Allopurinol Fails to Curtail Hypertension

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Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

EULAR 2019 Report – Day 2

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Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. It was a full and lively second day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day two at EULAR 2019.

Mortality from Falls in the Elderly

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JAMA reports that there is a trend of increasing mortality from falls in older US adults between 2000 to 2016 and that mortality rates are increased with increasing age. 

Disparities in Lupus Survival

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MMWR has published the outcomes from the Georgia Lupus Registry between 2002 and 2016, finding that black women were not only more likely to die from lupus than white lupus patients; but they died on average 13 years earlier (mean age 51.8 and 52.3 years, respectively) than whites (mean age 64.4 and 65.0 years, respectively).

Black women with lupus were 3.34 times more likely to die than black women in the general population, while white women with lupus were 2.43 times more likely to die than white women in the general population. None of the white women with lupus died within 5 years of diagnosis, while mortality was elevated for black women from the date of diagnosis on.

ACP Supports Transparency of Health Care Costs

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The American College of Physicians (ACP) is encouraged by the Trump administration’s executive order to improve transparency of health care costs.

DMARD Success in Myositis-Related Interstitial Lung Disease

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It is estimated that up to 50% of patients with idiopathic inflammatory myopathy will be complicated by interstitial lung disease, and having ILD may impart a poor prognosis. A recent review of the Johns Hopkins myositis-related ILD cohort has shown that azathioprine and mycophenolate mofetil use is associated improved lung function and less prednisone use.

Steroids in GCA and PMR Increase Infectious Risk

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A large study of UK family practice patients shows that polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) patients treated with glucocorticoids are at an increased risk of bacterial, viral, parasitic and fungal infection, even at daily doses of less than 5 mg prednisolone.

Lupus Patients at Risk for Heart Failure

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Patients with SLE are at increased risk for HF, not just of MI and stroke, with risk similar to that of patients with diabetes, researchers found in an analysis of Medicaid data.

No Difference Among Biologics in Arthroplasty Infectious Risk

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A large administrative claims analysis of rheumatoid arthritis (RA) patients undergoing arthroplasty has shown no difference among biologics with regard to the risk of infections, but corticosteroid use was associated with a dose dependent risk of infection. 

Allopurinol Fails to Curtail Hypertension

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A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Is Methotrexate Necessary with Tofacitinib?

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Rheumatoid arthritis patients taking tofacitinib (Xeljanz) plus methotrexate who achieved low disease activity (LDA) may be able to withdraw from the latter agent without significant worsening of disease activity, a researcher reported at EULAR 2019 in Madrid.

EULAR 2019 Report – Day 2

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It was a full and lively 2nd day in Madrid with sessions dedicated to Lupus, RA, Sjogren’s, imaging, rare diseases, psoriatic arthritis and spondyloarthritis. Here are a few of the highlights from day 2 EULAR in Madrid 

Industry Press Releases from EULAR19

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Many of the great presentations from EULAR 2019 feature industry sponsored clinical trials.  Often these become the pivotal studies for regulatory approval and the annual congresses are their first look.

Excess Non-CV Mortality Persists in Gout

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Patients with gout not only have a well-recognized increased risk of dying from cardiovascular (CV) disease, but also have higher all-cause mortality and die prematurely from other diseases, a Swedish study indicated.

Low Remission/LDA Rates with TNF inhibitors in Rheumatoid Arthritis

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Proinflammatory Diets May Increase CRP and RA Onset

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Despite the lack of good evidence, there has been great speculation about the role of diet in causing or alleviating inflammation. Now there's new research suggesting that proinflammatory diets can increase serum C-reactive protein levels and also the risk of rheumatoid arthritis onset.

Might IL-17 Inhibition Be Effective in RA?

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Interleukin 17 (IL-17) inhibitors are highly effective and FDA approved for use in psoriasis, psoriatic arthritis and ankylosing spondylitis. However, many of the initial trials were done in rheumatoid arthritis (RA) where it was projected to be effective, but was not. A recent metanalysis examines how effective IL-17 inhibition was in two RA populations: biologic-naïve or tumor necrosis factor inhibitor inadequate responders (TNF-IR).

Knee Injuries Increases Osteoarthritis Risk

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A systematic review of the medical literature shows anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury significantly increases the risk of future knee osteoarthritis (OA).

Recommendations for Exercise in Ankylosing Spondylitis

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Australian researchers have assessed the problem of exercise in ankylosing spondylitis (AS). After posing 10 questions to 11 experts they have provided evidence and consensus-based ecommendations on exercise in AS.

Despite Gout Numbers and Flares, Allopurinol is Underutilized

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A population-based survey from South Australia shows that gout flares are common in the community and have a significant effect on health-related quality of life (HRQoL), yet there is significant undertreatment of gout, even in those on current allopurinol.