Smoking and Worse Outcomes in Spondylitis

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BIRMINGHAM, England -- Smoking was a strong predictor of more severe disease in patients with axial spondyloarthritis (AxSpA), with people who had ever smoked having worse disease activity and worse quality of life than those who had never smoked, researchers reported here.

FDA Approves Abaloparatide for High Risk Patients

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The FDA has approved injectable Tymlos (abaloparatide) for use in postmenopausal osteoporosis patients at high risk for fracture, as the drug has been shown to reduce the risk of vertebral and nonvertebral fractures in such patients.

The RheumNow Week in Review – 28 April 2017

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Dr. Jack Cush reviews the news from the last week on RheumNow.com - from the ACR SOTA 2017 meeting in Chicago:

Lipstick Rheumatology

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A 25 year-old female recently diagnosed with seronegative rheumatoid arthritis was started on a TNF inhibitor. She came in for a follow-up visit and noted that her toenails were brittle and discolored when she removed her nail polish recently.  She is concerned that she may have psoriasis or that this may be a side effect of the TNF inhibitor.

What is your next step?

Elimination of Senescent Chondrocytes Reduces Post-Traumatic Osteoarthritis

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A study in the April 24 issue of Nature Medicine suggests that senescent cells in the joint contribute to age-related degenerative disease and that their removal can abrogate disease. 

Best to Rehab at Home Following Joint Replacement

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A New York Times article sheds light on recent evidence suggesting that those undergoing hip or knee replacement will do just as well with home therapy compared to inpatient rehabilitation following surgery.

Pregnancy Flares in RA and Spondylitis

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Despite the folklore, not all women with arthritis who become pregnant will improve or go into remission.  Recent studies have suggested that up to one-third of RA patients will flare during pregnancy.

EULAR/EFORT Taskforce on the Management of Fragility Fractures

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The morbidity associated with osteoporosis-related fragility fractures imposes tremendous socioeconomic and medical impact on patients and society.

Consensus on OP Drug Holidays

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Extending bisphosphonate treatment beyond 3–5 years does not confer additional benefit in low-risk populations. Treatment re-initiation (usually 1–3 years after bisphosphonate withdrawal) depends on risk factors, new fractures and bone mineral density. The evidence regarding denosumab discontinuation is limited but caution is advised, as there may be a “rebound effect” with regard to fractures.

FDA Approves Renflexis as Second Infliximab Biosimilar

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On the 21st of April, the FDA approved another infliximab biosimilar, called Renflexis (Infliximab-abda) following on the biologics license application of the South Korean manufacturer Samsung Bioepis Co. LTD.  In early developmental trials this agent was also called SB2.

The RheumNow Week in Review – 21 April 2017

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Dr. Jack Cush reviews highlights from the past week on RheumNow.com:

Paradoxical Toxicities with TNF Inhibitors

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Something is curiously wrong when a drug induces the disease it is intended to treat. Yet this phenomenon has been described with all five FDA-approved TNF inhibitors.

Inconsistent ESR & CRP in Spondylitis Patients

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Patients with active axial spondyloarthritis (axSpA) can lack evidence of inflammation on magnetic resonance imaging (MRI) but may develop evidence of inflammation over time.

Anti-IL-23 Therapy Effective in Crohn's Disease

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Lancet has reported the results of risankizumab, an interleukin-23 (IL-23) inhibitor, in Crohn's disease. Risankizumab is a humanised monoclonal antibody targeting the p19 subunit of interleukin-23, and is being developed for Crohn's disease.

The Cost of Not Taking Medicine

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The NY Times points out "there is is an out-of-control epidemic in the United States that costs more and affects more people than any disease Americans currently worry about. It’s called nonadherence to prescribed medications, and it is — potentially, at least — 100 percent preventable by the very individuals it afflicts.

FDA Delays Baricitinib Decision

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Eli Lilly and Company and Incyte Corporation announced today that the U.S. Food and Drug Administration (FDA) has delayed its' decision on baricitinib by issuing a complete response letter for baricitinib's New Drug Application. 

The RheumNow Week in Review – 14 April 2017

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Dr. Jack Cush reviews the past week's news, articles and advances from RheumNow.com.

Acute Steroid Use Comes with Risk

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Steroids are known for their acute therpeutic wonders and chronic hazards. Hence most practitioners are comfortable using short term, limited dose corticosteroids for a variety of ailments.

Celecoxib Plus PPI Preferred in High Risk Patients

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When do the risks outweigh the benefits of NSAIDs use, especially in those with prior cardiovascular and gastrointestinal events? The CONCERN study has tested the effects of proton-pump inhibitor (PPI) in preventing GI bleeds when using NSAIDs and ASA.

Spinal Manipulation Equal to NSAIDS for Acute Low Back Pain

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JAMA has published a review of 15 RCTs (1711 patients) analyzing the role of spinal manipulation therapy in patients with acute low back pain. The authors found modest improvements in pain and function at up to 6 weeks, with temporary minor musculoskeletal harms.