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Consensus Statements on Vitamin D
The “Controversies in Vitamin D” International Conference has published their proceedings on vitamin D metabolism, assessment, actions, and supplementation. Interestingly, optimal levels of 25-hydroxy vitamin D (25(OH)D) are still being debated.
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Infectious Mortality in Autoimmune Rheumatic Disorders
Infectious conditions are a significant cause of mortality in autoimmune rheumatic diseases (ARD). Among patients hospitalized with an infection, we compared in-hospital and long-term (3-year) mortality between those with and without ARD.
Small-molecule Drugs to Treat Systemic Lupus Erythematosus
A metanalysis of randomized controlled trials (RCTs) on treatments of systemic lupus erythematosus (SLE), confirm the efficacy of several targeted small-molecule drugs.
Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://t.co/CXdcEdWXhW https://t.co/j0ktehf9Sm
Dr. John Cush RheumNow ( View Tweet)
2023 Top 3 paper from JAMA Derm - 122 plaque psoriasis pts (mild-mod w/ PASI=3.1) & low vit D levels (~14.9), Rx w/ PBO vs vit D 20 000 IU/wk x 4 mos during winter; no signif vit D Rx benefit for PASI, MD global, DLQI or 25-OH levels(< than expected) https://t.co/8W5abvydY6 https://t.co/rKJjkiHwC6
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My Cancelled Lecture (5.11.2024)
In lieu of this weeks podcast, Dr. Jack Cush records his "Life Lessons (that keep changing) in Rheumatology Lecture. A lecture recently cancelled because some of this content was objectionable? (I dont think so!)
https://t.co/8iObw8cE5S https://t.co/k06P4mMwmD
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Inflammatory Myositis market size was valued at ~$575 million USD in 2022 with 184,204 confirmed IMM cases in the 7MM. In the USA there were 90,064 cases in 2022 https://t.co/uLtxOYGrLr https://t.co/W5TApBDV3C
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Metanalysis of 26 reports and 195 juvenile Dermatomyositis pts (age 4.9 yrs) treated w/ JAK inhib (tofa, rux, & bari); Good improvement in 90%, 69% & 93%, respectively. JAK indication refractory skin dz (35%) or muscle involvement (29%). TIME FOR RCTs!! https://t.co/0aaLV7iCWR https://t.co/DLGRqqmIyX
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National French study finds post COVID Vaccine the IR of PMR (179 cases; RR 7.1/mill) & GCA (54 cases; RR 2.1 /million) were reported 7-10d post vax. These #s are below population incidence rates (1-20/mill for GCA) https://t.co/XvaoWhqs2g https://t.co/BFDy2WKcLx
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Retrospective, cross-sectional study from the Osteoarthritis Initiative (OAI), 2607 pts (age 64yrs; BMI 28.5). After 48 mos regular bicycling yielded signif less knee pain (HR 0.83), Xray OA (0.91) & Sxs OA (0.79), Encourage Bicycling! https://t.co/ktocvwujwt https://t.co/DOfE1BFRJh
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Review article of Interstitial Lung Dz Assoc w/ Systemic Sclerosis. SSc-ILD prevalence ranges 25-95%; ILD is a main cause of morbidity and mortality, contributing to 35% of deaths https://t.co/aM5O6lwQLw https://t.co/RG6xe5rVE7
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Since 2010, use of RTX has increased & AZA decreased in GPA/MPA. French national insurance study of 977 GPA/MPA in 2010-12 vs 1131 GPA/MPA in 2014–2017 saw incr RTX, decr AZA, but stable use MTX, CTX, steroids over time https://t.co/ICtDqxthAN https://t.co/bFvOL3GGmf
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Alot of murky "research" on Platelet-rich plasma (PRP). This RCT of120 pts having anterior cruciate ligament reconstruction (half randomized to PRP) shows no PRP benefit, no significant improvement of knee symptoms & function post ACLR https://t.co/qscBvywWLS https://t.co/jSohaMhBnY
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Retrospective cohort study compared 5825 #AS pts vs 28,356 matched controls; showed an increased risk of pulmonary embolism w/ AS; not present pre-Dx ((0.4% vs 0.2%), but incr post-AS Dx (PE IR 11.6 vs 6.8/10KPY: adj HR 1.70;; p<0.001) https://t.co/Tsd77iUsjC https://t.co/sd6wbtuaqw
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In animal models, IL-22 may have protective effects against pulm fibrosis. Study of 66 new #RA pts (1/2 w/ ILD) & 14 controls. Serum IL-22 was signif lower in RA-ILD; and was inversely correlated with the severity of RA-ILD https://t.co/Rmr5N2JznH https://t.co/OZ1ZrgGXC3
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K Kuhn et al: Altered tryptophan catabolism by microbiome may contribute to inflammatory arthritis. Tryptophan increases indole leading to ncreases in serum IL-6, TNF, and IL-1β; splenic RORγt+CD4+ T cells, & IL-23 and IL-17 production https://t.co/Bqm5ecvGR5 https://t.co/O1jCSqFICr
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The EMAs CHMP has recommended for approval Two biosimilars, Tofidence (tocilizumab) and Wezenla (ustekinumab) https://t.co/mREclYdeCk https://t.co/zQX00Ys8oH
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MGH study compared 1148 acute CPPD vs 3730 controls (mean 73 yrs) found 2 fold more fractures (mostly wrist); 11.7 vs 5.5/1000 PYs (HR 1.8) in pseudogout pts (also had more steroids & OP) https://t.co/HhCV6fYubF https://t.co/3bcbvSzzPo
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Substitute Measures of Inflammation (many dervied from the CBC)
https://t.co/rYBqrNH8Zo https://t.co/Fa1mC17ErJ
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RECIPE Study: Non-opioid Analgesics following Total Hip Arthroplasty
Patients undergoing total hip arthroplasty using a combo of paracetamol, ibuprofen, + dexamethasone, had optimal responses with the lowest morphine consumption, & fewer adverse events.
https://t.co/PXmPGscwu3 https://t.co/2Lse0gNx70
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