EULAR/EFORT Taskforce on the Management of Fragility Fractures

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The morbidity associated with osteoporosis-related fragility fractures imposes tremendous socioeconomic and medical impact on patients and society.

Consensus on OP Drug Holidays

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Extending bisphosphonate treatment beyond 3–5 years does not confer additional benefit in low-risk populations. Treatment re-initiation (usually 1–3 years after bisphosphonate withdrawal) depends on risk factors, new fractures and bone mineral density. The evidence regarding denosumab discontinuation is limited but caution is advised, as there may be a “rebound effect” with regard to fractures.

The RheumNow Week in Review – 21 April 2017

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

Paradoxical Toxicities with TNF Inhibitors

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Something is curiously wrong when a drug induces the disease it is intended to treat. Yet this phenomenon has been described with all five FDA-approved TNF inhibitors.

Inconsistent ESR & CRP in Spondylitis Patients

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Patients with active axial spondyloarthritis (axSpA) can lack evidence of inflammation on magnetic resonance imaging (MRI) but may develop evidence of inflammation over time.

Anti-IL-23 Therapy Effective in Crohn's Disease

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Lancet has reported the results of risankizumab, an interleukin-23 (IL-23) inhibitor, in Crohn's disease. Risankizumab is a humanised monoclonal antibody targeting the p19 subunit of interleukin-23, and is being developed for Crohn's disease.

FDA Delays Baricitinib Decision

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Eli Lilly and Company and Incyte Corporation announced today that the U.S. Food and Drug Administration (FDA) has delayed its' decision on baricitinib by issuing a complete response letter for baricitinib's New Drug Application. 

The RheumNow Week in Review – 14 April 2017

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Dr. Jack Cush reviews the past week's news, articles and advances from RheumNow.com.

Acute Steroid Use Comes with Risk

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Steroids are known for their acute therpeutic wonders and chronic hazards. Hence most practitioners are comfortable using short term, limited dose corticosteroids for a variety of ailments.

Celecoxib Plus PPI Preferred in High Risk Patients

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When do the risks outweigh the benefits of NSAIDs use, especially in those with prior cardiovascular and gastrointestinal events? The CONCERN study has tested the effects of proton-pump inhibitor (PPI) in preventing GI bleeds when using NSAIDs and ASA.

Spinal Manipulation Equal to NSAIDS for Acute Low Back Pain

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JAMA has published a review of 15 RCTs (1711 patients) analyzing the role of spinal manipulation therapy in patients with acute low back pain. The authors found modest improvements in pain and function at up to 6 weeks, with temporary minor musculoskeletal harms.

Stroke Risk Highest in the First Year of Lupus

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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. 

Osteoporosis Drugs of Uncertain Efficacy with CKD

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More research is needed to determine the benefits and harms of osteoporosis medications on bone mineral density (BMD), fracture risk, and safety among patients with chronic kidney disease (CKD). This is important because complications of CKD include weak bones and increased fracture risk.

Hydroxychloroquine Underperforms in a Cutaneous Lupus Trial

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Hydroxychloroquine has become a mainstay in the treatement of patients with systemic lupus erythematosus (SLE) with proven efficacy in managing many domains of lupus, including skin, joint, and other autoimmune features.

Biologic Safety Holds Up in RA

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An updated systematic literature review has provided reassuring evidence regarding the increasing safety of biologic disease-modifying anti-rheumatic drugs (DMARDs) in the treatment of rheumatoid arthritis (RA), European researchers reported. 

Abatacept Use During Surgery

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The issue of medication management is a complicated one, especially in complex rheumatoid arthritis (RA) patients taking biologic or immunosuppressive drugs.

The RheumNow Week in Review – 31 March 2017

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Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

TNF Inhibitor Induced Psoriasis

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Tumor necrosis factor-α inhibitors (TNFi) rarely have been reported to induce new-onset psoriasis.

Mortality in Gout Increased

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Two current articles in the Journal of Rheumatology address issues surrounding mortality risk among those with new and established gout.

Alcohol Use During Methotrexate Studied

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A recent RheumNow survey of 495 rheumatologists found that half of rheumatologists allow 1-3 alcoholic drinks per week and 6-7% has no alcohol restrictions while being treated with methotrexate (MTX).