RheumNow Podcast – Loretta Lynn Arthritis (3.29.19)

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

For RA With COPD, Abatacept is Safe

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Patients with rheumatoid arthritis (RA) who also had chronic obstructive pulmonary disease (COPD) had no increased risk of serious respiratory complications when treated with abatacept (Orencia), a large claims-based analysis found.

Best of 2019 - Ups and Downs with Abatacept

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Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.

Artificial Intelligence to Predict Rheumatoid Disease Activity

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A recent study in JAMA Network Open shows that artificial intelligence models can use electronic health record data to prognosticate future patient outcomes in rheumatoid arthritis (RA).

CRA Position Statement on Medical Cannabis Use

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Courtesy of the Canadian Rheumatology Association (CRA) website, here are consensus guidelines on medical cannabis use.

Rheumatology patients experience prevalent pain that is only modestly controlled with current treatment strategies.

RheumNow Podcast – You Owe Me a DEXA (3.15.19)

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Dr. Jack Cush reviews this week's news and highlights from RheumNow.com.

First Line IL-1 Inhibition in Systemic JIA

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First-line treatment of systemic juvenile idiopathic arthritis (JIA) with anakinra (Kineret) was highly effective as monotherapy, minimizing the need for glucocorticoids, a single-center prospective study found.

Multiple Delays in Referral of New RA Patients

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A UK study of early onset arthritis or new rheumatoid arthritis patients shows multiple sources of delayed referral to the first rheumatology consultation.

Biologic Agents have Equal Efficacy in Enthesitis and Dactylitis

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A systematic review has shown that TNF inhibitors (TNFi) are equaled in efficacy by other biologic agents (ustekinumab, secukinumab, and ixekizumab) in psoriatic arthritis (PsA) patients with in dactylitis and enthesitis.

Does Smoking Cessation Reduce RA Risk?

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Individuals who quit smoking and maintained their nonsmoking status over a long duration of time had a decreased risk of developing seropositive rheumatoid arthritis (RA), an analysis of two large prospective cohorts found. 

Canadian Vaccination Guidelines for the Immunosuppressed

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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 Risk of Tuberculosis with TNF Inhibitors

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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.

RheumNow Podcast - Death and Surgery (2-22-19)

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

Safety Warnings for Higher Dose Tofacitinib

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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.  

Remission Unlikely in RA

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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."

TKR - One or Two at a Time?

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His would-be surgeon tried mightily to talk him out of a bilateral knee replacement. At 340 pounds, the patient's BMI -- above 43 -- was a significant contraindication. 

Older Men Less Likely to be Assessed and Treated for Osteoporosis

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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. 

RheumNow Podcast - MTX vs. Etanercept in Psoriatic Arthritis (2.15.19)

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Dr. Jack Cush discusses the news from the past week on RheumNow.com - including the SEAM trial, MRI guided T2T, biologics and infection, contraceptive use, ANA negative lupus, etc.

No Added Benefit to MRI-Guided Therapy in Rheumatoid Arthritis

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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.

Differing Effects of Smoking and HLA-DRB1 in Seropositive Rheumatoids

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Analyses from the Swedish EIRA incident rheumatoid arthritis cohort study shows that smoking and HLA-DRB1 exert differential effects on serologically defined RA subsets - but that the strongest influence was seen in double positive (CCP+, RF+) individuals.