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Diet and Osteoarthritis Pain
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MedPage Today
Knee osteoarthritis (OA) pain was worse with a pro-inflammatory diet, an observational study suggested.
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Dead Words Eulogy
This is a bonus lecture provided to RheumNow Live 2024 registrants, and being shared with our RheumNow audience. Today is the last day to register to attend virtually (or in person); go to https://t.co/fc9DGbVDJ5 for more information.
https://t.co/d4IbIbAIX8 https://t.co/egNtTNincb
Dr. John Cush RheumNow ( View Tweet)
Celebrities/famous folk who've had hip replacement: Steve Carrell Arnold Schwarzenegger, Michael Douglas, Billy Joel, Jane Fonda, Ray Charles, Eddie Van Halen, Bob Hope, Steve Perry,
Lionel Richie, Alec Baldwin & soon Paulina Porizkova https://t.co/z3v39gxAZa https://t.co/uqNJuPLUHL
Dr. John Cush RheumNow ( View Tweet)
No evidence of harm starting urate lowering Tx (ULT) during #gout attack. Metanalysis 6 RCTs (445 pts) w/ gout attacks given ULT vs PBO or delayed ULT. No differences in pain, time to resolve gout flare or risk of recurrent gout flare in 30d (RR 1.06) https://t.co/Spxoe3CI1q https://t.co/ECya8rvf1S
Dr. John Cush RheumNow ( View Tweet)
Microbiome study of 16 SLE pts (44 fecal samples) shows that blooms of Ruminococcus gnavus pathobiont was assoc w/ lupus flares and may be the drivers of clinical of relapsing lupus disease https://t.co/DIir59dkdM https://t.co/0p7Pat4gXS
Dr. John Cush RheumNow ( View Tweet)
Biden administration will re-negotiate top 10 Medicare costly drugs - this includes two of interest to rheumatologists
1. Stelara (ustekinumab) - avg Part D Rx cost = $119,951
2. Enbrel (etanercept) - avg Pt D Rx cost = $58,148
https://t.co/HuXmFodZfd https://t.co/BuGl34Zpv5 https://t.co/uniQoEywDB
Links:
Dr. John Cush RheumNow ( View Tweet)
FDA Safety Warning: denosumab now has a Boxed Warning for risk of severe hypocalcemia in CKD pts taking Prolia (usually seen 2-10 wks post injx). Pts may or may not be symptomatic. CKD pts should have Ca and Creatinine monitored. https://t.co/UMYxjWz9n4 https://t.co/AG5wzBrY1Y
Dr. John Cush RheumNow ( View Tweet)
Rheumatologists and the Early Diagnosis of Spondyloarthritis
SPACE study of adults referred to rheumatology with less than 2 years of chronic back pain (CBP), shows that only one-third can be reliably diagnosed with axial spondyloarthritis (axSpA).
https://t.co/nUappTl0wG. https://t.co/oouir55CO6
Dr. John Cush RheumNow ( View Tweet)
Prevalence of Cardiovascular Disease in Rheumatoid Arthritis
A prospective study of the BioSTAR registry estimates the prevalence of cardiovascular disease in rheumatoid arthritis (RA) to be 4.6%.
https://t.co/NRn0DrYoBX https://t.co/qOoTmBNB1p
Dr. John Cush RheumNow ( View Tweet)
#RNL2024 @RheumNow SPA spectrum Q and A 🔥 - @lihi_eder 👏advocating for #POCUS #mskus and enthesitis - we agree @CrusSurc - confirming the concept of #pocus as an extension of the clinical exam and to be kept in the hands of the clinician - doesn't seem an area yet for AI 🤖
CRUS-SURC CrusSurc ( View Tweet)
Oh, snap! But this is true, a single course rituximab at baseline and none at 6 months (or anything else) as a comparator is just wild in a 12 month trial @EBRheum @RheumNow #RNL2024 https://t.co/wuIkuLzIpg
Richard Conway RichardPAConway ( View Tweet)
A picture paints a thousand words. One of the reasons why statistical significance is not the be all and end all. I would say severe DAH is the most likely scenario I would use PLEX, more so than severe renal disease. @EBRheum @RheumNow #RNL2024 https://t.co/GHg6t4OHxf
Richard Conway RichardPAConway ( View Tweet)
Rituximab is superior to cyclophosphamide in relapsing AAV. Provided you are relapsing after having cyclophosphamide as your first agent of course... @EBRheum @RheumNow #RNL2024 https://t.co/JfbcKH2zCG
Richard Conway RichardPAConway ( View Tweet)
Does adding NSAID to TNFi help prevent radiographic progression?
@LianneGensler
#RNL2024 @RheumNow
Adding Celecoxib to TNFi: numerically less progression, but not statistically significant https://t.co/rzuOL9q93x
Eric Dein ericdeinmd ( View Tweet)
Dr. @lihi_eder approaches enthesitis both clinically and with imaging *highly recommended.
NSAIDs and local steroids may be useful with caution. Advanced tx strongly recommended if initial tx fails/other domains involved.
#RNL2024 @RheumNow https://t.co/SKrWmp115M
Dr. Rachel Tate uptoTate ( View Tweet)
Vedolizumab-induced enthesitis
@lihi_eder #RNL2024 @RheumNow
11/90 (12.2%) of pts on VDZ for IBD w/ develop new-onset enthesitis
Is this true drug rxn or previously masked by prior meds (TNF)?
Usually unilateral +/- oligo, dactylitis
Most respond to NSAID or injxn, 27% change Rx
Eric Dein ericdeinmd ( View Tweet)
Enthesitis @lihi_eder
@RheumNow #RNL2024
- NSAID - 1st line in mild/isolated
- GC injxn but caution at Achilles
- MTX cond rec by GRAPPA (SEAM PsA)
- All bDMARD work vs PBO (TNFi, IL17, 12/23, 23, JAK, PDE4) - none superior
- IL17 v ADA: higher resol for IXE v ADA, but mixed data https://t.co/20KnQo4kpq
Links:
Eric Dein ericdeinmd ( View Tweet)
Advanced therapies in enthesitis. Don't believe the spin, they all work, no clear evidence that any agent is better than others. @lihi_eder @RheumNow #RNL2024 https://t.co/FwLMUmmClB
Richard Conway RichardPAConway ( View Tweet)
@JointMD updates us on nomenclature. "AS" is out and "AxSpA" is in.
#RNL2024 @RheumNow https://t.co/gdmZeuMNpW
Dr. Rachel Tate uptoTate ( View Tweet)
#RNL2024 @RheumNow
@lihi_eder on enthesitis
- ~1/3 PsA, SpA
- Enthesitis precedes onset of PsA in PsO, high u/s score ass. w/ RFs (BMI, nail dyst)
- Exam: tenderness (non-specific), as swelling uncommon. U/s helpful, but non-specif
- Marker of severity, higher risk of damage
Eric Dein ericdeinmd ( View Tweet)