The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

Shared Epitope - Smoking Pathogenic Link Clarified

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Proceedings of the National Academy of Sciences (PNAS) has published new research on the mechanistic link between the rheumatoid arthritis (RA) "shared epitope" (SE) risk alleles and environmental triggers such as cigarette smoke that leads to joint inflammation and bony destruction. 

USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures

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The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use of vitamin D and calcium at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in postmenopausal women.

EMA to Review Methotrexate Overdose and Dosing Errors

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A recent meeting (April 9-12) of the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) considered the problem of dosing errors with methotrexate (MTX), citing "continued reports of overdose." 

Mayo and UAB Awarded $1 million Grant for Patient Research

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CreakyJoints and Pfizer have selected the Mayo Clinic and the University of Alabama at Birmingham (UAB) to each receive a $500K research award (funded by Pfizer Independent Grants) for Learning & Change.

ACR Projects Significant Manpower Shortages for 2030

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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.

Defining Refractory Rheumatoid Arthritis

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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.

Favorable Certolizumab Safety Profile in Pregnancy

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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. 

Uveitis in JIA: Screen All, Treat Early

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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.

IL-6 Inhibition Most Effective in Polycyclic Systemic JIA

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The German Autoinflammatory Disease (AID) registry has studied the effects of the IL-6 inhibitor tocilizumab (TCZ) in systemic juvenile idiopathic arthritis (sJIA) patients and shown a clinical response rate of 35% during the first 12 weeks, and inactive disease and/or remission (with medication)

The RheumNow Week in Review -30 March 2018

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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.

Precision Genetics Can Predict Methotrexate Non-Responders

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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.

2 Weeks Off Methotrexate OK for Flu Vaccine

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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.

Chronic Knee Pain Linked to Depression

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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.

Using Synovial Tissue Biopsies to Develop Precision Medicine for Rheumatoid Arthritis

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Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoi

MMWR: Arthritis Prevalence Increases and Varies Widely

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MMWR reports that In 2015, the number of adults with arthritis continued to increase; with marked geographic variability in arthritis estimates with gaps in arthritis management.

Repeat Malignancy Unlikely with Biologic Therapy

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Research from the Danish biologics registry shows that the use of a biologic in patients with a history of a primary cancer does not increase the risk of a second malignant neoplasm (SMN) or mortality in rheumatoid arthritis (RA) patients.

Opportunistic Infections in RA Rare with Biologics

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The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis has studied nearly 20,000 patients and observed that there is no substantially different risk of opportunistic infections between different biologics. 

Bone Marrow Edema Found in SI Joint of Athletes

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New research shows that young elite athletes will not commonly manifest bone marrow edema in the SI joint following activity.