Hypersensitivity Reactions and Gout Tx: Watch the Dose

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Both allopurinol and febuxostat (Uloric) were associated with an increased risk of hypersensitivity reactions among new users of these urate-lowering therapies, a large U.S. study found.

Bimekizumab Effective in Active Psoriatic Arthritis

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Interleukin 17 IIL-17) is important in the pathogenesis of psoriatic disease, with most current approaches targeting IL-17A. Now there is a noveal approach showing that dual neutralisation of IL-17A and IL-17F in psoriatic arthritis arthritis patients results in clinically significant improvement.

DMARD Inertia by Registry Rheumatologists

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A registry study of metric use (primarily RAPID3 and CDAI) in the treatment of rheumatoid arthritis (RA) patients shows that, even in the face of moderate or high disease activity, treatment changes by rheumatologists were relatively low (35.6–54.6%).

Upadacitinib Effective in Phase 3 Psoriatic Arthritis Study

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Abbvie has announced top line results of their SELECT-PSA trial of upadacitinib (UPA), wherein both the 15 and 30 mg doses met the primary endpoint of ACR20 response at week 12 and demonstrated radiographic inhibition at week 24.

RheumNow Podcast- Best Biologics (2.7.20)

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Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com

Bariatric Weight Loss Fails to Alter RA Risk

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Obesity has been shown to be a risk factor for the onset of rheumatoid arthritis (RA) and also shown to affect outcomes by impairing responses to many DMARD therapies. A Swiss study of RA patients undergoing bariatric surgery failed to show that bariatric surgery and weight loss had any effect on the incidence of RA.

Which Biologics are Best in Psoriasis

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A metanalysis of phase II, III and IV trials in moderate to severe plaque psoriasis suggests comparative efficacy biologic treatments, but that that brodalumab, guselkumab, ixekizumab, and risankizumab-rzaa were shown to have the past skin (PASI) response rates.

Aspirin after Hip or Knee Arthoplasty

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JAMA Internal Medicine has reported that use of low dose aspirin for venous thromboembolism (VTE) prophylaxis after total hip and knee replacement is equal in efficacy to other anticoagulants.

Start with Anti-TNF in RA? Not So Fast

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The suggestion to hit rheumatoid arthritis (RA) early and hard with biologic therapies itself took a hit in a new study.

EULAR Recommendations on Sjögren’s Syndrome

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The European League Against Rheumatism (EULAR) has established an international collaborative group (EULAR SS Task Force) to develop the first EULAR evidence and consensus-based recommendations for the management of patients with Sjogens syndrome (SjS).

Half of Opioids Rx Come from 1% of MDs

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The BMJ reports that while most US providers are cautious in their prescribing, half of opioid prescriptions are written by 1% of providers.

Between 2003 and 2017, there was an annual average of 669495 providers prescribing 8.9 million opioid prescriptions.

RheumNow Podcast- 2019 EULAR RA Guidelines (1.31.20)

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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

Hormone Therapy for Postmenopausal Women

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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

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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.

Rheumatoid Arthritis Antibodies Linked With COPD

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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.

Book Review: “Great Health Care Value: Chronic Diseases, Practice Teams and Population Management”

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The US healthcare market has evolved into an incredibly expensive system that often does not deliver good medical outcomes. While most of us know these problems exist, we rarely have up-to-date data or can offer alternatives to the way we manage care, especially to the chronically ill who consume much of our health care dollars. In their book, authors Tim Harrington, MD and Andrew Johnson, MS, MBA offer insights, evidence and experience on how we may do our part to improve the management of chronic rheumatic/orthopedic issues.

NSAIDs May Impair Healing if Taken Nightly

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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. 

2019 EULAR Recommendations for the Management of Rheumatoid Arthritis

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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)

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Dr Jack Cush comments on this week's journal articles, reviews and studies.

QD Clinic - "Doc, When Can I Stop?"

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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.