The RheumNow Week in Review -30 March 2018

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. News on drug regulatory decisions, fenofibrate and gout, Still's disease, TB and infection rates, SpA and hidradenitis suppurativa, and predicting methotrexate non-responders.

NHANES: Trends in Calcium Supplements

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The journal Bone reports that given excess calcium intake may not be entirely free from unintended health consequences, it's important to undestand trends in calcium supplement use. 

Precision Genetics Can Predict Methotrexate Non-Responders

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Investigators from Glasgow and Oxford have identified changes in genomic architecture, represented by a chromosome conformation signature, that can predict nonresponse to methotrexate in early rheumatoid arthritis patients.

Recognizing that studies show 35–59% of RA patients do not achieve clinically meaningful responses after starting MTX, they sought to identify a pattern of genetic changes in 59 early RA patients that would predict poor responses to MTX therapy.

2 Weeks Off Methotrexate OK for Flu Vaccine

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Stopping methotrexate for 2 weeks after the administration of flu vaccine led to improved immunogenicity without increasing disease activity among patients with rheumatoid arthritis (RA), a prospective Korean study showed.

FIELD Study: Fenofibrate Reduces Uric Acid and Gout Risk

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Lancet reports the results of the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study - where fenofibrate was shown to reduce uric acid by 20%, gout events by nearly 50% and may be useful in preventing gout in diabetes. 

Medicare Drug Prices Jump Ten Times the Inflation Rate

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CNN reports that a new congressional analysis of Medicare drug pricing shows the prices of the 20 most commonly prescribed brand-name drugs have risen nearly 10 times the annual rate of inflation in the past five years.

Anakinra May Attenuate Stroke Outcomes

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The journal Stroke has published a trial wherein the use of subcutaneous IL-1Ra (anakinra) was shown to reduce the peripheral inflammatory response in those with an acute ischemic stroke.

Chronic Knee Pain Linked to Depression

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Chronic pain and depression are intimately linked, but Japanese researchers have found that up to 12% of knee osteoarthritis (OA) may develop depression and that such patients should be screened for depression over time.

The Consequences and Cure of Hepatitis C

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I spent this past week seeing hepatitis C patients with our hepatologists, and being a rheumatologist, I was looking forward to seeing extra-hepatic manifestations of HCV that we read about in text-books - cryoglobulinemic vasculitis, sicca syndrome, porphyria cutanea tarda and many others. I suppose I should not be surprised that the week passed without seeing a single one of these. 

The RheumNow Week in Review - 23 March 2018

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Dr. Jack Cush reviews the highlights from the news, journals and major meetings. New announcements and approval from the FDA; novel associations between ANCA vasculitis and thyroid disease; flare rates after arthroplasty; and pregnancy outcomes for men and women.

Tai Chi Eases Fibromyalgia Pain

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The mind-body practice of tai chi was as effective or better than currently recommended aerobic exercise for fibromyalgia, a randomized controlled trial demonstrated.

Risk of Paternal Exposure to Anti-Rheumatic Drugs

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Seminars in Arthritis and Rheumatism features a review of the effects of paternal use of antirheumatic drugs on pregnancy, specifically addressing the effects of NSAIDs, steroids, DMARDs and biologics on spermatogenesis and the effect on pregnancy outcomes and offspring.

mTOR Inhibition with Sirolimus Effective in Lupus

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Lancet reports that 12 months of sirolimus treatment is associated with improvement in lupus disease activity presumeably by correction of pro-inflammatory T-cell activity.

Shoe Inserts Disappoint with Plantar Heel Pain

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A report from the British Journal of Sports Medicine shows that commonly used drug store shoe inserts or customized orthotics are often ineffective in managing plantar heel pain.

Novel Approach to Knee Osteoarthritis Pain

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Geniculate artery embolization was found to dampen knee pain arising from osteoarthritis, according to interim study results presented at the 2018 annual meeting of the Society of Interventional Radiology.

Time to Rethink Gout as a Chronic Disease

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The current issue of JAMA has a perspective article on Gout’s bad rap as dietary disease rather than the complex, chronic inflammatory disorder that is ineffectively treated in many. 

Using Synovial Tissue Biopsies to Develop Precision Medicine for Rheumatoid Arthritis

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Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoi

MMWR: Arthritis Prevalence Increases and Varies Widely

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MMWR reports that In 2015, the number of adults with arthritis continued to increase; with marked geographic variability in arthritis estimates with gaps in arthritis management.

Repeat Malignancy Unlikely with Biologic Therapy

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Research from the Danish biologics registry shows that the use of a biologic in patients with a history of a primary cancer does not increase the risk of a second malignant neoplasm (SMN) or mortality in rheumatoid arthritis (RA) patients.

The RheumNow Week in Review - 16 March 2018

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Dr. Jack Cush reviews the highlights from the news, journals and major meetings. Bigtime rheumatologic lessons with tales from intestinal crypts, the friendly skies & the hips of hockey players. Also the microbiome and lupus, benefits of ENT findings with GPA and rare risk of opportunistic infections with biologics.