Sleep Apnea Increases Gout Risk

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Both Gout and obstructive sleep apnea (OSA) comingle with a wide range of serious comorbidities. A matched retrospective cohort study from the UK Clinical Practice Research database shows those with OSA are at a higher risk of developing gout.

Severe Cutaneous Sarcoid Treated with Tofacitinib

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Researchers from Yale have taken a novel approach and shown benefits when using tofacitinib in severe cutaneous sarcoidosis.

Best of 2018: The Safety of Paternal Exposure to DMARDs and Biologics

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Pregnancy and drug safety is a complex issue, often with limited information about maternal drug exposure on the offspring. Greater uncertainty exists when considering whether paternal exposure may also influence fetal outcomes.

Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices

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An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

Best of 2018: Hydroxychloroquine Being Over-Dosed with New Guidelines?

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Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice.

A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).

Best of 2018: Patients May Not Fill Your Prescription

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A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics. 

Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib.

Best of 2018: Ustekinumab May be Effective in Lupus

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Ronald F van Vollenhoven and colleagues have reported in Lancet that ustekinumab (UST), an interleukin-12 and -23 inhibitor, when added to usual therapy in systemic lupus erythematosus (SLE) patients, was shown to be superior to placebo at improving clinical efficacy and laboratory param

Best of 2018: Unproven But Profitable Stem Cell Clinics

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Stem cell clinics are popular and proliferating as they are largely a cash business and fall outside of FDA regulatory control. In lieu of scientific proof, most advocates use patient testimonials and the placebo effect to back up their claims.

RheumNow Podcast – Rheumatologist Salaries (12.21.18)

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Dr. Jack Cush reviews the news from RheumNow for the week ending 12/21/18.

Zolendronate Protects Against Fracture in Osteopenia

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The NEJM reports that the use of zoledronate significantly reduces the risk of nonvertebral or vertebral fragility fractures in women with osteopenia.

Reassuring VTE Data for Tofacitinib

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No significant differences in risk for venous thromboembolism (VTE) were seen in patients with rheumatoid arthritis (RA) treated with tofacitinib (Xeljanz) and those receiving tumor necrosis factor (TNF) inhibitors, analysis of administrative data showed.

TIF1-Ab in Dermatomyositis Linked to Higher Cancer Risk

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Several epidemiological studies have reported that a diagnosis of DM or PM may be associated with increased cancer risk. The association appears stronger for DM than PM.

H2H: Ixekizumab vs. Adalimumab in Psoriatic Arthritis

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Lilly has issued an advanced press release on its SPIRIT-H2H trial, wherein ixekizumab (Taltz) was shown to be more effective than than adalimumab (Humira) in a 24 week psoriatic arthritis study.

Rising Physician Exclusion from Medicare and Medicaid

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JAMA Network Open has published that an increasing number of physicians are being excluded from Medicare and other forms of public insurance. 

Cryotherapy Never FDA Approved

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Another injury related to whole body cryotherapy (WBC) has been reported by practitioners in Philadelphia, serving as yet another warning of WBC's potential to cause serious adverse effects.

CDC Top 15 Most Common Opioid Overdose Drugs

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The Dec. 12 issue of the National Vital Statistics Reports from the U.S. Centers for Disease Control and Prevention reports that the most commonly abused drugs causing drug overdose deaths (between 2011-2016) include fentanyl, heroin, oxycodone, and cocaine.

Psoriatic Arthritis Does Not Add to Pregnancy Problems

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When psoriatic arthritis (PsA) patients become pregnant, they do not have more infertility or adverse pregnancy outcomes compared to healthy controls.

No End in Sight for the Shingrix Vaccine Shortage

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There is a national shortage of a new shingles vaccine, Shingrix, which is a problem for those who want to start the vaccine and those seeking to receive their second and final injection. 

IL-23 Outduels IL-17 Inhibition in Psoriasis

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Johnson & Johnson has announced the preliminary results of its phase 3 ECLIPSE study; a head-to-head trial wherein guselkumab (Tremfya; an IL-23 inhibitor) was compared to secukinumab (Cosentyx; an IL-17 inhibitor) in adults with moderate to severe plaque psoriasis.

SLE and Risk of Malignancy

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The risk for cancer in systemic lupus erythematosus (SLE) patients has been inconsistently studied.  A new metanalysis shows that SLE has an increased risk for 16 specific cancers and decreased risk for prostate cancer and cutaneous melanoma.