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Vitamin D Supplements Fail to Prevent Type 2 Diabetes - DUH!
A NEJM report shows that the use of vitamin D3 supplementation (4000 IU per day) in those without diabetes or vitamin D deficiency failed to significantly lower risk of type 2 diabetes (compared to placebo).
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Increasing Lung Disease in Systemic JIA
A single-center cohort analysis shows that lung disease is increasingly seen in children with systemic juvenile idiopathic arthritis (SJIA), especially those complicated by macrophage activation syndrome.
Prior to 2013, reports of pulmonary disease in SJIA were rare, but since there have been increasing reports of alveolar hypertension, interstitial lung disease and pulmonary alveolar proteinosis; often with a high mortality rate.
As such, since 2014, the Cincinnati Children’s Hospital Medical Center has seen an increase in lung disease and severe lung disease in SJIA.
New EULAR/ACR Classification Criteria for SLE
The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.
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War on RA - Part 3: Useless Drugs
We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.
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Are Non-TNF Biologics Superior to TNF inhibitors?
Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis.
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EULAR Recommendations on Large Vessel Vasculitis
Th European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) was originally published in 2009. Since then there have been new randomised clinical trials and cohort analyses leading to an update the original recommendations.
Read ArticleSjogren's Syndrome at Risk for Psychiatric Disorders
A population-based claims study from Taiwan shows significantly increased incidences of depressive disorder, anxiety disorder, and sleep disorder in patients with primary Sjögren’s syndrome (pSS).
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RheumNow Podcast – More Than a Spot of Tea (8.2.19)
Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com:
MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.
Biologic Therapy Improves Psoriasis and Reduces CV Inflammation
Psoriasis confers a significant risk of comorbidity, but is psoriasis associated with increased coronary inflammation and is this risk attenuated by biologic therapy?
JAMA Cardiology has published a cohort study of 134 consecutive patients with moderate to severe psoriasis, showing that biologic therapy was associated with a significant decrease in coronary inflammation as assessed by perivascular fat attenuation index, a marker of coronary inflammation associated with cardiovascular outcomes. Patients not receiving biologic therapy had no change in perivascular fat attenuation index at 1 year.
TNF Inhibitor and Biologic Induced Psoriasis
Analysis of RA patients in the German biologics register, RABBIT, shows an increased risk of psoriasis with TNF inhibitor (TNFi) compared to csDMARDs and other non-TNFi biologics.
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Top Rheumatology Centers Led by Johns Hopkins
Medscape has reported the results of the US News & World Report's annual ranking of the best adult rheumatology hospitals nationwide has again honored Johns Hopkins Hospital, with runner up status going to the Cleveland Clinic, Hospital for Special Surgery, NewYork-Presbyterian Unive
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Joint Surgery Rates Remain High in Psoriatic Arthritis
The incidence rate of joint surgery among patients with psoriatic arthritis (PsA) has remained persistently high, double that of the general population, according to a new Danish cohort study.
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War on RA - Part 2: It's All About You
Part II of this series is a direct message to rheumatologists. If we’re doing such a great job in RA, then why do we need a war on RA? Why is this conflict being laid at the feet of good soldier rheumatologists, those who toil daily at winning therapeutic battles one patient at a time? The reasons are blunt and true.
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Abatacept Disappoints in Systemic Sclerosis
A 12‐month, Phase 2 trial has shown that subcutaneous abatacept was well tolerated in patients with diffuse cutaneous systemic sclerosis (dcSSc), but failed to significantly change the skin outcomes as measured by the change in modified Rodnan skin score (mRSS)
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RheumNow Podcast – FDA Hyperactivity (7.26.19)
Dr. Jack Cush reviews the news, journal reports, and FDA releases and deliberations covered this past week on RheumNow.com
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Tofacitinib Gets a New Boxed Warning for Blood Clots and Death with Higher Doses
The U.S. Food and Drug Administration has approved new warnings about an increased risk of blood clots and of death with the 10 mg twice daily dose of tofacitinib (Xeljanz, Xeljanz XR), which is used in patients with ulcerative colitis.
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Efficacy of Maintaining or Switching to Baricitinib Monotherapy
A post hoc analysis of baricitinib use in rheumatoid arthritis (RA) patients shows that while many patients respond well to baricitinib monotherapy or to switching to baricitinib monotherapy, those with less disease control respond well to the addition of methotrexate (MTX) to baricitinb.&nb
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FDA AAC Splits Vote in Favor of Nintedanib for Scleroderma Interstitial Lung Disease
The FDA convened Arthritis Advisory Committee to consider nintedanib for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD) and voted 10-7 in favor of approving the drug for this new indication.
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FINCH2: Filgotinib in Biologic Refractory Rheumatoid Arthritis
The FINCH2 study has shown that filgotinib, an oral once daily JAK 1 inhibitor, is highly effective in rheumatoid arthritis (RA) patients who failed to respond to prior biologic therapy.
Read ArticleRisk of Major Gastrointestinal Bleeding With New vs Conventional Oral Anticoagulants
The comparative risk for gastrointestinal bleeding (GIB) with non-vitamin K antagonist oral anticoagulants (NOACs) was compared to vitamin K antagonists or anti-platelet agents in a recent metanalysis, which showed no significant difference in major GIB events between these agents.
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