9wmcZr17D https://t.co/9fUNrdVWuP
Osteonecrosis in Lupus
A single center analysis of systemic lupus erythematosus (SLE) patients found symptomatic osteonecrosis (ON) in nearly 10%.
https://t.co/PoVsm6TYT1 https://t.co/MTeTiUXDS4
Arthritis as a Harbinger of Pediatric Cancer
Lancet Rheumatology has published a cohort analysis showing that a small but significant subset of children presenting with arthralgia or arthritis may have a pediatric malignancy.
https://t.co/jospgTxqBd https://t.co/eewDj5rQgL
Knee corticosteroids injx within 4 wks of total joint arthroplasty may be assoc w/ a higher risk of postop infection (studies suggest a risk w/in 3 mos of TKA). Greatest risk seen w/in 2 wks of injx (OR 2.89), worse in <65 yrs & w/ comorbidities (RA) https://t.co/nZKTkv7ym5 https://t.co/4W6CNsrqpf
NEJM posts images of the malar rash, typical of #SLE. https://t.co/YZsnAXyhVX
Survey of women re: sex & reproduction (SRH) says women prefer 1) Rheums to initiate SRH discussions, 2) clear info on pregnancy & infertility risks w/ Dz & DMARDs, 3) holistic Rx approach, 4) not to be intermediaries betw Rheum & OB https://t.co/Orlh6gLO6P https://t.co/rS4r39Easx


