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Running with Data (8.30.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com - including tips on steroids, MAS, and myositis testing.
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Consumption of Alcohol and the Risk of Gout
Alcohol is a risk factor for gout and flares. While the inciting potential differs among alcohol types, are these differences sex specific?
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Scleroderma skin findings in pts w/ skin of colour (SOC) - Raynauds was common but SOC pts had fewer hallmark Sxs: telangiectasias, calcinosis, digital swelling (complicating Dx). SOC had more severe pulmonary Dz & increased mortality, Atypical skin findings… https://t.co/8XkelxqvYE https://t.co/JOw8OSNjzw
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It takes >3-4 weeks of steroids (@ any dose >5 mg pred/d) to pose risk of adrenal insufficiency – Hence, Endocrine Society Guideline says short-term glucocorticoid therapy of <3-4 wks, irrespective of dose, DOES NOT require GC tapering https://t.co/o7tz1Am9pe https://t.co/CndfCYRApj
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Birth Control Use in Lupus
Published guidelines on lupus mgmt urge that female patients plan and prepare carefully for pregnancy, and use contraceptives when it's not intended -- but these reco’s are rarely followed, a registry study suggested.
https://t.co/81mQbp5Sib https://t.co/NJmwxvtR44
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ANA's over time may be more dynamic than previously accepted. SLE & ANA+associated Dz tend to have higher titers, esp. higher in early disease, but decrease over time https://t.co/caUazl9U6S https://t.co/jBglFBJ886
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Renal Impairment in Rheumatoid Arthritis
Patients with highly active rheumatoid arthritis (RA) experienced faster declines in kidney function than those whose disease was under better control, analysis of a large registry indicated.
https://t.co/WaUDtJCitG https://t.co/RmPPLsihAG
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ACR Backs FDA Rule Change on Interchangeable Biosimilars
The ACR submitted comments to the FDA supporting their proposal to update the approval process for biosimilars’ interchangeability status.
https://t.co/YD11qZJxIr https://t.co/tVij0ebwz4
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ANCA-associated vasculitis analysis of 6 European registries, 3868 pts (2434 GPA, 1434 MPA), age ~57 yrs. Identified 5 clusters: 3 w/ renal dz a) variable ANCA, Hi CRP & Cr; b) MPO+; c) PR3+ & 2 extrarenal 1) PR3+ multisystem; 2) ENT w/ low CRP. Clusters better predicted outcomes… https://t.co/XZcSZ6lGjH https://t.co/yEg64YGTrA
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Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M
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Retrospective study of 58 pts w/ #SLE concurrent with PJP infx, showed that 39% died, with many of these having diabetes and invasive ventilation. A 4 fold incr Mortality seen risk factorsHyperglycemia/DM, decreased C3, & thrombocytopenia https://t.co/CqPpRXG8mN https://t.co/GyKbiU8GWY
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Diagnosing Seronegative Sjogren's Disease
Sjögren disease (SjD) is highly prevalent, but diagnosis may be challenged if anti-SSA antibodies or a labial salivary gland biopsy are negative. A recent cohort analysis suggests a novel autoantibody profile has predictive value SSA… https://t.co/v1Es7vVim2 https://t.co/RKxa2Iyeq0
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IV Methylprednisolone in Giant Cell Arteritis
A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP) in early GCA.
https://t.co/5udYabU5z5 https://t.co/5FHhBnAX2j
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Pooled data from BE MOBILE 1 & 2 RCTs shows Bimekizumab (dual-IL-17A/F inhib) may protect against uveitis in axSpA pts. N=349 pts - 0.6% BKZ vs 4.6% placebo developed uveitis (1.8 vs 15.4/100 PYs); even in pts w/ Hx of uveitis (6.2 vs 70/100 PYs; p=0.004) https://t.co/f8Uk0rEg86 https://t.co/mY1ikcGCNP
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Karolinska genotyping study of 329 JIA pts (oligo 161, Seroneg Poly 87, Seropos poly 12, Stills 24, ERA 22, PsA 19). HLA-DRB1*08 linked to JIA total; The HLA-DRB1*11 to Oligo; ANA+ JIA linked to HLA-DRB1-DQA1-DQB1, HLA-DRB1*11, & HLA-DPB1*02 https://t.co/1yNawNTEys https://t.co/dmmlH0CvRi
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Antibiotics May Increase Inflammatory Arthritis Risk
A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP)
https://t.co/5CEewNqirM https://t.co/FSOFp4N6ks
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Anterior Cruciate Ligament Injuries are more commone in Female Athletes compared to males playing same contact sports. From 1990-2020, ACL injuries decreased in males by nearly 30%, but did not change in women, who are also less likely to return to sport https://t.co/EiyU440vRT https://t.co/QvYiSOVQZr
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Early axSpA defined by ASAS -- duration of symptoms ≤2 years; axial symptoms defined as cervical/thoracic/back/buttock pain or morning stiffness; regardless of Xray damage. ASAS community endorsed this proposal (88% in favour). https://t.co/JEviEgyIql https://t.co/jw11UsL6Iv
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Novel: 2 case reports of refractory macrophage activation syndrome successfully treated w/ an investigational monoclonal Ab (MAS825 ) to IL-1β, and IL-18 https://t.co/ZqC77njbjk https://t.co/13W8RZIiRZ
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Study of 425 RA pts & 36 mo. bDMARD retention rates w/ TNFi, IL-6i & ABA based on renal funct (eGFR: ≥60, 30–60, <30 mL/min) showing little effect of CKD w/ TNFi (45%, 28%, 34%), IL-6i (47%, 67%, 71%) & CTLA-4Ig (50%, 31%, 33%), maybe lower w/ TNFi & higher w/ IL6i… https://t.co/FhXoSnEfG1 https://t.co/N29nLBOoUj
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