Celecoxib Plus PPI Preferred in High Risk Patients

Save

When do the risks outweigh the benefits of NSAIDs use, especially in those with prior cardiovascular and gastrointestinal events? The CONCERN study has tested the effects of proton-pump inhibitor (PPI) in preventing GI bleeds when using NSAIDs and ASA.

Spinal Manipulation Equal to NSAIDS for Acute Low Back Pain

Save

JAMA has published a review of 15 RCTs (1711 patients) analyzing the role of spinal manipulation therapy in patients with acute low back pain. The authors found modest improvements in pain and function at up to 6 weeks, with temporary minor musculoskeletal harms.

Stroke Risk Highest in the First Year of Lupus

Save

Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

Osteoporosis Drugs of Uncertain Efficacy with CKD

Save

More research is needed to determine the benefits and harms of osteoporosis medications on bone mineral density (BMD), fracture risk, and safety among patients with chronic kidney disease (CKD). This is important because complications of CKD include weak bones and increased fracture risk.

Hydroxychloroquine Underperforms in a Cutaneous Lupus Trial

Save

Hydroxychloroquine has become a mainstay in the treatement of patients with systemic lupus erythematosus (SLE) with proven efficacy in managing many domains of lupus, including skin, joint, and other autoimmune features.

Biologic Safety Holds Up in RA

Save

An updated systematic literature review has provided reassuring evidence regarding the increasing safety of biologic disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA), European researchers reported. 

Abatacept Use During Surgery

Save

The issue of medication management is a complicated one, especially in complex rheumatoid arthritis (RA) patients taking biologic or immunosuppressive drugs.

The RheumNow Week in Review – 31 March 2017

Save

Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

TNF Inhibitor Induced Psoriasis

Save

Tumor necrosis factor-α inhibitors (TNFi) rarely have been reported to induce new-onset psoriasis.

Mortality in Gout Increased

Save

Two current articles in the Journal of Rheumatology address issues surrounding mortality risk among those with new and established gout.

Alcohol Use During Methotrexate Studied

Save

A recent RheumNow survey of 495 rheumatologists found that half of rheumatologists allow 1-3 alcoholic drinks per week and 6-7% has no alcohol restrictions while being treated with methotrexate (MTX).

ICER Report Claims RA Drugs are Not Cost Effective

Save

On Friday March 24, the nonprofit Institute for Clinical and Economic Review (ICER) presented its report on the cost and value of targeted immune modulators (TIMs) for rheumatoid arthritis (RA) in a meeting in Boston that included clinical experts, manufacturers, payers, and patients.

Biologics Do Not Increase Melanoma Risk

Save

Rheumatoid arthritis (RA) patients have a higher risk of certain cancers (e.g., skin, lung, lymphoma).  At issue is whether the newer agents modify this risk appreciably.

Steroids, DMARDs and Biologics have Same Low Risk of Infection During Pregnancy

Save

Low rates of serious infections were observed in pregnant women receiving immunosuppressive therapies. Higher rates may be seen with steroid use in pregnancy and SIE trend towards lowest with DMARD or TNFi use. 

Lyrica Fails in Sciatica Pain

Save

Lyrica (pregabalin) was first approved in 2004 and since has been studied and approved for use in neuropathic pain (associated with diabetic neuropathy), postherpetic neuralgia, partial onset seizures, fibromyalgia and neuropathic pain with spinal cord injury.

The RheumNow Week in Review – 24 March 2017

Save

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

Rheumatic Manifestations Following Chikungunya Infection

Save

In the Makonde language, “Chikungunya” translates to “that which bends up”, descriptive of the twisted posture of those infected secondary to intense joint and muscle pain experienced during the acute phase of the disease.  

NEJM Reviews Psoriatic Arthritis

Save

A comprehensive review of psoriatic arthritis (PsA) was published this week in the NEJM, authored by leaders in the field, Drs. Ritchlin, Colbert and Gladman.

High points from their review inlcuded:

Limited Benefits with Intra-Discal Steroid Injections for Back Pain

Save

A a randomized trial published in Annals of Internal Medicine shows that intradiscal glucocorticoid injection has limited (1 month) efficacy in treating low back pain (LBP) associated with active discopathy, yet decreased over time.

Gadolinium Accumulation with Repeated MRI

Save

Clinical Rheumatology reports that the repeated intravenous administration of gadolinium-based contrast agents (GBCAs), although clinically useful, may be associated with rare toxicity and the uncertain clinical effects of accumulation.