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How Often Do You Monitor MTX? (6.16.2023)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com, including new drug approval, a new SpA variant and new rules for methotrexate (MTX) monitoring and depression screening.
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Why Depression Screening Should be Mandatory at Each Visit
Depression is more widespread than ever in the United States, according to a new study from Gallup, showing that 18% of adults are depressed (or receiving depression treatment for depression) – an increase in 7 percentage points since 2015.
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EULAR 2023 – Day 1 Report
EULAR 2023 launched today to crowds of attendees. The opening Plenary session and presidential address by Dr.
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c-Fos regulates chondrocyte proliferation and differentiation, and cFOS-positive chondrocytes were increased in human and murine OA cartilage. New research (humans an mice) suggests it plays a role in protecting cartilage and could be a therpeutic target https://t.co/B0tmo0AbQe https://t.co/KPrOm3Spfa
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Dr. John Cush RheumNow ( View Tweet)
Ultrasonography May Improve OA Pain Prediction
Dr. Bella Mehta reports on POS0107 from EULAR 2023 in Milan, Italy.
https://t.co/ZHBdWPWTys https://t.co/JLIScNVZGB
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Dr. John Cush RheumNow ( View Tweet)
Australian CRISTAL RCT 23 458 OA adults undergoing hip or knee replacements & given ASA 100 mg/d or SC enoxaparin 40 mg qd for 35 days (THR) or 14 days(TKR) for VTE prophylaxis = no difference betw groups: 90D mortality was 1.67% vs 1.53% https://t.co/wBLtlyCcsF https://t.co/WFkZ2KNHFF
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Dr. John Cush RheumNow ( View Tweet)
519 pts in the Hand OSTeoArthritis in Secondary care (HOSTAS) cohort studied & 17% had prolonged morning stiffness (>60 min); mild in 30%, intermediate in 37%, severe in 18% and extreme in 4%. Assoc w/ more pain, worse function and QOL https://t.co/6LSir7nSae https://t.co/lhoxwpfuqD
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Dr. John Cush RheumNow ( View Tweet)
#EULAR2023 Clinical Highlights. Osteoarthritis. OP0071 Single centre Phase 2 RCT showed Denosumab halted erosion in Erosive OA at 24 weeks treatment, and the treatment effect enhances after 48 weeks vs PBO @RheumNow https://t.co/YWFUg3cp7P
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Denosumab in hand OA prevented erosions!
#eular2023 @RheumNow https://t.co/Ij2CVjh1ET
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 Clinical Highlights. Osteoarthritis. OP0071 Single centre Phase 2 RCT showed Denosumab halted erosion in Erosive OA at 24 weeks treatment, and the treatment effect enhances after 48 weeks vs PBO @RheumNow https://t.co/YWFUg3cp7P
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Nocicpetor ablation in mice model with #OA - pain was reduced.
If its done before OA progression, it helps, but after it doesnt!
@AM_Malf work highligted at #EULAR2023 @RheumNow https://t.co/zvxHmlCIrD
Bella Mehta bella_mehta ( View Tweet)
We need to assess CV risk in IA but how?
Performances of QRisk3, Framingham & Reynolds scores for prediction of CV event in OA RA PsA AS PSO
Bummer: these 3 prediction tools are less accurate in IA but also OA.
We need a dedicated tool.
@Rheumnow OP0267 #EULAR23 https://t.co/O73cETXXoe
Aurelie Najm AurelieRheumo ( View Tweet)
Interesting study presented by Dr Kent Kwoh in #KneeOA using the OAI data - effusion-synovitis produced heterogenous effects on pain reporting depending on the activity - walking, stairs, standing etc. effect not in bone marrow lesions
@rheumnow abst#POS0108 #EULAR2023 https://t.co/MvI5z1KHlE
Bella Mehta bella_mehta ( View Tweet)
Phase 2b-human Knee #OA MM-II, a novel suspension of empty large multilamellar liposomes dimyristoylphosphatidylcholine (DMPC)and dipalmitoylphosphatidylcholine (DPPC)- upto 6ml IA injection - well tolerated with minimal AE. some effect on WOMAC @rheumnow #EULAR2023 abs#POS0106 https://t.co/MM8jIG5bkP
Bella Mehta bella_mehta ( View Tweet)
Erosive #handOA is associated with more pain and more functional impairment than #RA - 10 year duration, which ofcourse has more comorbidities. 138 OA, 379 RA pts. #EULAR2023 @rheumnow abst#POS0103 https://t.co/mP3Nzgmw07
Bella Mehta bella_mehta ( View Tweet)
Would you rather have Erosive hands OA or RA?
130+ EHOA and 370+ RA, dis duration > 10 yrs for both cohorts
📍EHOA associated w/ > pain & functional impairment
📍RA associated w/ > comorbidities
@RheumNow #EULAR23 POS0103 https://t.co/KdDG7E6PZw
Aurelie Najm AurelieRheumo ( View Tweet)
Fluorescence optical imaging in early arthritis?
Nice images but not ready for clinics yet
Can not differentiate OA from RA & PsA
SLE/SSc associated arthritis display a specific pattern, but usually auto-antibody profiles help w/ diagnosis
OP0173 #EULAR23 @Rheunow https://t.co/bAMi9kDKS5
Aurelie Najm AurelieRheumo ( View Tweet)
What would you do? A middle aged woman has pain and impaired hand function with her PIP&DIP erosive hand #osteoarthritis? Exam - jts are tender w soft tissue swelling? #NSAIDs, #denosumab, #methotrexate? 🤷♀️ A +RCT of #MTX in #erosive #hand #OA at #EULAR2023 @RheumNow @eular_org https://t.co/7rp3nReTPd
Janet Pope Janetbirdope ( View Tweet)
Are we going to treat hands OA with MTX?
Moderate effect on VAS pain at 6 and 12 months in a small RCT vs. PBO in hands OA WITH MRI detected synovitis.
Thoughts
1) Is it really OA?
2) Benefit Risk balance remains debatable
@RheumNow OP0070 #EULAR23 https://t.co/WLlX48NtGT
Aurelie Najm AurelieRheumo ( View Tweet)
Randomized double blind, placebo controlled MTX trial in inflammatory #handOA - pts with MrI detected synovitis. 97 pts 20mg MTX helped reduce pain and stiffness at 6 months. @rheumnow
#EULAR2023 abst#OP0070
Early work with some promise!
Bella Mehta bella_mehta ( View Tweet)
