The National Rheumatoid Arthritis Society's (NRAS) annual audit has identified significant treatment delays for patients with suspected early inflammatory arthritis could result in unnecessary harm. 

Intra-articular sprifermin given to patients with symptomatic and radiographic knee osteoarthritis has been shown to significantly improve total femorotibial joint cartilage thickness after 2 years, but without significant clinical benefits. Which begs the question, why is there a disconnect between radiographic disease modification (cartilage thickness) and symptomatic improvement?

Annals of Internal Medicine reports that age-adjusted mortality rates for antineutrophil cytoplasmic autoantibody–associated vasculitides (AAV) have improved over time - with a decline of nearly 2 percent per year in the United States from 1999 to 2017. Nevertheless, long-term outcomes continue to lag behind mortality rates of the general population.

Even though oral bisphosphonates are widely used, there is an inordinate concern over the risk of osteonecrosis of the jaw (ONJ). A new UK study suggests that the risk of ONJ is elevated six fold by the use of biphosphonates.

Elevated serum levels of interferon-α among patients whose systemic lupus erythematosus (SLE) was in remission helped predict future disease flares, European researchers found.

The FUTURE 5 trial studied the effect of secukinumab (SEC) on radiographic progression through 52 weeks in patients with active psoriatic arthritis (PsA) and found that SEC was clinically and radiographically superior to placebo (PBO).

Patients received s.c. secukinumab 300 mg load (300 mg), 150 mg load (150 mg), 150 mg no load regimens or placebo at baseline, at weeks 1, 2 and 3 and every 4 weeks starting at week 4. The majority (87%) of patients enrolled at baseline remained in the study for 52 weeks.

Another UK study has suggested that prior use of antibiotics increases the risk of developing rheumatoid arthritis (RA).

Patients diagnosed with interstitial pneumonia with autoimmune features (IPAF) are at an increased risk of developing a systemic autoimmune rheumatic disease (ARD).

Dr. Jack Cush reviews the News and Journal Reports from this week on RheumNow.com.

The American Society for Bone and Mineral Research has developed multistakeholder consensus clinical recommendations for the prevention of secondary fractures for those aged 65 years and older after an initial hip or vertebral fracture.

JAMA Internal Medicine has an analysis of the growing trend of more women enrolling in medical schools in the last few decades, such that more than half of US Med school matriculants in 2017 were women.  Also in 2017, 42% of residents in internal medicine were women.  The reported analy

The Annals of Rheumatic Disease reports a psoriatic arthritis study where in ixekizumab was non-inferior to adalimumab for achievement of ACR50 responses but was superior to adalimumab for achievement of PASI100 by week 24.

While the efficacy and safety of interleukin 1 (IL-1) inhibitors (e.g., anakinra) in the acute management of gout and pseudogout has been repeatedly shown, the cost efficacy of such biologic therapy has rendered it impractical for most. A new retrospective study has shown that IL-1 inhibitors may be effective and appropriate for some medically complex, hospitalized patients with acute gout or calcium pyrophosphate crystal arthritis.

The NEJM reports on a randomized comparison of hemiarthroplasty and total hip arthroplasty in displaced femoral neck fractures and shows no difference in function and quality of life over 24 months.

The NEJM reports the results of a one year trial wherein ustekinumab (UST) was shown to be effective at inducing and maintaining remission in patients with moderate-to-severe ulcerative colitis. Ustekinumab, currently approved for use in psoriasis, psoriatic arthritis and Crohn's disease, is a monoclonal antibody against the p40 subunit of interleukin-12 and interleukin-23.

The U.S. Food and Drug Administration has approved Rituxan (rituximab) for the treatment of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in children 2 years of age and older in combination with glucocorticoids.

This is the first approved treatment for children with vasculitis.

Dr. Jack Cush reviews the news and articles from the past week on RheumNow.com.

Opioids are generally not indicated for pain in systemic lupus erythematosus (SLE) and other rheumatic diseases because of limited efficacy and risks for preference and adverse health effects.

A double-blind, placebo-controlled clinical trial of low-dose IL-2 in patients with systemic lupus erythematosus (SLE) has shown that low-dose IL-2 induced was clinically effective while expandng regulatory T cells and NK cells, which may benefit immune homeostasis in SLE patients.

As the leading organization for people with arthritis, the Arthritis Foundation has just released the first CBD guidance for adults with arthritis. CBD, or cannabidiol, a plant-based compound, has become popular among people with arthritis seeking to ease chronic joint pain.