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Poor Sleep Increases Risk of Cognitive Decline
The Journal of Neurology, Neurosurgery & Psychiatry reports there is moderate evidence that six sleep disorders (insomnia, fragmentation, daytime dysfunction, prolonged latency, rapid eye movement sleep behaviour disorder and excessive time in bed) significantly increases the ri
Read ArticleShould We Screen Younger Postmenopausal Women for Osteoporosis?
Do postmenopausal women, under age 65 years, need a baseline BMD testing? A JAMA Insights review suggests that the absolute risk of fracture is low in this group and that USPSTF guidelines should be considered - that we should be screening women younger than 65 years who are at increased risk of osteoporosis and we should be using a formal risk assessment tool to identify candidates for bone density testing.
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Diabetics using SGLT2 Inhibitors have a lower Gout Risk
Researchers from the Brigham and Women's Hospital have reported that adults with type 2 diabetes who were treated with SGLT2 inhibitors had a lower risk of gout compared to GLP1 agonist, suggesting that sodium–glucose cotransporter-2 inhibitors may reduce the risk for gout with type 2 diabetes mellitus (T2DM).
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Steroids Up the Risk of Organ Damage in SLE
Lancet Rheumatology has reported the results of a multicenter follow-up study of systemic lupus erythematosus (SLE) patients showing that organ damange is linked to glucocorticoid use, independent of clinical or serological disease activity.
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Treatment of Statin-induced anti-HMGCR myopathy
Statin-induced myositis, often with anti-HMGCR autoantibodies can be difficult to manage, Arthritis Research & Therapy yhas published the experience of 55 patient with HMGCR myopathy, demonstrating that while steroid management may be reasonable in select patients, the use of tr
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RheumNow Podcast- Knee Pain Knockout (1.10.20)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. The podcast covers: best therapies for dactylitis and enthesitis; we have a new knockout for knee pain in OA; and are you on the naughty or nice list when it comes to the new ACR-AF guidelines for arthritis? This and more. Tune in.
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ACR-Arthritis Foundation Treatment Guidelines for Osteoarthritis
Today, the American College of Rheumatology (ACR), in partnership with the Arthritis Foundation (AF), released the 2019 ACR/AF Guideline for the Management of Osteoarthritis of the Hand, Hip and Knee.
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Taltz Shines in Non-Radiographic Axial Spondyloarthritis
Ixekizumab (IXE), an interleukin-17A (IL-17A) inhibitor, was recently approved for use in ankylosing spondylitis (also known as radiographic axial spondyloarthritis- axSpA).
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Best of 2019 - Is Methotrexate Necessary with Tofacitinib?
Rheumatoid arthritis patients taking tofacitinib (Xeljanz) plus methotrexate who achieved low disease activity (LDA) may be able to withdraw from the latter agent without significant worsening of disease activity, a researcher reported at EULAR 2019 in Madrid.
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Best of 2019 - War on RA - Part 1: Walk on the Moon
It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.
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Best of 2019 - Biologic Safety Guidelines from the British Society for Rheumatology
In the United Kingdom, NICE has looked to the British Society of Rheumatology (BSR) to develop evidence based guidance on the safe use of biologic DMARDs in patients with inflammatory arthritis.
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Best of 2019 - Ups and Downs with Abatacept
Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.
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Best of 2019 - War on RA - Part 3: Useless Drugs
We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.
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Best of 2019 - Are Non-TNF Biologics Superior to TNF inhibitors?
Current ACR and EULAR guidelines list TNF-inhibitors (TNFi) abatacept, rituximab, and tocilizumab as being equally effective after methotrexate or as second line therapies when treating rheumatoid arthritis.
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Best of 2019 - Methotrexate and the Risk of Lung Disease
Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.
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Best of 2019 - The Shame Behind Adalimumab Biosimilars
JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).
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Best of 2019 - SEAM-PsA Study - Does Monotherapy MTX Win Despite Losing to Etanercept in Psoriatic Arthritis?
The SEAM-PsA study examined the efficacy of methotrexate monotherapy, etanercept monotherapy or the combination of MTX and ETN in psoriatic arthritis patients, and found that ETN monotherapy was equivalent to combination therapy - and that both were superior to MTX alone in clinical (ACR and MDA) and radiographic responses.
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Dr. John Cush RheumNow ( View Tweet)
From the 9/11 World Trade Center registry, 118 persons found w/ a CTD (RA=71, Sjӧgrens 22, SLE 20, myositis 9,MCTD 7, PSS 4. Responders w/ intense dust cloud exposure had 2 fold CTD risk & Community members w/ PTSD had 3‐fold risk. https://t.co/07GhloezNA
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Dr. John Cush RheumNow ( View Tweet)
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Dr. John Cush RheumNow ( View Tweet)
