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Do NSAIDs Increase Cardiovascular Risk in Osteoarthritis?

d Jack Cush, MD

A longitudinal study of administrative data from British Columbia shows that nonsteroidal antiinflammatory drugs (NSAIDs) use increases the risk of cardiovascular disease (CVD) among osteoarthritis (OA) patients.

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In Lupus, Older Age and Male Sex Raise Cancer Risk

d RheumNow

Among patients with systemic lupus erythematosus (SLE), cancer risks overall were associated with older age at diagnosis and male sex, and lung cancer specifically was related to smoking, analysis of data from a large multicenter cohort found.

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Update on Polymyalgia Rheumatica and Giant Cell Arteritis

d Jack Cush, MD

JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has approved tocilizumab as a first-line glucocorticoid-sparing agent. 

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Diagnostic Accuracy of Symptoms, Signs and Labs in GCA

d Jack Cush, MD

A systematic review and meta-analysis of 68 diagnostic cohort studies (14 037 patients) suggests that no one feature is more impactful that the combination of symptoms, signs, and laboratory tests to diagnose the presence giant cell arteritis (GCA).

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Selective Biologic Responses in Seropositive RA

d Jack Cush, MD

The Journal of Rheuatology reports a pooled analysis of patients from 16 observational RA registries that examined the association between seropositivity (RF or ACPA) with biologic DMARDs responses; they showed better clinical responses when seropositive RA patients receive abatacept (ABA) o

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Metformin as cotherapy in RA? It lowers RA risk in animal models. >2500mg/d lowers risk incident RA in women. Japanese study shows it suppresses osteoclastogenesis and upregulation of inflammatory cytokines, protease and growth factor genes. https://t.co/UEDMgtqLZG

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Successful treatment of refractory palmoplantar psoriasis in a psoriatic arthritis patient with the JAK inhibitor tofacitinib https://t.co/bdhppoUkmz

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President Trump took HCQ/Azithromycin.... Lancet Rheumatology reports that HCQ in RA has no cardiac risk but long term HCQ increases risk cardiovascular mortality, that may be further augmented by azithromycin. https://t.co/JRtkkAuEeu

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Study of 1,631 incident RA & 3283 controls shows respiratory disease assoc with risk of RA, irrespective of RF & CCP and mostly in nonsmokers. aOR increased for chronic upper (1.4), acute lower (2.4) & chronic lower (1.6) Resp Dz, stronger for ACPA/RF+ https://t.co/C1hA631PIW

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Stanford grows new cartilage in mice OA knees using resident skeletal stem-cells generated using microfracture (MF) surgery. MF-activated SSCs Rx w/ BMP2 and soluble VEGFR1 skewed differentiation toward articular cartilage. https://t.co/dkr1vgU9CF https://t.co/WpKpaDG2qf https://t.co/vi4VGqn0U0

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Mayo case controlled study of 212 autoimmune pts - half w/ CNS inflamm dz and half without. TNF inhibitor use was associated with an increased risk of inflammatory CNS dz (adj OR, 3.01; 1.55-5.82; P = .001); most of these occurred in RA pts (aOR, 4.82) https://t.co/8TsYxDhUZx

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Fibromyalgia & Exercise? Systematic review of 50 trials, shows that, compared to usual care, exercise had moderate effect on fatigue, small effect on sleep and meditative exercise programs were the most effective for improving sleep quality. https://t.co/iloD8rMx64

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Responses to switching TNFi in SpA go down w/ the 2nd TNFi. 1st TNFi @ 3 mos ASAS CII 51%; 2nd TNFi 41%; BASDAI @6 mo, 1st 46%, 2nd TNFi 33%. Compared to primary failure, pts w/ 2nd failure (OR 7.3 ) or toxicity (OR 9.1) had better ASDAS-I https://t.co/jMCUfBtxmY https://t.co/PBkQNOwVRQ

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Telemedicine: What's Changed and What Needs to be Addressed? An update on legislative changes, uncertainties, and the care gap post COVID https://t.co/HRAsEP7IL6 https://t.co/X6PL0W4tI7

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Gilead/Galapagos gets a setback for filgotinib, its JAK1 inhib, that was poised to be the next approved RA drug by FDA. Instead the FDA issued a complete response letter; citing concerns over sperm studies (MANTA, MANTA-RAy) & 200 mg dose. Delay till 2021? https://t.co/H0rLjOMXq8 https://t.co/vb4FDUUVoS

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RheumNow Podcast - The Bad News That's Fit to Print (8.21.20) Dr Jack Cush reviews this week highlights filgotinib rejection, delays in Diagnosis, metformin benefits COVID, Abx and IBD, and UPA beats MTX https://t.co/1oZtU14VOB https://t.co/rcWlbYVKYn

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The FDA approves Novartis'anti-CD20 mAb, Kesimpta (ofatumumab) for the treatment of relapsing forms of multiple sclerosis (MS). https://t.co/2DgA4Modds

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RheumNow Podcast The Bad News That's Fit to Print - highlights filgotinib rejection, Dx delays, metformin in COVID, Abx & IBD, UPA beats MTX. Watch here> https://t.co/PV6b2wcanD or listen to the podcast on iTunes> https://t.co/FHJv01AAbC or SoundCloud> https://t.co/1oZtU14VOB

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ATS Abstract: n=616 survey contrasts rheums (57%) & pulmonologists (43%) beliefs on RA associated ILD. Both preferred to use steroids, MMF, RTX for RA-ILD, but Rheums tend avoid ADA & LEF. Rheums (17%) & Pulms (24%) think MTX a risk factor https://t.co/W5gbu84FBv

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Metanalysis of total elbow arthroplasty in RA - 38 studies, 2,118 TEAs w/ mean F/U of 819 mos - the implant failure & complication rates were 16% & 24%. Aseptic loosening was most common failure (9.5%). Higher failures in younger pts & unlinked design https://t.co/Pq2N1Kku60

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