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Two-Fold Increase of Demyelinating Diseases with TNF Inhibition
Despite the potential contributory role of TNF in the pathogenesis of multiple sclerosis, several trials have shown that TNF inhibitor (TNFi) use may lead to worsening of MS, optic neuritis and other demyelinating disorders.
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DRIVE Trial: Denosumab and Methotrexate Prevent Joint Erosions
Joint erosions in RA result from a complex process with multiple contributing mechanisms. One of those mechanisms involves RANK receptor activation by RANKL leading to osteoclast differentiation, activation and survival.
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Changing Patterns of Drug Use in Pregnant Rheumatic Patients: Steroids Down, Biologics Up
Desai and coworkers analyzed public and private insurance claims data (2001-2012) to assess patterns of drug use in pregnant woment with RA, SLE, PsA and AS. Specifically, they looked at immunosuppressive drug use in the 3 months preceding and during pregnancy.
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EULAR 2015 Psoriatic Arthritis Treatment Guidelines
The management of psoriatic disease, including psoriatic arthritis (PsA) has evolved significantly in the last decade. Nevertheless, there are still some uncertainties - such as what the role of methotrexate should be, and when to use newer and novel therapies.
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Microvesicles May Ameliorate Arthritis Damage
Microvesicles are emerging as a new mechanism of intercellular communication by transferring cellular lipid and protein components to target cells, yet their function in disease is only now being explored.
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Azathioprine Adverse Events Associated with TPMT Polymorphisms
Azathioprine (AZA) is widely used in the treatment of several autoimmune diseases. Its use and optimal dosing may be limited by adverse drug reactions (ADRs). Thiopurine S-methyltransferase (TPMT) is an important enzyme involved in AZA metabolism.
Read ArticleRituximab's Efficacy May Be Correlated with CD4 T Cell Counts
Rituximab (RTX) is highly effective at B cell depletion and this may be one of several hypothetical ways in which the drug works. B cell numbers (measured as CD19+ B cells) plummet rapidly after the first infusion and stay down for 6-12 months.
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Reduced Uric Acid from Weight Loss Tied to Triglycerides
Weight loss is one of several nonpharmaceutical interventions to reduce serum urate (SUA) levels and control gout. French researchers examined the role of xanthine oxidase (XO), low-grade inflammation, and weight loss on SUA levels in obese patients.
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Prudent Diet Reduces Risk of RA and Gout
The 2015 ACR meeting in San Francisco highlighted several studies wherein dietary patterns predicted a reduced risk of both rheumatoid arthritis (RA) and gout.
Read ArticleJuvenile Dermatomyositis Responds Best to Methotrexate and Prednisone
Lancet reports the results of a randomized controlled trial comparing prednisone alone to prednisone combined with either methotrexate (MTX) or cyclosporine (CyA) in new-onset juvenile dermatomyositis (JDM).
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UCSF Study Shows Weight Loss Protects OA Cartilage
Researchers at the University of California at San Francisco have shown that >10% weight loss may impact the rate of cartilage loss as determined by MRI scanning. They presented their findings yesterday at the annual meeting of the Radiological Society of North America (RSNA).
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Curbside Consults - December 2015
The following is a collection of cases presented to me by my colleagues in Canada during a day of workshop case discussions among clinical consultants. Each case is presented because of a challenging therapeutic issue.
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The Rising Price of Dermatologic Drugs
Containment of health care costs was a primary goal of the Patient Protection and Affordable Care Act. But there is little evidence of success in curbing the rising price of prescription drugs. As such, many medications are unaffordable to those who need them.
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Fertility in RA Linked to Disease Activity, NSAIDs and Prednisone
Brouwer and colleagues from the University Medical Center Rotterdam in The Netherlands have studied the issue of infertility in a cohort of RA patients followed prospectively.
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ACP Says There are Reasons for Generics Over Branded Drugs
The American College of Physicians (ACP) says that prescribing generic medications whenever possible can improve adherence to therapy, improve outcomes, and reduce costs for patients and the health care system. ACP’s best practice advice paper is published in Annals of Internal Medicine.
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DSB: ACR 2015 Safety Reports
The following is a compilation of abstracts presented at the 2015 Annual ACR meeting in San Francisco. These were chosen on the basis of impact, quality and safety message.
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Power Doppler Ultrasound Detects Early Synovitis Change in APPRAISE Study
While new recommendations suggest early aggressive management of rheumatoid arthritis, our ability to assess treatment response is limited to clinical and laboratory assessment.
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EU Endorses Biosimilar Etanercept (SB4) from Samsung/Biogen
Reuters today reported that a copy of the blockbuster biotech drug Enbrel (SB4) was recommended for approval in Europe on Friday, making it the second so-called biosimilar antibody medicine to win such a green light from the continent's regulators.
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CMS Releases Final Rule on Joint Replacement
MedPage Today reports that the Centers for Medicare & Medicaid Services (CMS) has issued a final rule governing payment for hip and knee replacements for Medicare patients this week that includes several concessions to stakeholders, such as delaying implementation from early 2016 to later in
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AMA Proposes Ban on Television Drug Ads
The American Medical Association has called for a ban on direct-to-consumer (DTC) advertising for prescription drugs and medical devices, noting these forms of advertising drive up health care costs and often mislead the public.
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