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.

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. 

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.

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).

Biologics Do Not Increase Melanoma Risk

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Rheumatoid arthritis (RA) patients have a higher risk of certain cancers (e.g., skin, lung, lymphoma).  At issue is whether the newer agents modify this risk appreciably.

Steroids, DMARDs and Biologics have Same Low Risk of Infection During Pregnancy

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Low rates of serious infections were observed in pregnant women receiving immunosuppressive therapies. Higher rates may be seen with steroid use in pregnancy and SIE trend towards lowest with DMARD or TNFi use. 

Limited Benefits with Intra-Discal Steroid Injections for Back Pain

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A a randomized trial published in Annals of Internal Medicine shows that intradiscal glucocorticoid injection has limited (1 month) efficacy in treating low back pain (LBP) associated with active discopathy, yet decreased over time.

Cause of Death in Ankylosing Spondylitis

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A French population based study of ankylosing spondylitis (AS) was report in the Journal of Rheumatology.

They analyzed the death certificates and cause of death in 2940 AS patients over 3 different decades (1969-78; 1979-99; 2000-2009).

ACR Says the New AHCA is Insufficient for Arthritis Patients

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Dr. Sharad Lakhanpal, MBBS, MD, President of the American College of Rheumatology (ACR) has issued a press release condeming the insufficiencies of the newly proposed American Health Care Act (AHCA).

The RheumNow Week in Review – 17 March 2017

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Dr. Jack Cush reviews highlights in the news from the past week at RheumNow.com.  News on hepatitis C in RA and risk of hepatotoxicity; TNF inhibitor persistence in PsA; unnecessary injections in pre-operative OA knee patients; and a delay in the FDA decision on abaloparatide.

Drug Adherence is Problematic for All

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The March 2017 issue of the ACP Internist has reviewed the ubiquitous practice of medication adherence. 

AAOS: High Prevalence of Low-Value Interventions in Pre-Op Knee OA

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The American Academy of Orthopaedic Surgeons announced five measures that inappropriately increase costs in those undergoing total knee replacement (TKR).  Data was presented yesterday at the annual 2017 AAOS Annual Meeting in San Diego.

The UnderManagement of Gout

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Most physicians believe they understand and can manage gout. Yet, the number of gout patients has risen at an alarming rate and the introduction of 4 new drugs has done little to close the education gap and improve the care and outcomes of gout patients. Misuse, misunderstandings and missed opportunities abound in the wide world of gout.

EULAR Treat-to-Target Guidelines for Gout

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Treat-to-target (T2T) works when they are pragmatic and conform well to daily practice.  

Gout is an ideal therapeutic area where T2T could be and should be applied.

Targeting CD11b as Treatment for Lupus

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Researchers from Rush University Medical Center have reported in the March 6 issue of the Journal of Clinical Investigation that engagement of the integrin CD11b with a novel compound, may improved outcomes in patients iwth systemic lupus erythematosus (SLE).

CDC Says 1 in 5 Have Arthritis

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In the United States, doctor-diagnosed arthritis is a common and widespread chronic condition (1,2). Arthritis is a leading cause of disability (3) and is projected to affect 78.4 million adults by 2040.

Non-Ischemic Heart Failure in Rheumatoid Arthritis

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The current issue of the Journal of the American College of Cardiology reports on the relative risk of heart failure (HF) in rheumatoid arthritis (RA) and its relation to ischemic heart disease (IHD).

TNF Inhibitor Therapy and the Risk of Anterior Uveitis Recurrence

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The TNF inhibitor drug development trials have indirectly taught us that monoclonal antibody based TNFi was capable of retarding the recurrence of anterior uveitis (AU) in patients with ankylosing spondylitis (AS).

Meta-analysis Reveals Numerous Pregnancy Complications Associated with Lupus

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On the heels of the recently published EULAR recommendations for the management of pregnancy in patients with systemic lupus erythematosus (SLE) and the anti-phospholipid syndrome (APS) comes a new meta-analysis published in the Journal of Autoimmunity on pregnancy outomes in lupus.