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ACR Responds to CY2020 Medicare Physician Fee Schedule Proposed Rule
Rheumatology leaders commend CMS for proposing E/M code changes and urge agency to make additional changes to final rule.d
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RheumNow Podcast – Believe in Vitamin D or Rituximab? (9.20.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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FEAR: A Perception of Fact In Spite of the Fiction
Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve.
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Sensitivity of Temporal Artery Biopsy
Metanalysis shows that temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) has a sensitivity of 77%, similar to results seen with temporal artery imaging. These data suggest clinicians may be willing to accept a GCA diagnosis without proof by TAB.
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ACR Survey Shows Half of Patients Cannot Afford Treatments
Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.
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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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RheumNow Podcast – Do’s and Don’ts in Spondylitis (9.5.19)
Dr. Jack Cush reviews the news and important research published in the last two weeks on RheumNow.com.
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Influenza Vaccination Update
FDA's Vaccines and Related Biological Products Advisory Committee met in Silver Spring, Maryland, on March 6 and 22, 2019, to select the influenza viruses for the composition of the influenza vaccine for the 2019-2020 U.S. influenza season.
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RheumNow Podcast - I Wanna New Drug (8-30-19)
Dr. Jack Cush vents on choosing new therapies in rheumatoid arthritis.
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RheumNow Podcast – Upadacitinib FDA Approved for RA (8.23.19)
Dr. Jack Cush reports on the news and journal reports from the past week on RheumNow.com, including: how your genetics may shape your microbiome; GERD as a risk factor for TMJ?; how can MDA-5+ dermatomyositis be any worse; new drug happenings; StillsNow.com; and more.
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RheumNow Podcast – Antibiotics Increase RA Risk (8.16.19)
Dr. Jack Cush reports the news and important journal articles from the past week on RheumNow.com.
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Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease
Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results.
On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.
RheumNow Podcast – Tricked Up Lupus Criteria (8.9.19)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including new SLE criteria, ULT in gout and MSU reductions, IVIG in ANCA vasculitis and non-TNF biologics outperform the TNF inhibitors.
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Vitamin D Supplements Fail to Prevent Type 2 Diabetes - DUH!
A NEJM report shows that the use of vitamin D3 supplementation (4000 IU per day) in those without diabetes or vitamin D deficiency failed to significantly lower risk of type 2 diabetes (compared to placebo).
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New EULAR/ACR Classification Criteria for SLE
The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.
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War on RA - Part 3: Useless Drugs
We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.
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EULAR Recommendations on Large Vessel Vasculitis
Th European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) was originally published in 2009. Since then there have been new randomised clinical trials and cohort analyses leading to an update the original recommendations.
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90 SLE pts (SLEDAI<6) on immunosuppressives were given PBO or Live Virus zostavax - Vax pts had significantly higher Wk 6 anti-VZV IgG, more injection site reactions (31 vs 7%). 3 pts flared (1PBO; 2 Zostavax) and no one developed zoster postvaccination https://t.co/pVrQ4tHAwY
Dr. John Cush RheumNow ( View Tweet)
"People don't believe what you tell them. They rarely believe what you show them. They often believe what their friends tell them. They always believe what they tell themselves." - SETH GODIN
Dr. John Cush RheumNow ( View Tweet)
S.Sweden study of ANCA Assoc Vasculitis (GPA, MPA, EGPA) 195 pts followed x8 yrs: found all cancers increased (SIR=2.8). SIR for squamous cell CA=12.9; 4.3 bladder cancer, & 7.0 for pancreatic CA. CYC total <10g were not associated w/ higher CA https://t.co/wqRKaFYWGb
Dr. John Cush RheumNow ( View Tweet)
