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RheumNow Podcast – Boiling Hot MAS (7.12.19)
Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.
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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.
CRP Utility in COPD Exacerbations
NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.
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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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Pregnancy Outcomes Improve in Lupus
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. The large decline in in-hospital maternal mortality was greater for lupus pregnancies than for non-lupus pregnancies. Findings from a retrospective cohort study are published in Annals of Internal Medicine.
Opioids Overused in Acute Gout
Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.
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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 Report – Day 2
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. It was a full and lively second day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day two at EULAR 2019.
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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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Mortality from Falls in the Elderly
JAMA reports that there is a trend of increasing mortality from falls in older US adults between 2000 to 2016 and that mortality rates are increased with increasing age.
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Disparities in Lupus Survival
MMWR has published the outcomes from the Georgia Lupus Registry between 2002 and 2016, finding that black women were not only more likely to die from lupus than white lupus patients; but they died on average 13 years earlier (mean age 51.8 and 52.3 years, respectively) than whites (mean age 64.4 and 65.0 years, respectively).
Black women with lupus were 3.34 times more likely to die than black women in the general population, while white women with lupus were 2.43 times more likely to die than white women in the general population. None of the white women with lupus died within 5 years of diagnosis, while mortality was elevated for black women from the date of diagnosis on.
DMARD Success in Myositis-Related Interstitial Lung Disease
It is estimated that up to 50% of patients with idiopathic inflammatory myopathy will be complicated by interstitial lung disease, and having ILD may impart a poor prognosis. A recent review of the Johns Hopkins myositis-related ILD cohort has shown that azathioprine and mycophenolate mofetil use is associated improved lung function and less prednisone use.
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Study Looks at Opioid Use After Knee Surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more
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Sjögren's Syndrome Differs in Minorities
Minority groups in the U.S. have differing rates of Sjögren's syndrome and exhibit distinct clinical patterns of the disease, a large cross-sectional study revealed.
The percentage of American Indians in a SS cohort of 610 patients was much higher than expected, at 25.3%, whereas the percentage of African Americans was lower, at 3.1%. In addition, American Indians had higher levels of disease activity and more extraglandular manifestations, whereas African Americans had a symptom pattern associated with subsequent lymphoma development, researchers reported in Arthritis Care & Research.
Steroids in GCA and PMR Increase Infectious Risk
A large study of UK family practice patients shows that polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) patients treated with glucocorticoids are at an increased risk of bacterial, viral, parasitic and fungal infection, even at daily doses of less than 5 mg prednisolone.
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Lupus Patients at Risk for Heart Failure
Patients with SLE are at increased risk for HF, not just of MI and stroke, with risk similar to that of patients with diabetes, researchers found in an analysis of Medicaid data.
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