The RheumNow Week in Review –Fateful Outcomes in Rheumatology (7.13.18)

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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Fateful outcomes in Rheumatology, what happens to Seronegatives, IL-23 fails, MRI progression, Not all inflammatory back pain becomes SpA:

The Diverse Fate of Seronegative Rheumatoid Arthritis

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A Finnish Rheumatology Center followed 435 early, seronegative rheumatoid arthritis (RA) patients for 10-years and found that only 3% became erosive or seropositive RA.

Defining Refractory RA by Biologic Use

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A study from the  British Society for Rheumatology Biologics Register (BSRBR) has shown that biologic refractory disease is seen in at least 6% of patients who have ever received a biologic DMARD (bDMARDs).

Nailfold Capillary Density Predicts Dermatomyositis Lung Involvement

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In patients with juvenile dermatomyositis (DM), an association was seen between low nailfold capillary density and pulmonary involvement, European researchers reported.

Liver Disease Increased in Psoriasis

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An observational case-control study has shown that psoriasis is associated with an increased prevalence of nonalcoholic fatty liver disease (NAFLD).

IL-23 Inhibitor Fails in Ankylosing Spondylitis

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A study of the IL-23 risankizumab in active ankylosing spondylitis (AS) patients failed to show efficacy and did not meet primary efficacy endpoints in a 6-month trial.

Systemic Sclerosis: More Common than Expected

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Systemic sclerosis is more common in the United Kingdom than previously reported, a nationwide population-based study determined.

Obesity, Hypertension and Diuretics Drive Gout Risk

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A recent metanalysis suggests that obesity, hypertension and diuretic use are associated with a two-fold increased risk of incident gout.

From a potential of 9923 articles, researchers analyzed 11 studies with data suitable for the meta-analysis.

Hydroxychloroquine Being Over-Dosed with New Guidelines?

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Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice.

A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).

Best of 2017: Cause of Death in Ankylosing Spondylitis

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A French population based study of ankylosing spondylitis (AS) was report in the Journal of Rheumatology.

They analyzed the death certificates and cause of death in 2940 AS patients over 3 different decades (1969-78; 1979-99; 2000-2009).

Best of 2017: Death Rates from Lupus Remain Disproportionately High

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The Annals of Internal Medicine reports that despite improving trends in mortality, death rates from systematic lupus erythematosus (lupus) remain high compared to those in the general population, and disparities persist between subpopulations and geographic regions. Underreporting of lupus on death certificates may have resulted in underestimates of mortality rates. 

Best of 2017: Are ANA Tests Unreliable?

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Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.

While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.

Best of 2017: New EULAR Guidelines on Behçet's

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At the EULAR 2016 meeting, new EULAR recommendations for the management of Behçet's disease (BD) were presented.

The RheumNow Week in Review – Life Savers for Rheumatologists (6.29.18)

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

Ixekizumab Effective in Ankylosing Spondylitis

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Eli Lilly announced today the results of the COAST-W trial showing that ixekizumab (Taltz) was effective in a Phase 3 study Ankylosing Spondylitis (AS) patients who had an inadequate response or intolerance to tumor necrosis factor (TNFi) inhibitor therapy.

Does RA Have a Prodrome?

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A pattern of increased primary care visits and joint complaints during the 2 years before rheumatoid arthritis (RA) was diagnosed were predictive of the diagnosis, a British case-control study found.

NPF Dietary Recommendations for Psoriatic Disease

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The National Psoriasis Foundation has released dietary recommendations for adults with psoriasis and psoriatic arthritis, based on a systematic review of the current literature, with the strongest focus on weight reduction for those who are overweight or obese.

Five Barriers to Biosimilar Adoption in the US

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A recent Deloitte analysis of the biosimilar market in the USA suggests there are defined obstacles to biosimilar use that must be dealt with, especially as the current administration is seeking to lower drug prices and reduce out-of-pocket costs for US consumers.

Public Citizen Pressures FDA to Pull Febuxostat

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Public Citizen has petitioned the U.S. Food and Drug Administration (FDA) to remove Takeda's drug febuxostat (Uloric) from the market, citing the FDA's own warnings and evidence of serious cardiovascular harms. This follows on a recent FDA safety warning and NEJM paper citing cardiovascular concerns over febuxostat.

Can DMARDs Delay Rheumatoid Onset?

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Preclinical rheumatoid arthritis (RA) is a hot new area wherein at risk individuals (seropositive, first degree relatives of RA patients, etc.) are being studied to assess the triggers that lead to progression to RA or whether therapies can be used to avert the onset of RA.