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Great and Not So Great (9.30.2022)

Jack Cush, MD

This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.

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ACR's State-by-State Report Cards for Rheumatic Disease

Jack Cush, MD

New report examines access, affordability, and activity and lifestyle factors in all 50 states and the District of Columbia, evaluating how easy it is to live with a rheumatic disease in your state. No state scored an "A" or "F", and only two states improved their 2018 grades.

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70% of Older Adults Report Joint Pain

Jack Cush, MD

Dr. Beth Wallace and colleagues at the University of Michigan surveyed a national sample of older adults (50–80 yrs) and found that 70% currently report experiencing joint pain and 60% reported being told by a health care professional that they have arthritis. 

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Gout Comes With Increased Heart Risk

MedPage Today

Incidence of acute coronary syndrome (ACS) was significantly higher among gout patients than in the general Swedish population, researchers found, even when data were adjusted for common comorbidities.

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Does Fibromyalgia Need B12? (9.9.2022)

Jack Cush, MD

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.

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Year in Review #ACR22 Pegloticase and MTX now FDA approved co-administration for tophaceous gout to prevent anti-drug antibodies ⁦@RheumNow⁩ https://t.co/EPtOrjJqLd
Eric Dein ericdeinmd ( View Tweet)
Preview of what is sure to be discussed more in detail later.. MIRROR trial of MTX co-administration with pegloticase in treatment of gout. MTX co-administration improved control of gout, reduced infusion reactions @RheumNow #ACR22 https://t.co/r0MEq1rkgO
Robert B Chao, MD doctorRBC ( View Tweet)
Population study shows among vaccinated gout pts, COVID breakthrough infection occurred in @ 4.68/1K Pt-mos vs 3.76/1K Pt-mos in non-Gout persons. Gout w/ Covid had More Hosp (aHR=1.30) & death (aHR=1.36), moreso in Women w/ gout (aHR 1.55 & 2.46) https://t.co/ViwiPzqTbZ https://t.co/BrXd6pbgRI

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Dr. John Cush RheumNow ( View Tweet)
Single center study from UAB shows 72 gout pts treated & D/C from ED were Rx w/ steroids (64%), opioids (63%), NSAIDs (43%), colchicine (32%). But only 26/72 (36%) had subsequent outpatient clinic visit for gout. https://t.co/I8jjqIqJXd https://t.co/05YSibd6iz

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Dr. John Cush RheumNow ( View Tweet)
Will we see you there? #ACR2022 What are you most looking forward to on the agenda? https://t.co/KQGHJtwboe
Dr. John Cush RheumNow ( View Tweet)
#Gout clinic study of 223 gout pts on allopurinol ≥300 mg compared Pt & MD gout control assessments (0-10). Better agreement & higher scores seen w/o flares (3 or 12 mos) & SUA w/in target. Disagreement (22%) w/ recent flares & tophi https://t.co/a0WsMLvfYk https://t.co/zZwV4XVJzS

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Dr. John Cush RheumNow ( View Tweet)
Follow us for real time coverage #ACR2022 https://t.co/5CBdiKWdKM
Dr. John Cush RheumNow ( View Tweet)
Top Tweet of September: Gout: diagnosis and management—summary of NICE guidance https://t.co/CWg4otNBVv https://t.co/wRcjnC59eL

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Dr. John Cush RheumNow ( View Tweet)
Rheumatology Salaries and Career Choices A recent Doximity report shows how rheumatology salaries increase by years in practice. Rheumatologists tend to earn their highest salaries after gaining 30-39 years of experience. https://t.co/wxWQruIlu9 https://t.co/gUsIffoHn6

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Dr. John Cush RheumNow ( View Tweet)
Record a Question or Comment... Rheums: Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/rICbSJzPbk https://t.co/VIjlR6xlwQ

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Dr. John Cush RheumNow ( View Tweet)
RCT of allopurinol in 183 #gout pts. After 6.5 yrs 30% (60) were dead. Survivors 82% Rx w allopurinol, 4% febuxostat, 8% not on ULT. Urate levels only available in 72%!! & only 58% achieved SU T2T <6 mg/dl (<0.36 mmol/L) Dont you think we should do better? https://t.co/NwS6I2A9M8 https://t.co/xvarJQJG2N

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Dr. John Cush RheumNow ( View Tweet)
#Gout Guidelines--> great outcomes! French study of 300 pts; 95% followed French Rx Guidelines, T2T SU < 6 mg/dL in 59% @6mos, 79% @24 mos & @2 yrs hald were Rx w/ allopurinol (313 mg/d) and 48% febuxostat (84 mg/d) https://t.co/iQ9NvHJXd8 https://t.co/2tkBWrHY32

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Dr. John Cush RheumNow ( View Tweet)
Patients with incident gout have a 44% increased risk of 1st-time ACS, higher in women than in men. This risk is largely explained by the underlying comorbidities, Swedish study of 20,146 pts w/ incident gout. Risk decr in multivariate analysis (15-20%) https://t.co/KbjszXNFSQ

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Dr. John Cush RheumNow ( View Tweet)

The 2022 ACR abstracts are published and posted for you. Let the Learning begin! https://t.co/ZqMAc8jV3U https://t.co/3iCGnzsPI5

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Dr. John Cush RheumNow ( View Tweet)
The ACR is developing a new clinical practice guideline for systemic autoimmune rheumatic disease with interstitial lung disease (ILD). The Call for Public Comment is open until September 29, 2022. https://t.co/UxXDbGEQlh https://t.co/zGoBpbKLTC

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Dr. John Cush RheumNow ( View Tweet)
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