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Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease
Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results.
On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.
Rise in Fatty Liver Disease Linked to Obesity and Diabetes
Gut has published population results from NHANES population study showing that the prevalence of fatty liver disease is rising in the US and is driven by obesity and diabetes.
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Trends in Inflammatory Arthritis Care in Germany
The German National Database (NDB) has reviewed their experience in the care and quality of life of inflammatory rheumatic disease patients snce 1993, showing improved use of metrics, improved outcomes and a changing profile of biologic and anti-rheumatic drug use.
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With Autoimmunity, Checkpoint Inhibitors Can Be Used
Among patients with pre-existing autoimmune diseases who developed cancer and were treated with immune checkpoint inhibitors (ICI), flares of the underlying disease and other immune-related adverse events were common, a retrospective study conducted in France showed.
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Bisphosphonate Use Associated with Reduced Mortality
The Journal of Bone and Mineral Research (JBMR) has published a report showing that a reduction in the rate of bone loss by nitrogen bisphosphonates was associated with a 40% lower mortality risk.
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War on RA – Part 4: Desperado – Time to Open the Gate
Do you know what the best-selling album of all time is? Could it be Bing Crosby? U2? Fleetwood Mac? AC/DC? I know, it’s Michael Jackson’s “Thriller” right?
Actually it’s the Eagles Greatest Hits – it surpassed Jackson’s Thriller in August 2019 as the best-selling with a total of 36 million copies sold since it was released in 1976. Wait! Are we not Rheumatologists? Aren’t we supposed to be discussing rheumatoid arthritis?
Enbrel Patent Battle Won by Amgen
The ugly, legal, financial underbelly of US biosimilar drug development showed up in court last Friday, when a U.S. judge upheld two of Amgen's patents for Enbrel, thwarting a legal challenge by Novartis/Sandoz over its etanercept-szzs biosimilar, Erelzi.
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RA Disease Activity Drives Lung Complications
A longitudinal study from the BRASS registry shows that increase rheumatoid arthritis disease activity increases the risk of RA-associated interstitial lung disease (RA-ILD).
RA patients without RA-ILD at baseline, enrolled in the Brigham RA Sequential Study (BRASS, 2003–2016), were followed from 2003-2016 with serial clinical, DAS28, serologic and imaging assessments.
NSAIDs Mediate Cardiovascular Risk in OA
NSAIDs have been linked to an increased risk of cardiovascular disease, but does this also hold for osteoarthritis (OA) patients.
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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.
Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA
A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.
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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.
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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