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FDA Public Review of CBD Oil
The US Food and Drug Administration convened a public hearing and specialty panel on May 31st to review the potential use, safety and effectiveness of cannabidiol (CBD) products that do not contain THC.
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Proinflammatory Diets May Increase CRP and RA Onset
Despite the lack of good evidence, there has been great speculation about the role of diet in causing or alleviating inflammation. Now there's new research suggesting that proinflammatory diets can increase serum C-reactive protein levels and also the risk of rheumatoid arthritis onset.
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Might IL-17 Inhibition Be Effective in RA?
Interleukin 17 (IL-17) inhibitors are highly effective and FDA approved for use in psoriasis, psoriatic arthritis and ankylosing spondylitis. However, many of the initial trials were done in rheumatoid arthritis (RA) where it was projected to be effective, but was not. A recent metanalysis examines how effective IL-17 inhibition was in two RA populations: biologic-naïve or tumor necrosis factor inhibitor inadequate responders (TNF-IR).
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Knee Injuries Increases Osteoarthritis Risk
A systematic review of the medical literature shows anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury significantly increases the risk of future knee osteoarthritis (OA).
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Recommendations for Exercise in Ankylosing Spondylitis
Australian researchers have assessed the problem of exercise in ankylosing spondylitis (AS). After posing 10 questions to 11 experts they have provided evidence and consensus-based ecommendations on exercise in AS.
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Despite Gout Numbers and Flares, Allopurinol is Underutilized
A population-based survey from South Australia shows that gout flares are common in the community and have a significant effect on health-related quality of life (HRQoL), yet there is significant undertreatment of gout, even in those on current allopurinol.
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ACR Announces New Executive Vice President Steven Echard
The American College of Rheumatology (ACR) Board of Directors is pleased to announce that Steven C. Echard, IOM, CAE is the new Executive Vice President (EVP) of the American College of Rheumatology.
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RheumNow Podcast – Rituximab Monitoring (5.31.19)
Dr. Jack Cush presents the news and best of rheumatology and medicine from the past week on RheumNow.com
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Lupus Disease Control with Rituximab
Rituximab (Rituxan) may be an option for maintenance therapy in patients with difficult-to-treat systemic lupus erythematosus (SLE), European researchers reported.
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The Cost of Physician Burnout
An article in the Annals of Internal Medicine has analyzed the cost-consequences of physician burnout, including costs related to physician turnover and reduced clinical hours.
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2019 EULAR Guidelines on Antiphospholipid Syndrome Management
A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.
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Biologic Retention in Ankylosing Spondylitis Patients
A study of biologic-naïve patients with ankylosing spondylitis (AS) who started therapy with a tumour necrosis factor inhibitor (TNFi) shows that after 5 years only 46% are still on a TNFi and that some are able to lower the dose over time.
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Upadacitinib Monotherapy in MTX-IR Rheumatoid Arthritis
Upadacitinib (UPA) is an oral, selective JAK1-selective inhibitor being developed for use in rheumatoid arthritis patients; Lancet has reported the SELECT-MONOTHERAPY trial showing that UPA is safe and effective in RA patients with an inadequate response to methotrexate (MTX).
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Additive Effects of Insomnia and Depression on Osteoarthritis
A study of osteoarthritis patients, finds that pain is the primary driver for health care utilization, and that the presence of insomnia or depression augments health care use.
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ACR Statement on CMS Medicare Advantage Final Rule
In August 2018, the CMS announced that Medicare Advantage (MA) plans would be allowed to utilize step therapy for Part B drugs. The American College of Rheumatology (ACR) expressed strong concerns about this proposal.
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Lung Disease in RA: Which Factors are Linked With Mortality?
Among patients with rheumatoid arthritis (RA) who had interstitial lung disease (ILD), the pattern of ILD did influence mortality, but other pulmonary factors also contributed, a meta-analysis suggested.
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Lupus Outcomes Influenced by Race/Ethnicity
A lupus registry from San Francisco County analyzed racial/ethnic differences in lupus manifestations and found significant differences in SLE manifestations among racial/ethnic groups. Researchers found that Blacks, Asians/Pacific Islanders (API), and Hispanics are more likely to develop severe manifestations following a diagnosis of SLE.
From their database, they identified 724 SLE patients, and identified specific features in different subgroups.
Nintedanib May Benefit Systemic Sclerosis Related Interstitial Lung Disease
The NEJM reports a randomized placebo controlled trial of nintedanib, a tyrosine kinase inhibitor, in systemic sclerosis patients with interstitial lung disease (ILD) resulted in less pulmonary decline, but had no effect on other features of systemic sclerosis.
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EMA Restricts Tofacitinib Dosing
The Pharmacovigilance Risk Assessment Committee of the European Medicines Agency issued recommendations limiting the use of Xeljanz (tofacitinib) 10 mg twice daily in patients with ulcerative colitis in the EU.
The new recommendations are temporary while PRAC undertakes a review of all available evidence on the safety and efficacy of tofacitinib. The review follows warnings of an increased risk of pulmonary embolism (PE) and death from the U.S. Food and Drug Administration based on Pfizer's large post-marketing safety study (in high risk rheumatoid arthritis patients with one or more underlying cardiovascular risk factors) wherein those receiving in tofacitinib 10 mg twice daily in study A3921133 had more PE and mortalities than comparator groups (tofacitinib 5 mg bid or adalimumab).
Opioids, SSRIs and Steroids Increase Fracture Risk in RA
Analysis of a large US observational rheumatoid arthritis (RA) patients finds that opioids, SSRIs and glucocorticoids were associated with increased risk of fracture in RA, whereas statins and TNFi had a decreased vertebral fracture risk.
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