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RheumNow Podcast – A Tofa Two-fer (4.12.19)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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GCA Relapse Risk High with Steroids

d Jack Cush, MD

Prior to the introduction of tocilizumab to manage giant cell arteritis (GCA), glucocorticoids (GC) have been the mainstay of therapy, but has been limited by relapses in disease.

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Dietary Supplements Fail to Reduce Mortality Risks

d Jack Cush, MD

An NIH funded prospective study has shown that the use of daily dietary supplements was not associated with a subsequent lowering of mortality risk.

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An Autoimmune Diagnosis Alters Perceptions of Pregnancy and Lactation

d Jack Cush, MD

A study from UT Southwestern and the Baylor Research Institute examined the preceptions and practices of women with autoimmune or inflammatory rheumatic diseases (AIRD) noting that an AIRD diagnosis changed most womens future hopes and plans regarding pregnancy and lactation.

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FDA Approves Romosuzumab (Evenity) for High Risk Osteoporosis

d Jack Cush, MD

The US Food and Drug Administration today approved Evenity (romosozumab-aqqg) to treat osteoporosis in postmenopausal women at high risk of osteoporotic fracture, including those with a history of osteoporotic fracture or multiple risk factors for fracture, or those who have failed or are intoler

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Chronic Kidney Disease Augments Gout Risks

d Jack Cush, MD

A population based cohort analysis shows that patients with incident gout and chronic kidney disease (CKD) have far worse outcomes than those without CKD.

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Congratulations to Dr. Jonathan Adachi from McMaster University who has been awarded the Herbert A Fleisch ESCEO-IOF Medal at the World Congress on Osteoporosis, Osteoarthritis &Musculoskeletal Diseases for his work and research in osteoporosis https://t.co/sR0q0xWBxS

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71-80% of primary care diagnosed gout patients meet criteria for a gout diagnosis. https://t.co/bfmIpWiu0d

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A giant in Rheumatology and #RA research, Dr. Harold E Paulus passed away on April 5th, one day after his 90th birthday. A modest man who wielded great impact in RA research, clinical trials and medical education. https://t.co/U4QWdVgKsE

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117 pregnancies exposed to biologics were compared to 585 pregnancies not exposed to biologics; 6% of newborns had ≥1 congenital anomalies. No significant association between biologic exposure and congenital anomalies (HR 1.06; 95%CI 0.46-2.47) was seen. https://t.co/bLOtPTmpL1

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36 studies of 6662 depression patients shows the addition of antiinflammatory drugs (NSAIDs, steriods, statins, cytokine inhib, minocycline) improved antidepressant effects in Major Depression pts without increasing the risk of side‐effects. https://t.co/RdRNtVCfjh

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MMWR reports that for the 8th yr in a row the US TB rate dropped 1.3% to 2.8 per 100,000. In 2018 there were 9029 TB cases (69% in non–U.S.-born). TB risk in non-US born was >14 times that of U.S.-born persons. https://t.co/qdzvyavNVX

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Claims data shows among 60 028 psoriasis or psoriatic arthritis pts, there was NO significant difference in the risk of developing atrial fibrillation or major adverse cardiovascular events with ustekinumab (vs a TNF inhibitor) https://t.co/kJhUsmupLx

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ACR announces the agenda and faculty for the 2019 Annual ACR meeting (Atlanta) - Premeeting begins Octobr 19th and Scientific program begins Sunday Oct. 21, 2019. https://t.co/pNwEpgmCTX

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A downward trend in Rheumatology fellowship positions reversed after 2013 and since (2014-17) there has been a 44% increase in fellowship positions (230-332), more than other subspecialties. More applicants per position, more US grads, higher salaries. https://t.co/STbmG4QnSA

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Long term tofacitinib in RA shows lymphocyte #s dropped ~24% by 48 mos. Monitor ALC at baseline & q3 mos; ALC <500 seen in 1.2% of 2983 pts and was assoc w/ higher risk of SIE & Zoster. ALC <500 more likely with low ALC, age, higher dose Tofa & MTX https://t.co/5CHMmoGWJw

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US Veterans Study examined 17,415 patients starting MTX - only 20.6% started a biologic w/in 2-yrs. Biologic use was significantly lower in elderly [aHR 0.20 ≥ 80 vs < 50], pts w/ comorbidities [aHR 0.79], CHF [0.68], cancer [0.78] & nonwhites [0.79] https://t.co/3LcPVQAgcp

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151 pts w/ myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) were treated with either rituximab or PBO showing no effect of RTX!! Really? someone, somewhere believes ME/CFS or FM is an immunologic dz? Do NOT use biologics, DMARDS in such pts. https://t.co/1xXG94QEnP

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Data from the Osteoarthritis Initiative (n 4369) shows that fluctuating or persistent Knee pain over 1 yr had an increased risk of cartilage volume loss and structural progression over 4 years (OR 1.62, 95% CI 1.04–2.54) https://t.co/Inf4WsQ4Lz

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17.6 million adult Americans, 1 of 12, have an alcohol-use disorder, according to the National Council on Alcoholism and Drug Dependence. https://t.co/duojLFsNjD

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