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Efficacy of Maintaining or Switching to Baricitinib Monotherapy
A post hoc analysis of baricitinib use in rheumatoid arthritis (RA) patients shows that while many patients respond well to baricitinib monotherapy or to switching to baricitinib monotherapy, those with less disease control respond well to the addition of methotrexate (MTX) to baricitinb.&nb
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FDA AAC Splits Vote in Favor of Nintedanib for Scleroderma Interstitial Lung Disease
The FDA convened Arthritis Advisory Committee to consider nintedanib for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD) and voted 10-7 in favor of approving the drug for this new indication.
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War on RA - Part 1: Walk on the Moon
It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.
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Partial or Total Knee Replacement for Osteoarthritis?
Lancet has reported on a clinical trial comparing total knee replacement (TKR) and partial knee replacement (PKR) in late-stage isolated medial compartment knee osteoarthritis patients finding that both TKR and PKR are equally effective, PKR should be considered the first, because of lower costs
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FDA Approves Apremilast for Behcet's Oral Ulcers
The US Food and Drug Administration (FDA) has approved apremilast (Otezla) for the treatment of oral ulcers associated with Behçet’s Disease, a rare chronic multisystem inflammatory disease that affects about 5 in 100,000 persons in the USA.
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RheumNow Podcast – Don’t Take My Advice (7.19.19)
Dr. Jack Cush reports the news and new journal articles from the past week on RheumNow.com.
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Intraarticular Capsaicin in Knee Osteoarthritis
A novel compound, synthetic trans‐capsaicin (CNTX‐4975), has been studied as an intraarticular injection and shown to significantly reduce pain in patients with chronic moderate‐to‐severe osteoarthritis of the knee.
A phase II, multicenter, double‐blind study enrolled 172 knee OA patients between the ages of 45–80 years. Patients were randomized to receive either intraarticular placebo, or a high‐purity synthetic trans‐capsaicin CNTX‐4975 0.5 mg, or CNTX‐4975 1.0 mg.
Upadacitinib Superior to Adalimumab in Methotrexate Refractory RA
Upadacitinib, a JAK1-selective inhibitor, was studied head to head against adalimumab and placebo in rheumatoid arthritis after an inadequate response to methotrexate, and shown to be superior to ADA and PBO in ACR20 and DAS remission level responses.
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Rituximab Safety Concerns when Used in anti-TNF Refractory RA
The SUNSTONE study evaluated the long‐term safety of rituximab in rheumatoid arthritis (RA) previously exposed to ≥1 anti–tumor necrosis factor inhibitors (TNFi) and showed a stable, but high, rate of serious infections, opportunistic infections and an overall higher mortality rate.
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RheumNow Podcast – Boiling Hot MAS (7.12.19)
Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.
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NIH Conference Review of Chronic Fatigue Syndrome
The current issue of JAMA reviews recent advances on chronic fatigue syndrome, also known as myalgic encephalomyelitis/(ME/CFS), based on a 2-day conference held at the NIH in an April 2019.
The NIH 2-day conference reviewed recent progress and new research in several areas described below.
EHR-Related Adverse Events Usually Involve Medications
Concerns about the unintended risks inherent in electronic health records (EHR) by analysis of EHR–related harms identified from large database of malpractice suits and claims; they found that EHR related adverse events exist, and may be associated with an severe harms and uncommonly, death.
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Pregnancy Outcomes Improve in Lupus
Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve. The large decline in in-hospital maternal mortality was greater for lupus pregnancies than for non-lupus pregnancies. Findings from a retrospective cohort study are published in Annals of Internal Medicine.
Opioids Overused in Acute Gout
Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.
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Benefits vs Harms for Osteoporosis Drug Continuation or Discontinuation
While it is clear that long-term bisphosphonate therapies reduce fracture risk in women with osteoporosis, it is unclear how to counter-balance these benefits against rare serious harms and how to optimize therapeutic benefits with appropriate drug holidays.
A systematic analysis of 48 studies compared long-term osteoporosis drug treatment (ODT) (>3 years) versus control versus ODT continuation versus durg discontinuation, to examine incident fractures or harms.
RheumNow Podcast – EULAR 2019 Streamin' - (6.14.19)
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Dr. Jack Cush reports from Madrid on several novel presentations from EULAR 2019, including low-dose steroids in hand OA, ABA vs. ADA in double positive RA patients, psoriasis predictors of PsA, tildrakizumab and more.
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EULAR 2019 Report – Day 2
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. It was a full and lively second day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day two at EULAR 2019.
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Disparities in Lupus Survival
MMWR has published the outcomes from the Georgia Lupus Registry between 2002 and 2016, finding that black women were not only more likely to die from lupus than white lupus patients; but they died on average 13 years earlier (mean age 51.8 and 52.3 years, respectively) than whites (mean age 64.4 and 65.0 years, respectively).
Black women with lupus were 3.34 times more likely to die than black women in the general population, while white women with lupus were 2.43 times more likely to die than white women in the general population. None of the white women with lupus died within 5 years of diagnosis, while mortality was elevated for black women from the date of diagnosis on.
ACP Supports Transparency of Health Care Costs
The American College of Physicians (ACP) is encouraged by the Trump administration’s executive order to improve transparency of health care costs.
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Steroids in GCA and PMR Increase Infectious Risk
A large study of UK family practice patients shows that polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) patients treated with glucocorticoids are at an increased risk of bacterial, viral, parasitic and fungal infection, even at daily doses of less than 5 mg prednisolone.
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