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War on RA - Part 1: Walk on the Moon
It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.
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Partial or Total Knee Replacement for Osteoarthritis?
Lancet has reported on a clinical trial comparing total knee replacement (TKR) and partial knee replacement (PKR) in late-stage isolated medial compartment knee osteoarthritis patients finding that both TKR and PKR are equally effective, PKR should be considered the first, because of lower costs
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FDA Approves Apremilast for Behcet's Oral Ulcers
The US Food and Drug Administration (FDA) has approved apremilast (Otezla) for the treatment of oral ulcers associated with Behçet’s Disease, a rare chronic multisystem inflammatory disease that affects about 5 in 100,000 persons in the USA.
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RheumNow Podcast – Don’t Take My Advice (7.19.19)
Dr. Jack Cush reports the news and new journal articles from the past week on RheumNow.com.
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Intraarticular Capsaicin in Knee Osteoarthritis
A novel compound, synthetic trans‐capsaicin (CNTX‐4975), has been studied as an intraarticular injection and shown to significantly reduce pain in patients with chronic moderate‐to‐severe osteoarthritis of the knee.
A phase II, multicenter, double‐blind study enrolled 172 knee OA patients between the ages of 45–80 years. Patients were randomized to receive either intraarticular placebo, or a high‐purity synthetic trans‐capsaicin CNTX‐4975 0.5 mg, or CNTX‐4975 1.0 mg.
Increased Risk of Cardiovascular Death in Hip and Knee Osteoarthritis
Hip and knee osteoarthritis patients have been shown to have increased mortality rates from cardiovascular events when compared to the general population.
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A Potential Biomarker for Chronic Fatigue Syndrome Patients
Myalgic encephalomyelitis/chronic fatigue syndrome affects at least 2 million people in the United States and bears tremendous overlap with fibromyalgia - both being difficult to diagnosis because the symptom complex is often unrecognized and these conditions have no biomarker test.
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Upadacitinib Superior to Adalimumab in Methotrexate Refractory RA
Upadacitinib, a JAK1-selective inhibitor, was studied head to head against adalimumab and placebo in rheumatoid arthritis after an inadequate response to methotrexate, and shown to be superior to ADA and PBO in ACR20 and DAS remission level responses.
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Cardiovascular Disease Increased in Hospitalized Lupus Patients
Systemic lupus erythematosus (SLE) patients who are hospitalized have an increased prevalence of atherosclerotic cardiovascular disease (ASCVD) and its individual phenotypes of coronary artery disease (CAD), peripheral artery disease (PAD), and cerebrovascular disease.
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Rituximab Safety Concerns when Used in anti-TNF Refractory RA
The SUNSTONE study evaluated the long‐term safety of rituximab in rheumatoid arthritis (RA) previously exposed to ≥1 anti–tumor necrosis factor inhibitors (TNFi) and showed a stable, but high, rate of serious infections, opportunistic infections and an overall higher mortality rate.
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Rituximab Superior to Cyclosporine for Membranous Nephropathy
The NEJM has reported that rituximab (RTX) and cyclosporine (CYA) was noninferior to cyclosporine in inducing complete or partial remission of proteinuria at 12 months and was superior in maintaining proteinuria remission up to 24 months.
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NIH Conference Review of Chronic Fatigue Syndrome
The current issue of JAMA reviews recent advances on chronic fatigue syndrome, also known as myalgic encephalomyelitis/(ME/CFS), based on a 2-day conference held at the NIH in an April 2019.
The NIH 2-day conference reviewed recent progress and new research in several areas described below.
EHR-Related Adverse Events Usually Involve Medications
Concerns about the unintended risks inherent in electronic health records (EHR) by analysis of EHR–related harms identified from large database of malpractice suits and claims; they found that EHR related adverse events exist, and may be associated with an severe harms and uncommonly, death.
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Safety Concerns Offset the Modest Improvements of Tanezumab in Osteoarthritis
JAMA reports that although tanezumab is modestly effective in moderate to severe osteoarthritis (knee or hip), with statistically significant improvements in pain and physical function, the tanezumab (TNZ) treated patients had more joint safety events and total joint replacements than pa
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Benefits vs Harms for Osteoporosis Drug Continuation or Discontinuation
While it is clear that long-term bisphosphonate therapies reduce fracture risk in women with osteoporosis, it is unclear how to counter-balance these benefits against rare serious harms and how to optimize therapeutic benefits with appropriate drug holidays.
A systematic analysis of 48 studies compared long-term osteoporosis drug treatment (ODT) (>3 years) versus control versus ODT continuation versus durg discontinuation, to examine incident fractures or harms.
RheumNow Podcast – EULAR 2019 Streamin' - (6.14.19)
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Dr. Jack Cush reports from Madrid on several novel presentations from EULAR 2019, including low-dose steroids in hand OA, ABA vs. ADA in double positive RA patients, psoriasis predictors of PsA, tildrakizumab and more.
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Allopurinol Fails to Curtail Hypertension
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.
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EULAR 2019 - Day 1 Report
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Here are a few of the highlights from day 1 EULAR in Madrid, including another IL-23 inhibitor, BTK inhibition, abatacept in Sjogren's syndrome, don't repeat the ANA, and drug free remission in systemic JIA.
CAM Use is Common in Psoriasis
The July issue of the Journal of the American Academy of Dermatology reports that patients with psoriasis are frequent users of complementary and alternative medicines (CAMs) largely because of disatisfaction with traditional medications.
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RheumNow Podcast – Prevalence of Methotrexate Toxicities (6.28.19)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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