One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs). 

Researchers from Vanderbilt University Medical Center used electronic health records (EHR) to perform a phenome-wide study comparing African American (AA-SLE) and Caucasian (C-SLE) with systemic lupus erythematosus (SLE) and found more comorbidities in AA-SLE, especially renal, cardiovascular, an

Arthritis & Rheumatology has published the results of the 2015 Workforce Study of Rheumatology Specialists, and estimates a current shortage (demand > supply) of 700 (12.9%) full-time rheumatologists and that this deficit will worsen (102%) to 4133 FTE by 2030.

Apremilast (Otezla) monotherapy was effective for psoriatic arthritis among patients who had not previously received disease-modifying anti-rheumatic drugs (DMARDs) or biologics, a phase III clinical trial funded by the drug's manufacturer found. 

Dr. Maya Buch from Leeds has a thoughtful Viewpoint article in Annals of Rheumatic Disease on how to consider and manage the refractory or difficult rheumatoid arthritis (RA) patient.

Clowse and colleagues have published an extensive review of the certolizumab pegol (CZP) in pregnancy database, and found no evidence that CZP has a teratogenic effect or contributes to fetal harm when compared to the general population. 

A European group of experts has formulated consensus-based recommendations for the treatment of juvenile idiopathic arthritis (JIA)-associated uveitis, focusing on screening, monitoring, and treatment of this potentially devastating extra-articular manifestation of JIA.

Lancet has several reports on low back pain (LBP) as a major problem worldwide, largely because of the aging population.

Low back pain is the leading cause of disability worldwide.

Three reports from JAMA Internal Medicine demonstrate favorable trends with less opioid use when cannabis became legal.

Abhishek et al have written on the results of an international survey of crystal arthritis experts and identified the unmet needs  regarding calcium pyrophosphate crystal deposition (CPPD) - research, classification, diagnosis and management.

Laparoscopic gastric band (LAGB) surgery was associated with significant decreases in knee pain from osteoarthritis (OA), with the greatest improvements seen among those whose body mass index (BMI) had the greatest decreases and among younger patients, researchers reported.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. News on drug regulatory decisions, fenofibrate and gout, Still's disease, TB and infection rates, SpA and hidradenitis suppurativa, and predicting methotrexate non-responders.

The journal Bone reports that given excess calcium intake may not be entirely free from unintended health consequences, it's important to undestand trends in calcium supplement use. 

Investigators from Glasgow and Oxford have identified changes in genomic architecture, represented by a chromosome conformation signature, that can predict nonresponse to methotrexate in early rheumatoid arthritis patients.

Recognizing that studies show 35–59% of RA patients do not achieve clinically meaningful responses after starting MTX, they sought to identify a pattern of genetic changes in 59 early RA patients that would predict poor responses to MTX therapy.

Stopping methotrexate for 2 weeks after the administration of flu vaccine led to improved immunogenicity without increasing disease activity among patients with rheumatoid arthritis (RA), a prospective Korean study showed.

Lancet reports the results of the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study - where fenofibrate was shown to reduce uric acid by 20%, gout events by nearly 50% and may be useful in preventing gout in diabetes. 

CNN reports that a new congressional analysis of Medicare drug pricing shows the prices of the 20 most commonly prescribed brand-name drugs have risen nearly 10 times the annual rate of inflation in the past five years.

The journal Stroke has published a trial wherein the use of subcutaneous IL-1Ra (anakinra) was shown to reduce the peripheral inflammatory response in those with an acute ischemic stroke.

Chronic pain and depression are intimately linked, but Japanese researchers have found that up to 12% of knee osteoarthritis (OA) may develop depression and that such patients should be screened for depression over time.

Dr. Jack Cush reviews the highlights from the news, journals and major meetings. New announcements and approval from the FDA; novel associations between ANCA vasculitis and thyroid disease; flare rates after arthroplasty; and pregnancy outcomes for men and women.