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Pollution and Autoimmunity (7.12.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Is Cannabis Safe? (6.7.2024)
Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!
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Role of Diet in Gout Risk
Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.
This prospective study assessed the risk of developing incident gout based on consumption of healthy and unhealthy plant-based diets.
Metformin Lowers Gout Risk in Pre-Diabetes
A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout.
"Don't You Know Who I am?" (5.17.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?
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Rheum Chapter Notes (4.26.2024)
Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.
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POS0277: proof of concept: Prophlx with canakinumab x 1 dose rather than steroids/colch/NSAIDS when starting pegloticase with MTX in pts with active, refractory gout: 11 pts: #gout flares 0 (compared 54% in MIRROR-C), infusion rxn 0, no safety signal @rheumnow https://t.co/4qFnQTOuq0
TheDaoIndex KDAO2011 ( View Tweet)
Great 1st #EULAR2024 scientific session: “Asymptomatic” Hyperuricemia — innocent bystander vs. menacing foe. Data re: effects on joints, kidneys, & heart have not supported clear clinical consequences w/ exception of kidney crystal deposition. TIGER Study results eagerly awaited. https://t.co/IPQU3Ww0NA
Links:
Tuhina Neogi, MD, PhD Tuhina_Neogi ( View Tweet)
Flavinoids (herbs, cherries, berries) have clinical efficacy in #Gout. Review of the mechanisms of flavonoids in gout includes:
- Cox-2 inhibition
- Lowers xanthine oxidase activity (mediated thru inflammasome, NOD/TLR4, NFKB, OAT1 & OAT3 transporters https://t.co/UC55GGZBCJ https://t.co/L6nE3BMIj1
Dr. John Cush RheumNow ( View Tweet)
Role of Diet in Gout Risk
Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.
https://t.co/cqP7G4KeWi https://t.co/zxiOeACb5u
Dr. John Cush RheumNow ( View Tweet)
Canadian study of 44,438 older adults (age 76) w/ gout found only 52% reached serum uric acid (SUA) target w/in 12-mos, improving from 45% (2010) to 61% (2019). ULT adherence was 55%, also improved annually. Only 3.5% Rx by Rheumatologist! https://t.co/vAc8myxiRm https://t.co/gcMz379iPH
Dr. John Cush RheumNow ( View Tweet)
Colchicine prophylaxis w/ allopurinol (“start-low go-slow” 100mg escalation strategy), is best used in pts w/ gout flare in month prior to allopurinol. Longer prophylaxis may be required w/ ongoing flares in 1st 6mos of allopurinol if T2T not achieved https://t.co/yupiq26BJA https://t.co/KDF394SC30
Dr. John Cush RheumNow ( View Tweet)
Save the date! We are covering #EULAR24! We'll be sharing recaps, videos, and more. https://t.co/NMWtHB94Pi https://t.co/ok43pnagFg
Links:
Dr. John Cush RheumNow ( View Tweet)
Metformin Lowers Gout Risk in Pre-Diabetes
A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout.
https://t.co/IQ1Z7rhhp1 https://t.co/vYKBKsWh0y
Dr. John Cush RheumNow ( View Tweet)
Do you have a rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/qvVEUoNYi5 https://t.co/duw6jg5xpp
Dr. John Cush RheumNow ( View Tweet)
Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush RheumNow ( View Tweet)
Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://t.co/CXdcEdWXhW https://t.co/j0ktehf9Sm
Dr. John Cush RheumNow ( View Tweet)
MGH study compared 1148 acute CPPD vs 3730 controls (mean 73 yrs) found 2 fold more fractures (mostly wrist); 11.7 vs 5.5/1000 PYs (HR 1.8) in pseudogout pts (also had more steroids & OP) https://t.co/HhCV6fYubF https://t.co/3bcbvSzzPo
Dr. John Cush RheumNow ( View Tweet)
RISE study of 700 Pegloticase users (14 mos F/U) found 18% on immunosuppressive (MTX, MMF, LEF), these had signif less PEG D/C (HR 0.52-0.69). Immunosuppressives not assoc w/ more lab abnormalities https://t.co/4ytot7HOMh https://t.co/0wrjvnZur3
Dr. John Cush RheumNow ( View Tweet)
Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD https://t.co/ZkhpzaTjjI https://t.co/e3BO813b30
Dr. John Cush RheumNow ( View Tweet)
