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.

Stroke Risk Highest in the First Year of Lupus

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Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

Osteoporosis Drugs of Uncertain Efficacy with CKD

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More research is needed to determine the benefits and harms of osteoporosis medications on bone mineral density (BMD), fracture risk, and safety among patients with chronic kidney disease (CKD). This is important because complications of CKD include weak bones and increased fracture risk.

Osteoporosis Screening Indicated Following Non-Vertebral Fractures

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The Archives of Osteoporosis have published the results of a cohort study supporting the use of osteoporosis (OP) screening in those sustaining a non-vertebral fracture in patients over age 50 years, independent of sex of level of trauma sustained.

Hydroxychloroquine Underperforms in a Cutaneous Lupus Trial

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Hydroxychloroquine has become a mainstay in the treatement of patients with systemic lupus erythematosus (SLE) with proven efficacy in managing many domains of lupus, including skin, joint, and other autoimmune features.

The RheumNow Week in Review – 7 April 2017

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Dr. Jack Cush reviews highlights from this week's meeting at the Cleveland Clinic Foundation - Biologics Summit VII; and of course a few other tweets and journal articles.

Biologic Safety Holds Up in RA

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An updated systematic literature review has provided reassuring evidence regarding the increasing safety of biologic disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA), European researchers reported. 

Abatacept Use During Surgery

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The issue of medication management is a complicated one, especially in complex rheumatoid arthritis (RA) patients taking biologic or immunosuppressive drugs.

Healthy Bones Formed During Adolescence

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An article in the Journal of Bone and Mineral Research reports that physical activity during adolescence is an important determinant in bone strength. (Citation source http://buff.ly/2oph6vO)

The RheumNow Week in Review – 31 March 2017

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Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

TNF Inhibitor Induced Psoriasis

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Tumor necrosis factor-α inhibitors (TNFi) rarely have been reported to induce new-onset psoriasis.

Mortality in Gout Increased

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Two current articles in the Journal of Rheumatology address issues surrounding mortality risk among those with new and established gout.

Alcohol Use During Methotrexate Studied

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A recent RheumNow survey of 495 rheumatologists found that half of rheumatologists allow 1-3 alcoholic drinks per week and 6-7% has no alcohol restrictions while being treated with methotrexate (MTX).

ICER Report Claims RA Drugs are Not Cost Effective

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On Friday March 24, the nonprofit Institute for Clinical and Economic Review (ICER) presented its report on the cost and value of targeted immune modulators (TIMs) for rheumatoid arthritis (RA) in a meeting in Boston that included clinical experts, manufacturers, payers, and patients.

Biologics Do Not Increase Melanoma Risk

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Rheumatoid arthritis (RA) patients have a higher risk of certain cancers (e.g., skin, lung, lymphoma).  At issue is whether the newer agents modify this risk appreciably.

Steroids, DMARDs and Biologics have Same Low Risk of Infection During Pregnancy

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Low rates of serious infections were observed in pregnant women receiving immunosuppressive therapies. Higher rates may be seen with steroid use in pregnancy and SIE trend towards lowest with DMARD or TNFi use. 

Lyrica Fails in Sciatica Pain

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Lyrica (pregabalin) was first approved in 2004 and since has been studied and approved for use in neuropathic pain (associated with diabetic neuropathy), postherpetic neuralgia, partial onset seizures, fibromyalgia and neuropathic pain with spinal cord injury.