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NICE Guidelines on Chronic Pain Management
In the United Kingdom, where it is estimated that chronic pain affects one‑third to one‑half of the population, NICE (National Institute for Health and Care Excellence) has recently released an updated guideline on the management of chronic pain for people aged 16 years and over.
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IL-23 Targeting for Enthesitis in Psoriatic Arthritis
Treatment with guselkumab (Tremfya) was effective in resolving enthesitis among patients with psoriatic arthritis (PsA), a post-hoc analysis of two phase III trials found.
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DMARD Dropouts During COVID-19
A full year from the onset of the SARS-COV-2 pandemic, rheumatologists are still seeing the consequences of COVID, with many patients avoiding usual care, follow-up visits, routine lab testing and with many self-stopping their antirheumatic meds, because it seemed like the right thing to do.
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Anti-inflammatory Diet Control of Rheumatoid Arthritis
The TOMORROW study assessed the relationship between diet and disease activity in rheumatoid arthritis (RA) patients and has shown that RA patients are more likely to have higher inflammatory diets, but that a change to an anti-inflammatory diet resulted in lower disease activity s
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GLP-1 Therapy in Knee Osteoarthritis
Knee osteoarthritis is best managed by weight loss, as the effects of most analgesic therapies have been marginal and debatable. The use of anti-diabetic glucagon-like peptide-1 therapies have demonstrated significant weight loss benefits; hence this trial evaluated the potential weight loss and pain relieving effects of liraglutide in obese patients with KOA.
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Can Targeting RANKL in RA Heal Erosions?
Treatment with denosumab (Prolia) helped heal bone erosions over 2 years among patients with rheumatoid arthritis whose disease activity was well controlled, researchers reported.
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Implementing Smoking Cessation Programs
Rheumatologists are keen to the effects of smoking (increased arthritis risk, worse outcomes, blunted DMARD responses, added cardiopulmonary risks), but often do not have the resources or plan to encourage or implement smoking cessation from the rheumatology clinic. A new study details the success of a rheumatology staff‐driven protocol, Quit Connect, to increase the rate of electronic referrals to free, state‐run tobacco quit lines.
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Rheumatology Care Derailed by COVID-19
A survey study from the ArthritisPower PPRN or CreakyJoints database shows that during the COVID-19 pandemic patient care was substantially affected in unforeseen ways.
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Reactogenicity Following mRNA COVID-19 Vaccines
JAMA has published the real-world reporting of mRNA vaccine side effects (reactogenicity) gathered from CDC V-safe Surveillance system and shows that local and systemic reactions were often mild and transient and most commonly seen during the first day following their second dose.
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Cost Efficacy of Knee Replacement in Obese Osteoarthritis
Total knee replacement (TKR) in obese patients with end-stage knee osteoarthritis appears to be a beneficial and cost-effective strategy for treating. The only potential limitation is a greater risk for adverse events in those with a body mass index (BMI) of 40 kg/m2 or greater.
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Rituximab in Systemic Sclerosis?
No drug is FDA approved to manage the skin or joint complaints of systemic sclerosis (SSc); a recent metanalysis suggests that rituximab may improve skin score and disease activity indices (DAS, mRSS) while stabilizing organ involvement in SSc patients.
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US Senate Introduces the Safe Step Act
The American College of Rheumatology (ACR) today commended leaders in the United States Senate for introducing the bipartisan Safe Step Act of 2021 (S. 464), new legislation that would place reasonable limits on insurer use of step therapy.
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Upadacitinib Clinical Efficacy in Psoriatic Arthritis
McInnes and colleagues have published the results of the SELECT - PsA trial in NEJM showing updacitinib (UPA) to be superior to placebo in active psoriatic arthritis (PsA) patients, with 15 mg UPA equal to adalimumab (ADA) and 30 mg UPA qd being superior to ADA.
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Hypertension Unaffected by Urate Lowering Therapy
Does uric acid contribute to the risk of hypertension (HTN)? A recent cohort trial shows that allopurinol in young adults does not sufficiently lower blood pressure (BP).
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RheumNow Podcast – Infection in ANCA-Associated Vasculitis (3.26.2021)
Dr. Jack Cush reviews the news, FDA Denials and journal articles from the past week on RheumNow.com.
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Safety of Paternal DMARD or Biologic Use
A large cohort study of expectant fathers treated for immune-mediated inflammatory diseases (IMIDs) failed to show any detrimental effect from paternal exposure to immunosuppressive or biologic agents on offspring outcomes.
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RECIPE Trial - Mycophenolate to Suppress Immunogenicity with Pegloticase in Gout
Pegloticase is indicated in the treatment of severe gout patients but prolonged use may be limited by immunogenicity to the PEG moiety. A randomized, controlled trial has shown that concomitant mycophenolate mofetil (MMF) may prolong the efficacy of pegloticase in gout.
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Rituximab vs. JAK inhibitors in Rheumatoid Lung Disease
There are no current FDA approved therapies for rheumatoid arthritis associated interstitial lung disease (RA-ILD) or bronchiectasis, but a recent retrospective cohort study showed equivalent outcomes when RA-ILD patients were treated with either rituximab or janus kinase inhibitors.
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Are You a Super Rheum?
Several weeks ago, at the Rheumatology Winter Clinical Symposia, an interesting debate between Drs. Orrin Troum and Marty Bergman hashed over the concept of whether rheumatologists should sub-specialize with a practice, research or career devoted to one disease ("Super Rheum"), or be "selective" about what disorders and diseases they would treat or just be a generalist.
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Potent Topical Corticosteroids and the Risk of Osteoporotic Fractures
JAMA Dermatology has published a Danish national cohort study showing that potent topical corticosteroid use was associated with an increased risk of osteoporosis and major osteoporotic fractures with a dose-response association for cumulative use.
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