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Pizza and Rheumatoid Arthritis (8.11.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the wonderful wide world of Rheumatology. This week:

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Fatigue, FM, fibromyalgia

Postural Orthostatic Tachycardia Syndrome Review

d Jack Cush, MD

The Cleveland Clinic Journal has published a full-read review of postural orthostatic tachycardia syndrome (POTS), a condition often seen in clinic with symptoms like fibromyalgia, but is clinically diagnosed with finding sustained tachycardia upon standing without orthostatic hypotension.

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English for the Biologically-Challenged (8.4.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  This week highlights Veterans, Vegetarians and Antenatal Corticosteroids.

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HEALTH DISPARITIES: Lancet study shows from 2000-2019, all-cause mortality was signif. higher in the American Indian/Alaska Native (1028/100K) & Blacks (953·/100K) compared to Whites (802); but lower in Asians (442) & Latinos (595) https://t.co/g8Z3h6BYw8 https://t.co/Ckz1L3O0W7

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Rheums: Have a rheumatology question or case for Dr. Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/uY9Mwyrsn3

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Chronic neck pain is associated with increased mortality in individuals with osteoarthritis. NHANES study of 5965 adults, OA in 8.2% and 5.9% had neck pain. Neck pain assoc w/ 2 fold risk OA. OA pts w/ chr neck pain higher all-cause mortality risk (OR ~3) https://t.co/MLzJUa3AnY https://t.co/WB8lhvUOjw

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Structured interviews from 462 pts from Michigan SLE clinic. 22% admit to cost-related non-adherence (CRNA) over 12 mos. CRNA associated signif. higher levels SLE disease activity & more lupus damage. Worse scores in those with Fibromyalgia https://t.co/NHIIqmWVqJ https://t.co/zX4gTFTcW7

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US study shows 1635 adults receiving chiropractic spinal manipulation for radicular LBP receive significantly less gabapentin prescription (OR 0.53; 0.40 to 0.71; p<0.0001) over 1-year follow-up compared with those receiving usual medical care https://t.co/t0uTMdLEzO https://t.co/rCR04sMdRV

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Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/vGt12ul6iy https://t.co/044BScmSYc

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Research from 12 states with medical cannabis laws looked at 583 820 adults w/ chronic noncancer pain. Data over 3 yres shows < 0.05% change in the use of opioid prescriptions, nonopioid prescriptions, pain meds, or chr pain procedures https://t.co/ArbP4xe4dH https://t.co/MPRBZNIIoS

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In AUSTRALIA, 30% (~ 7million) have a chronic #MSK condition, costing $14.6 billion (10% of all healthcare spending) in 2019-20. Overall, 4 million w/ back problems, 3 million arthritis, 900,000 osteoporosis, 450,000 w/ #RA. https://t.co/TDV50PoRXj https://t.co/EtSUuv6jMA

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Anti-Drug Antibodies with Biologics (7.14.2023)

d Jack Cush, MD

Dr. Jack Cush Reviews the news and journal reports on CVA, TKA, PJP, ADA, and more!

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Metanalysis of 8 RCT, 188751 pts assessed mortality risk & FM. Overall, all-cause mortality increased in FM (HR 1.27, 1.04 to 1.51), but not in subgroup Dx by 1990 criteria. Increased SMR for accidents, infxn, suicide & decreased for cancer (0.82) https://t.co/Ujv8KP8FJK https://t.co/lNGUM0wB3O

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Pain is the leading cause of disability worldwide. Chronic pain affects 33-50% of the population. High impact chronic pain is seen in 4.8% of US adult population. Chronic pain accounts for 22-50% of GP consultations. More from BMJ.. https://t.co/IRVpJZNS0L https://t.co/YVIM38aWWK

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Opioids Ineffective in Acute Lower Back and Neck Pain A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo. https://t.co/96mETyhKyL https://t.co/48ojNCnoZW

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2022 of fibromyalgia Year in review discusses possible causes (inflammation, gut dysbiosis, neuroinflammation), new Rx (kinin antagonists, neurostimulation, mind-body Rx; but more needed on ketamine, vitamin D, and hormonal therapy https://t.co/sya8fSCbFX https://t.co/F2HDcp2XYb

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In pts seeking care for MSK pain cannot assume that improving pain/function will result in improved depression, but substantial improvements are required to effect anxiety. Study of 11 236 Ortho pts in JAMA https://t.co/5vvoPs31GU https://t.co/gEwZNW35xB

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back, LBP, spine, AS

Opioids Ineffective in Acute Lower Back and Neck Pain

d EurekAlert!

A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo. 

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Why Patients Don't Take Medicines This report examines the characteristics of adults aged 18–64 who took prescription medication in the past 12 months and did not take medication as prescribed due to cost. https://t.co/zuPgMjKYbh https://t.co/62cG9LDYWi

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What is Colchicine Worth? (6.23.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and reports from the past week on RheumNow.com. This week a new colchicine FDA approval, rising rate of IgG4 related disease and what's the safest biologic?

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