A multidisciplinary Canadian task force has developed guidelines for vaccination in patients receiving immunosuppressive therapies, based on the evidence that immunosuppressive use in immune-mediated disease may be  associated with an elevated risk of infections. 

The U.S. Food and Drug Administration (FDA) has reviewed data from the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial and concluded there is an increased risk of death with Uloric (febuxostat) compared with allopurinol, and has added this as a boxed warning to the drug’s product label.

A study from Turkey shows that among 2117 patients treated with a TNF inhibitor (TNFi) the risk of developing TB was 6 fold higher in those treated with a TNFi compared to non-users.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com:

Silverman and colleagues have published their study of the fecal microbiome of systemic lupus erythematosus (SLE) patients and found roughly five times more gut bacteria known as Ruminococcus gnavus, and that these abnormalities in microbiota can correlate with measures of disease severity i

The drug retention rate of interleukin-1 inhibitors (IL-1) used to treat systemic juvenile idiopathic arthritis (JIA) appears to be quite high according to a new study. 

Pfizer has issued a press release regarding the safety of tofacitinib, citing higher rates of pulmonary embolism and death associated with the use of higher dose tofacitinib 10mg bid in rheumatoid arthritis (RA) patients treated in a long-term safety trial.  

Dr. Marwan Bukhari (editor of Rheumatology) has written an editorial wherein he suggests that true remission is hard to achieve. He notes that "remission as a target is a noble objective that we should all aspire to but we should not chastise our practice if we do not achieve it, as more and more evidence suggests that we should consider it the ideal but not the norm."

A study from the University of Washington in Seattle find that men with osteoporosis were less likely to be assessed by dual-energy X-ray absorptiometry (DXA); vitamin D measurements and were less like to receive calcium/vitamin D and bisphosphonate prescriptions. 

Lancet reports that, based on a literature review and metanalysis, patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients.

PHAROS is a prospective cohort studying the natural history of pulmonary hypertension (PH) in systemic sclerosis (SSc). They have shown that risk factors for poor outcomes in this cohort included male sex, DLCO < 50%, exercise oxygen desaturation, and pericardial effusions. 

A Cleveland Clinic review of patients undergoing thoracic aortic surgery (1996‐2012) identified 196 patients with histopathology‐proven non‐infectious aortitis.

A treat-to-target (T2T) strategy to manage rheumatoid arthritis hinges on clinical metrics to optimize therapy. But investigators from Denmark have shown that using magnetic resonance imaging–guided T2T failed to improve disease activity remission rates or reduce radiographic progression.

The SEAM-PsA study examined the efficacy of methotrexate monotherapy, etanercept monotherapy or the combination of MTX and ETN in psoriatic arthritis patients, and found that ETN monotherapy was equivalent to combination therapy - and that both were superior to MTX alone in clinical (ACR and MDA) and radiographic responses.

A group of French researchers have pooled their interests to identify the challenges ahead in the management of patients with systemic lupus erythematosus (SLE). 

WASHINGTON -- Patients would have access to their electronic health records free of charge and would be able to transfer them more easily from one provider to another under rules proposed Monday by the Department of Health and Human Services (HHS).

Dr. Jack Cush reviews this past week's news and reports from RheumNow.com:

Specialty tier drugs, including biologics, accounts for nearly half of all medication spending by Medicare Part D patients. High out-of-pocket costs for these patients is a major concern. 

Biologic therapy for severe psoriasis was associated with better plaque morphology and less non-calcified coronary plaque, according to a prospective, observational study.

A report from the University of Michigan examined state-wide medical marijuana showing most of it is used for chronic pain.