RNL 2022: Rheumatoid Arthritis - Best Management

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This week's Tuesday Night Rheumatology, hosted by Dr. Jack Cush, featured highlights from the 2022 RheumNow Live Rheumatoid Arthritis - Best Management Pod, followed by a lively audience Q & A. Lectures featured:

Recommendations – Good & Bad (5.27.2022)

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Dr. Jack Cush reviews the news, regulatory updates and journal reports from the past week on RheumNow.com. This week gout worries, mortality risks, measuring anti-drug antibodies and a better way in lupus?

Cardiovascular Risk in Calcium Pyrophosphate Deposition Disease

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The cardiovascular (CV) risks of inflammation and gout are well known, but until recently hasn't been tied to calcium pyrophosphate deposition (CPPD) disease. A recent EHR study shows that acute CPPD crystal arthritis was significantly associated with elevated risks for non-fatal CV events.

Psoriasis and Nonalcoholic Fatty Liver Disease

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A large US population based study shows that psoriasis is associated with a higher risk of nonalcoholic fatty liver disease (NAFLD).

Increasing Corticosteroid Use in Non-Hospitalized COVID-19

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JAMA reports that despite NIH recommendations (that corticosteroids only be used in hospitalized COVID-19 patients), nonhospitalized COVID infected patients were oftent prescribed systemic corticosteroids.

Is Gout Protective Against Dementia?

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People with gout appeared less likely to develop dementia than age- and sex-matched peers, a database study from Korea found.

Long COVID Manifestations

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The acute consequences of a SARS-CoV-2 infection may be bothersome or devastating, but the long-term consequences may lead to so-called "long COVID" syndrome.  Long COVID appears to affect up to 20% of those who survive COVID-19 infection. 

To TDM or Not in Rheumatology?

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Therapeutic Drug Monitoring (TDM), especially for biologic therapies, has become a standard in gastroenterology, but shunned by most rheumatologists.

Can SGLT2 Inhibitors Be Protective in Lupus and Vasculitis?

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SGLT2 inhibitors are all the buzz in the renal world with reports of a renal protective and mortality lowering effects. Maybe these agents should be considered and studied in lupus nephritis and ANCA- associated vasculitis.

Amitriptyline and FDA Treatments for Fibromyalgia

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Both old and newer pharmacological treatments for fibromyalgia are often promoted; but a recent systematic review and network meta-analysis showed that duloxetine had higher efficacy in pain and depression, while amitriptyline had higher efficacy in treating sleep, fatigue, and quality of life outcomes.

Biologic Persistence in Psoriatic Arthritis and Psoriasis

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Two recent studies examined the durability and persistence of biologic agents in patients with psoriasis (PSO) and psoriatic arthritis (PsA) and while some differences were noted overall persistence was low 3 years later.

Inflammatory Arthritis Spread by ATP and Neural Crosstalk

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A novel study from the Journal of Experimental Medicine suggests that a reflex neural signaling at sites of inflammation may lead to spread to other inflammatory sites via and ATP-mediated neural crosstalk.

Relevance of Raynaud’s in Systemic Sclerosis

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Raynaud’s phenomenon (RP) is integral to the diagnosis and management of systemic sclerosis (SSc) patients; a recent analysis suggests that RP should be characterized based on color change and the presence of other symptoms to know whether RP portends more serious manifestations.

RNL 2022: Spondyloarthritis Spectrum

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This RheumNow Live 2022 session features highlights from lectures on Spondyloarthritis.

- Microbiome in Spondyloathritis - Jose Scher, MD

- Axial Psoriatic Arthritis - Philip Mease, MD

- Juvenile Spondyloathritis - Pamela Weiss, MD

Rising Incidence of Systemic Lupus Erythematosus

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Data from Olmstead county, MN over the past four decades shows that the incidence and prevalence of systemic lupus erythematosus (SLE) is increasing.

SLE was diagnosed using the EULAR/ACR criteria and looked at patients seen between 1976–2018.

Multimorbidity Burden in Rheumatoid Arthritis

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Crowson and colleagues at the Mayo Clinic have shown that rheumatoid arthritis (RA) patients have a higher prevalence of multimorbidity with as many as 44 different morbidities of interest in RA.

Acute Inflammatory Responses Needed to Resolve Chronic Pain

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Science Translational Medicine has published results of a Canadian study of low back pain (LBP) suggests that pain control by anti-inflammatory treatments might have negative effects on pain duration and may be counterproductive for long-term pain outcomes.

Bimekizumab Development Delayed by FDA

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UCB announced they have received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) regarding the Biologics License Application (BLA) for bimekizumab for the treatment of adults with moderate to severe plaque psoriasis (PSO).

Methotrexate Monitoring (5.13.2022)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.