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Hormone Therapy for Postmenopausal Women
The NEJM weighs in on the problem of post-menopausal osteoporosis (OP) and tackles the use of hormonal therapy.
The decline in estrogen after menopause may increase risks for osteoporosis, cardiovascular disease, and cognitive decline. The use of hormone replacement therapy (HRT) to obviate these issues may be primarily driven by hot flashes in postmenopausal women.1
Who may benefit from hormone therapy among postmenopausal women?
Knee Replacements Last 25 Years
UK registry reports that greater than 80% of total knee replacements can last for 25 years.
The outcomes regarding the duration and durability of knee arthroplasties is sketchy, with many orthopedists projecting a 15 to 20 year survivial. Hence the need for an appraisal of the data.
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Rheumatoid Arthritis Antibodies Linked With COPD
Women who were seropositive for anti-citrullinated protein antibodies (ACPA) and ultimately went on to develop rheumatoid arthritis (RA) were also at increased risk for being diagnosed with chronic obstructive pulmonary disease (COPD), analysis of data from the Nurses' Health Study showed.
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Prospectively study of neuropsychiatric (NP) events in1827 SLE - found that NP-SLE occured in 52%; with 31% directly attributed to SLE. Risk of NP-SLE was highest in the first 2 years (RR 6.16) and mortality risk was higher in NP-SLE pts ((16% vs 7%) https://t.co/03wfX5SxNm
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Study of 260 TB patients treated with pyrazinamide or fluoroquinolones showed a higher risk of joint pain (mostly ankles knees) with FQN (29%) vs PZA (17%); median latency was 55 days vs 138 days; half had hyperuricemia. https://t.co/ylc4Az0yOz
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Dr. John Cush RheumNow ( View Tweet)
NSAIDs May Impair Healing if Taken Nightly
A new study in Scientific Reports suggest that circadian rhythms play an important role in wound healing, and that nonsteroidal anti-inflammatory drugs (NSAIDs) may be disruptive if taken at night given primary healing that occurs in a body at night.
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2019 EULAR Recommendations for the Management of Rheumatoid Arthritis
The 2019 update to the EULAR recommendations on the use of synthetic and biological disease-modifying antirheumatic drugs in rheumatoid arthritis (RA) have been published in Annals of Rheumatic Disease - highlighting the efforts of an international consensus committee effort.
In the end, the task force put forth 5 overarching principles and 12 recommendations concerning use of conventional synthetic DMARDs, glucocorticoids, biological DMARDs, biosimilar DMARDs, and targeted synthetic DMARDs (the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, filgotinib, upadacitinib).
RheumNow Podcast- A Good First Impression (1.24.20)
Dr Jack Cush comments on this week's journal articles, reviews and studies.
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QD Clinic - "Doc, When Can I Stop?"
QD Clinic - Lessons from the clinic. In this video: Patients stable on a biologic need guidance on when, and if, they can stop their biologic.
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QD Clinic - Hepatitis B and Biologics
QD Clinic - Lessons from the clinic
Active HBV infection (HGsAg+) on anti-viral therapy but needs a biologic - what should you use?
Biosimilars for Rheum Disease: Failure to Launch
The availability of biologic biosimilars has thus far had negligible impact on prescribing practices in the United States, in stark contrast to what has been observed in some European countries, researchers reported.
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QD Clinic - Dealing with Non-adherence
QD Clinic - Lessons from the clinic. Today’s clinic topic: Dealing with Non-Adherence in the Clinic.
Steroid-Sparing Effect of Tocilizumab in Refractory Takayasu Arteritis
A controlled clinical trial has shown that giving the IL-6 receptor antibody, tocilizumab (TCZ), to patients with Takayasu arteritis (TAK) results in clinical efficacy and has a steroid sparing efffect.
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RheumNow Podcast- The Down Side of Steroids (1.17.20)
Dr. Jack Cush reviews the journal reports and news from RheumNow.com.
Be sure to register for RheumNow Live 3/13/2020 in Fort Worth
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NSAID Safety Guidelines
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for acute or chronic arthritis, headache, visceral pain, postoperative pain, etc but come with a small but significant risk of serious adverse effects, including hypertension, cardiovascular disease, kidney injury and GI complica
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TULIP2 - Anifrolumab Succeeds in Lupus
NEJM has published the results of the TULIP2 trial with anifrolumab, an alpha interferon blocker, in the treatment of systemic lupus erythematosus, showing significant improvement (over placebo) in multiple lupus outcome measures, including BICLA, SRI-4, CLASI and others.
Poor Sleep Increases Risk of Cognitive Decline
The Journal of Neurology, Neurosurgery & Psychiatry reports there is moderate evidence that six sleep disorders (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) significantly increases the ri
Read ArticleShould We Screen Younger Postmenopausal Women for Osteoporosis?
Do postmenopausal women, under age 65 years, need a baseline BMD testing? A JAMA Insights review suggests that the absolute risk of fracture is low in this group and that USPSTF guidelines should be considered - that we should be screening women younger than 65 years who are at increased risk of osteoporosis and we should be using a formal risk assessment tool to identify candidates for bone density testing.
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Diabetics using SGLT2 Inhibitors have a lower Gout Risk
Researchers from the Brigham and Women's Hospital have reported that adults with type 2 diabetes who were treated with SGLT2 inhibitors had a lower risk of gout compared to GLP1 agonist, suggesting that sodium–glucose cotransporter-2 inhibitors may reduce the risk for gout with type 2 diabetes mellitus (T2DM).
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Rheumatologists Ranked #1 in Happiness (Again)
Medscape has reported the results of its 2020 annual physician survey, This year rheumatologists (60%), general surgeons (60%), public health and preventive medicine physicians, and allergists/immunologists are the "happiest" outside of work compared to other specialists, according to Medscap
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