Dr Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  

Malcolm Gladwell (along with coauthor David Epstein) is well known for his national bestsellers The Tipping Point, Blink, and Out¬liers; all addressing the psychosociologic side of human behaviors and trends.

An editorial and systematic review of complications seen when checkpoint inhibitor (CPI) therapies are given to patients with immune mediated inflammatory disorders (IMIDs) and cancer shows that nearly 75% manifest autoimmune and inflammatory immune-related adverse events (irAEs).

A UK Study published in Lancet shows that community-based screening programme for fracture risk in older women is feasible, and may reduce hip fractures. 

The Journal of Rheumatology has published a nationwide survey of US rheumatologists and shown that despite trends for increasing metric assessments, nearly half of rheumatoid arthritis (RA) patients are not routinely assessed with a disease activity metric and the evidence they

Rheumatology has published a study demonstrating that bone marrow edema as measured by magnetic resonance imaging (MRI) may be found in healthy people, but that such changes do not change with intense physical activity.

The British Society for Rheumatology/British Health Professionals in Rheumatology first published a guideline for the management of gout in 2007. They have just updated and published their new guideline, largely because of new therapies, an increasing incidence of gout, low penetrance of urate lowering therapies, and the inability to achieve a target serum uric acid level.

In this Therapeutic Update, Drs. Mease, Gibofsky and Cush answer five questions regarding the August 3rd FDA Arthritis Advisory Committee meeting that reviewed the potential approval of tofacitinib (Xeljanz) in patients with active psoriatic arthritis. The panel was nearly unanimous (10-1) in favor of the efficacy and safety profile of of tofacitinib, and similarly voted 10-1 to approve this drug for use in PsA. Final decisions on these recommendations from the AAC panel will be made at a later date by the FDA. 

Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

The Annals of Internal Medicine reports that despite improving trends in mortality, death rates from systematic lupus erythematosus (lupus) remain high compared to those in the general population, and disparities persist between subpopulations and geographic regions.

Dr. Jack Cush reviews highlights and news from the past week on RheumNow.com. 

Hypertension, nephrolithiasis and chronic kidney disease (CKD) commonly associates with gout.  While there is a clear need to dose adjust NSAIDs and colchicine in those with CKD, there is some debate about the need to dose adjust when using allopurinol with CKD.

Serum uric acid (SUA) levels are clearly linked to gout. Researchers from Harvard have systemically reviewed the literature to quantify the risk of onset and flare with varying levels of SUA.

The medical use of cannabis is often extended to management of chronic pain and neuropathic pain.

A metanalysis of 27 chronic pain trials show that there is low-strength evidence that cannabis alleviates neuropathic pain but insufficient evidence in other pain populations.

A prospective Swedish study between 2001–2009 found a higher risk of aortic regurgitation, pacemaker, AV block and atrial fibrillation in SpA, AS, uSpA and PsA patients.

Despite large randomized trials failing to show the efficacy of RTX in SLE (LUNAR, EXPLORER), uncontrolled observational data suggests possible efficacy and safety of RTX in refractory SLE.

Lancet reports on the analysis of 2416 studies, involving 128.9 million persons over 5 years of age shows previously rising trends in children's and adolescents' BMI have plateaued in many high-income countries, but still at high levels. 

A time-series analysis of incident rheumatoid arthritis (RA) patients seen between 1996 and 2011 in the Danish National Patient Register shows that the incidence of hip (THR) and knee replacements (TKR) began to decrease after the introdution of biologic agents for RA in 2002.

Curtis and colleagues have analyzed the certolizumab (CZP) RAPID1 and RAPID2 trials to assess the risk of serious infectious events (SIEs), and shown that steroids combined with an age-adjusted comorbidity index (AACI) yields a 2-3 fold predictable risk for SIE.

Researchers from the Nottingham University Hospitals have analyzed the efficacy and safety of  oral (PO) and intravenous (IV)  cyclophosphamide (CTX) in ANCA-associated vasculitis (AAV) patients and demonstrated a trend for fewer relapses, better 1 year survival and less toxicity w