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ACR Responds to CY2020 Medicare Physician Fee Schedule Proposed Rule
Rheumatology leaders commend CMS for proposing E/M code changes and urge agency to make additional changes to final rule.d
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Persistent Inflammatory Arthritis After Immune Checkpoint Inhibitors
Braaten and colleagues from Johns Hopkins School of Medicine have reported their experience with chronic inflammatory arthritis induced by immune checkpoint inhibitor therapies, showing that in some, inflammatory arthritis persists after the immunotherapy has been discontinued.
Parenteral Out-Performs Oral Weekly Methotrexate
A systematic review in PLOS suggests that parenteral MTX therapy is more successful than oral MTX in achieving optimal disease activity control.
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Higher Rates of Venous Thromboembolism in Gout
A Canadian administrative claims analysis has shown that gout-associated inflammation increases the risk of venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE) before and after the diagnosis of gout.
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RheumNow Podcast – Believe in Vitamin D or Rituximab? (9.20.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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NSAID Use Linked With Hypertension in Ankylosing Spondylitis
Continuous use of nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with ankylosing spondylitis (AS) was associated with the development of incident hypertension, a prospective cohort study found.
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FEAR: A Perception of Fact In Spite of the Fiction
Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve.
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Sensitivity of Temporal Artery Biopsy
Metanalysis shows that temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) has a sensitivity of 77%, similar to results seen with temporal artery imaging. These data suggest clinicians may be willing to accept a GCA diagnosis without proof by TAB.
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FDA Grants Breakthrough Status for Potential Lupus Nephritis Drug
Obinutuzumab (Gazyva) has been granted Breakthrough Therapy Designation (BTD) by the U.S. Food and Drug Administration (FDA) for use in adults with lupus nephritis (LN). The drug made by Genentech, is going forward based on the Phase II NOBILITY study in adult patients with proliferative lupus nephritis (LN). Currently, there are no FDA-approved medicines for lupus nephritis.
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Anakinra Shows Benefits in Cytokine Storm
The interleukin (IL)-1 receptor antagonist anakinra (Kineret) showed promise in critically ill children who develop the often-lethal condition known as secondary hemophagocytic lymphohistiocytosis (sHLH)/macrophage activation syndrome (MAS), a retrospective single-center study found.
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ACR Survey Shows Half of Patients Cannot Afford Treatments
Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.
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Medical Use of Cannabis in 2019
JAMA has published an overview of cannabis and its medical uses. Although nearly 10% of cannabis users in the United States report using it for medicinal purposes, there is insufficient evidence to support the use of medical cannabis for most conditions for which its use is advocated or advised. Nevertheless, there is increase in favoring the public availability of cannabis, largely for the management of more than 50 medical conditions.
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Prior Authorizations Delay Care in Rheumatology
Physicians who believe their patients' health is negatively affected by insurers' demands for prior authorization, and the delays that often result, will find that opinion vindicated by a new study of rheumatology care: when permission had to be sought from insurers to provide intravenous drugs,
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RheumNow Podcast – The End of Arthritis (9.13.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Two vs. Four Weeks of Antibiotic Therapy in Septic Arthritis
A prospective trial has shown that 2 weeks of antibiotic therapy is as effective as 4 weeks of antibiotic therapy, with similar outcomes but shorter hospital stays.
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74 Percent of Rheumatoid Arthritis Patients Dissatisfied with Treatment
CreakyJoints has completed a 258 patient survey showing that nearly three-fourths of people with rheumatoid arthritis (RA) have expressed dissatisfaction with their treatments, including conventional (csDMARDs) and biologic Disease Modifying Antirheumatic Drugs (bDMARDs).
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Steroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis
Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.
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Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement
JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.
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Riociguat Fails in Systemic Sclerosis-Associated Digital Ulcers
Riociguat is an oral, selective soluble guanylate cyclase stimulator that has been studied in patients with digital ulcers (DU) due to systemic sclerosis (SSc) but study results show that short term (16 weeks) riociquat therapy does not sufficiently reduce the DU burden in SSc patients.
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Anti-IL-23 Beats IL-17 in Plaque Psoriasis
Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).
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