All News
Anakinra Use in Hospitalized Gout Patients
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.
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Similar Outcomes for Hip Arthroplasty or Hemiarthroplasty in Hip Fracture
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.
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MMWR: Increased Opioid Use in Lupus
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.
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Low Dose IL-2 Effective in Lupus
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.
Persistent Inflammatory Arthritis After Immune Checkpoint Inhibitors
Braaten and colleagues from Johns Hopkins School of Medicine have reported their experience with chronic inflammatory arthritis induced by immune checkpoint inhibitor therapies, showing that in some, inflammatory arthritis persists after the immunotherapy has been discontinued.
Higher Rates of Venous Thromboembolism in Gout
A Canadian administrative claims analysis has shown that gout-associated inflammation increases the risk of venous thromboembolism (VTE), deep vein thrombosis (DVT), and pulmonary embolism (PE) before and after the diagnosis of gout.
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NSAID Use Linked With Hypertension in Ankylosing Spondylitis
Continuous use of nonsteroidal anti-inflammatory drugs (NSAIDs) among patients with ankylosing spondylitis (AS) was associated with the development of incident hypertension, a prospective cohort study found.
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FDA Grants Breakthrough Status for Potential Lupus Nephritis Drug
Obinutuzumab (Gazyva) has been granted Breakthrough Therapy Designation (BTD) by the U.S. Food and Drug Administration (FDA) for use in adults with lupus nephritis (LN). The drug made by Genentech, is going forward based on the Phase II NOBILITY study in adult patients with proliferative lupus nephritis (LN). Currently, there are no FDA-approved medicines for lupus nephritis.
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RheumNow Podcast – The End of Arthritis (9.13.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Two vs. Four Weeks of Antibiotic Therapy in Septic Arthritis
A prospective trial has shown that 2 weeks of antibiotic therapy is as effective as 4 weeks of antibiotic therapy, with similar outcomes but shorter hospital stays.
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Bimekizumab Add-on Therapy in Rheumatoid Arthritis
Bimekizumab is a dual inhibitor of IL-17A and IL-17F that has been shown to be effective in psoriasis and psoriatic arthritis. A proof-of-concept study shows that giving bimekizumab to rheumatoid arthritis patients not adequately controlled by certolizumab pegol resulted in a rapid decrease in disease activity achieved after 12 weeks of treatment. These findings are novel as anti-IL-17 monoclonal antibody therapy has previously been shown to be ineffective in RA.
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74 Percent of Rheumatoid Arthritis Patients Dissatisfied with Treatment
CreakyJoints has completed a 258 patient survey showing that nearly three-fourths of people with rheumatoid arthritis (RA) have expressed dissatisfaction with their treatments, including conventional (csDMARDs) and biologic Disease Modifying Antirheumatic Drugs (bDMARDs).
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Steroid Sparing Effects of Methotrexate and Mycophenolate in Uveitis
Patients with noninfectious uveitis (intermediate, posterior uveitis, or panuveitis) often require high dose corticosteroids and therefore may need steroid-sparing DMARD therapy. The FAST study investigated the corticosteroid-sparing effect of methotrexate or mycophenolate mofetil in adults with noninfectious uveitis.
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Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement
JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.
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Anti-IL-23 Beats IL-17 in Plaque Psoriasis
Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).
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Modifiable Risk Factors for Hyperuricemia
Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia.
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Respiratory Risks Not Increased in RA Patients with COPD
An insurance claims based study of RA patients with COPD shows that biologics do not have an increased rate of respiratory events compared to those on conventional DMARDs.
A real world cohort of RA patients with COPD was drawn from US-based MarketScan databases. Patients on biologic DMARDs and/or targeted synthetic DMARDs (tsDMARDs) were propensity matched to those on conventional synthetic DMARDs (csDMARDs).
Tocilizumab Shows No Increase in Cardiovascular Risk
The ENTRACTE trial examined the risk for major adverse cardiovascular events (MACE) in RA patients and found no increased risk of MACE in patients treated with tocilizumab (TCZ) versus etanercept (ETN).
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Number of Prior DMARDs Portends Poorer Outcomes
Detailed analysis of two clinical trials in RA has shown that clinical responses decrease as the disease duration and number of prior DMARDs increase.
The associations between disease duration and number of prior DMARDs and response to therapy were assessed using data from two randomised controlled trials in patients with established RA (mean duration, 11 years) receiving adalimumab+methotrexate.
High-Dose Vitamin D: No Help for Bone Health
Vitamin D might not be much help for strengthening bones among healthy adults without osteoporosis, Canadian researchers reported, even at doses far higher than recommended daily allowances.
In a clinical trial assessing three levels of daily vitamin D supplementation -- 400 IU, 4,000 IU, and 10,000 IU -- radial volumetric bone mineral density was significantly lower among those (ages 55-70) taking higher doses for 3 years, according to Steven Boyd, PhD, of the University of Calgary in Canada, and colleagues.
