The Unregulated $37 Billion Supplement Industry

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In 1994 there were 600 supplement companies, producing 4,000 OTC supplement products for a total revenue of about $4 billion. Today we have close to 6,000 companies, producting nearly 75,000 supplement products, bringing in $37 billion annually.

Pegloticase Infusion Reactions Largely Seen in Non-Responders

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The introduction of intravenous pegloticase (PEG) in 2010 was felt by many to be a major advance in the treatment of patients with severe, refractory tophaceous gout.  But for some, concerns over infusion reactions and safety have limited its use.

The RheumNow Week in Review – 18 August 2017

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The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com.

Bad Knees Through the Ages

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The average American today is twice as likely to be diagnosed with knee osteoarthritis as in the years before World War II, Harvard scientists say. And the reasons are less clear than you might think.

Based on a study of more than 2,000 skeletons from cadaveric and archaeological collections across the United States, a Harvard report is the first to definitively show that knee osteoarthritis prevalence has dramatically increased in recent decades.

Osteoporosis Care for RA Patients Found Suboptimal, Declining

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Fewer than half of rheumatoid arthritis (RA) patients at a risk of fracture sufficient to warrant guideline-recommended osteoporosis treatment received appropriate care, according to a large study of U.S. osteoarthritis (OA) and RA patients.

How Much Testing is Enough?

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I saw a patient this past week with new onset polyarthralgia, which led me to ponder how my fellow rheumatologists would utilize laboratory testing in such a patient.

No Evidence to Support Use of Gabapentinoids in Low Back Pain

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Management of chronic low back pain (CLBP) is often complex, requiring multiple modalities and meds to control pain. An analysis of studies shows that Gabapentinoids, including pregabalin and gabapentin, have little to no benefits but significant risk of adverse effects.

Marijuana Has Little Effect on Most Types of Pain

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Cannabis has become a regulated product, and many states have made it available with the intent of treating a variety of medical disorders, including chronic pain. A metanalysis published in Annals of Internal Medicine has shown that while cannabis may help neuropathic pain, it is not proven to benefit other types of chronic pain.

Duration of Azathioprine Maintenance in AAV Does Not Alter Relapse Rates

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A European multicentre study examined whether the duration of azathioprine (AZA) maintenance therapy in ANCA-associated vasculitis patients would influence the relapse rate during long-term follow-up.

Psoriatic Arthritis Patients with Comorbidities have Worse Disease and Poor Responses

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A population-based cohort study shows that comorbidities in psoriatic arthritis patients (PsA) were associated with higher disease activity, shorter persistence and reduced clinical response to TNF inhibitors (TNFi). 

Uveitis Events Reduced with Select TNF Inhibitors

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Uveitis may occur in up to 40% of spondyloarthritis patients. Metanalyses have shown that treatment with tumour necrosis factor-α inhibitor may reduce the rates of anterior uveitis. A multicenter study from Sweden and Norway has confirmed that amongst TNFi, adalimumab and infliximab offer better protection against AU than etanercept.

Kids with Crohn's have Profound MSK Deficits - but No Increase in Fractures

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Crohn’s disease (CD), a chronic inflammatory condition of the gastrointestinal tract, is also known for its propensity to affect the musculoskeletal system.

The RheumNow Week in Review – 11 August 2017

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The RheumNow Week in Review caps the week's news every Friday. Dr Jack Cush reviews the news, journal reports and important events from the past week in rheumatology.

Joint Pain Linked to Increasing Temperature, Not Rainfall

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Every rheumatologist knows and every rheumatic patient woes about the havoc weather inflicts on joint pains. Yet, research on this issue has seldom confirmed these impressions.

Criteria for Early Referrals from Primary Care

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Early diagnosis and early intervention has been the mantra of all who manage musculoskeletal (MSK) diseases for decades. While the rules for referral may be clear to some, the lack of uniformity and promotion amongst primary care providers is less certain.

JIA Worsens Quality of Life Long into Adulthood

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Adult patients with a history of juvenile idiopathic arthritis (JIA) showed poorer health-related quality of life decades later, compared with individuals who were healthy as children -- even if they were in clinical remission, reported researchers in Norway.

Mycophenolate and Steroids in Neuropsychiatric Lupus

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Beyond diagnosis, management of neuropsychiatric lupus (NPSLE) can be challenging. Moreover, there are scant studies addressing optimal management. In this issue of Clinical Rheumatology, researchers show the efficacy of mycophenolate mofetil (MMF) and deflazacort in NPSLE.

Therapeutic Update: 5 Questions on Sirukumab FDA Hearing

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Drs. Cush and Gibofsky answer 5 questions about the August 2, 2017 FDA Arthritis Advisory Committee meeting that reviewed the NDA for sirukumab use in rheumatoid arthritis. The panel voted against (1-12) the approval of sirukumab.

MSK Ultrasound Now Standard for Rheumatology Training

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In the United States, musculoskeletal ultrasound (MSUS) in rheumatology has grown significantly in the last few decades. Ten years ago, more than half of rheumatology fellows had training or exposure to MSUS. A current survey of training programs shows that 94% provide MSUS training.

H1N1 Vaccination Triggers TLR Activation and Autoantibody Production in DMARD-naïve pSS

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Increased morbidity and mortality from infectious causes in patients with autoimmune disorders has led to the overall consensus that vaccination of such patients is important and should be widely promoted in clinical practice.