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RheumNow Podcast – Cancer Risk in Systemic Sclerosis (9.27.19)

d Jack Cush, MD

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

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MMWR: Increased Opioid Use in Lupus

d Jack Cush, MD

Opioids are generally not indicated for pain in systemic lupus erythematosus (SLE) and other rheumatic diseases because of limited efficacy and risks for preference and adverse health effects.

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Low Dose IL-2 Effective in Lupus

d Jack Cush, MD

A double-blind, placebo-controlled clinical trial of low-dose IL-2 in patients with systemic lupus erythematosus (SLE) has shown that low-dose IL-2 induced was clinically effective while expandng regulatory T cells and NK cells, which may benefit immune homeostasis in SLE patients.

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Arthritis Foundation Releases First CBD Guidance for Adults With Arthritis

d Jack Cush, MD

As the leading organization for people with arthritis, the Arthritis Foundation has just released the first CBD guidance for adults with arthritis. CBD, or cannabidiol, a plant-based compound, has become popular among people with arthritis seeking to ease chronic joint pain.

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ACR Responds to CY2020 Medicare Physician Fee Schedule Proposed Rule

d Jack Cush, MD

Rheumatology leaders commend CMS for proposing E/M code changes and urge agency to make additional changes to final rule.d

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Persistent Inflammatory Arthritis After Immune Checkpoint Inhibitors

d Jack Cush, MD

Braaten and colleagues from Johns Hopkins School of Medicine have reported their experience with chronic inflammatory arthritis induced by immune checkpoint inhibitor therapies, showing that in some, inflammatory arthritis persists after the immunotherapy has been discontinued.

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Parenteral Out-Performs Oral Weekly Methotrexate

d Jack Cush, MD

A systematic review in PLOS suggests that parenteral MTX therapy is more successful than oral MTX in achieving optimal disease activity control. 

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TIF1-γ antibodies may be associated with dermatomyositis and are found in between 13 – 31% of adults and 22 – 29% of children. TIF1-γ antibodies have a strong association with malignancy, esp in patients over the age of 39. https://t.co/0o2VfNwbZC

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Dr. Rob Speira & HSS investigators will lead a multicenter, phase II, 6 mos clinical trial of anti-GM-CSF (mavrilimumab) in patients with giant cell arteritis (GCA. There is still heavy reliance on steroids in GCA; tocilizumab was FDA approved in in 2017 https://t.co/zDWgSVuXec

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Question for Rheumatologists - How do you scoreboard your performance as a Rheumatologist?

Dr. John Cush RheumNow ( View Tweet)

41 participants with RA and T2D were randomised to recv anakinra or a TNFi; RA dz activity decreased in both groups over 6 mos. Anakinra significantly improved A1C at 3 and 6 mos, but TNFi did not. https://t.co/UIBsRjMbKR

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JAMA study shows inconsistencies and inaccuracies in EMR documentation of ROS and PE findings compared to observer audible recorded observations - study of 9 ED Residents, 30 pt encounters each, total of 180 ED patients. https://t.co/PttGYvgCue

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Dr. John Cush RheumNow ( View Tweet)

Question for Rheumatologists - How do you scoreboard your performance as a Rheumatologist?

Dr. John Cush RheumNow ( View Tweet)

Systemic sclerosis is associated with an increased cancer risk. A cohort of 1727 SSc pts showed an increased cancer SIR of 2.15 (CI 1.84‐2.49). Most common cancers were breast, melanoma, hematological & lung. CA risk higher w/ RNAP III Ab, CCB Rx & ILD https://t.co/q5iTRI91Ng

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FDA issues warning against the use of higher doses of Imodium (loperamide) - has been associated with "serious heart problems and deaths with much higher than the recommended doses of loperamide". https://t.co/UxPn6F6BL0

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Altoona Arthritis Center and Dr. Alan Kivitz praised in the news for their unique blend of patient care and clinical trials research https://t.co/9kGLBhwzsn

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Dr. John Cush RheumNow ( View Tweet)

Renal Review on treating asymptomatic hyperuricemia in CKD patients finds very few studies demonstrating renal protective effects w/ ULT w/ an abnormal uric acid. (this is without consideration of degree of CKD or hyperuricemia) https://t.co/nKo018lb6v

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Novartis announced 16 wk results from the PREVENT trial - secukinumab shown to have superior ASAS40 responses in active non-radiographic axial spondyloarthritis (nr-axSpA). They estimate there are 1.7 million with nr-axSpA in the EU and US. https://t.co/IamZNN7Itc

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The RheumNow Podcast is up – Should you Believe in Vitamin D or Rituximab? Watch it on RheumNow>> https://t.co/bX5u9KcKYz or listen to the podcast on iTunes or SoundCloud>> https://t.co/MxDcIyej3L

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142 pts with ANCA-Associated Vasculitis were studied for lipid levels - Lipid levels increased during remission in newly diagnosed AAV and PR3+ AAV (not MPO or relapsing pts). Lipid levels correlated w/ ESR but not other inammatory markers. https://t.co/9UgUXv6BhI

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