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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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Rituximab Superior to Cyclosporine for Membranous Nephropathy
The NEJM has reported that rituximab (RTX) and cyclosporine (CYA) was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months.
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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.
CRP Utility in COPD Exacerbations
NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.
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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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Safety Concerns Offset the Modest Improvements of Tanezumab in Osteoarthritis
JAMA reports that although tanezumab is modestly effective in moderate to severe osteoarthritis (knee or hip), with statistically significant improvements in pain and physical function, the tanezumab (TNZ) treated patients had more joint safety events and total joint replacements than pa
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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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Study of 182 hospitalized adult-onset Still's disease patients shows predictive factors for developing macrophage activation syndrome to include: 1. Splenomegaly (OR 5.745), 2. pericarditis (OR 6.5), and 3. ferritin >2000 (OR 4.7). https://t.co/oNsaCL6O92
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Dr. John Cush RheumNow ( View Tweet)