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Increasing Lung Disease in Systemic JIA
A single-center cohort analysis shows that lung disease is increasingly seen in children with systemic juvenile idiopathic arthritis (SJIA), especially those complicated by macrophage activation syndrome.
Prior to 2013, reports of pulmonary disease in SJIA were rare, but since there have been increasing reports of alveolar hypertension, interstitial lung disease and pulmonary alveolar proteinosis; often with a high mortality rate.
As such, since 2014, the Cincinnati Children’s Hospital Medical Center has seen an increase in lung disease and severe lung disease in SJIA.
Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA
A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.
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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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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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RheumNow Podcast – More Than a Spot of Tea (8.2.19)
Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com:
MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.
Top Rheumatology Centers Led by Johns Hopkins
Medscape has reported the results of the US News & World Report's annual ranking of the best adult rheumatology hospitals nationwide has again honored Johns Hopkins Hospital, with runner up status going to the Cleveland Clinic, Hospital for Special Surgery, NewYork-Presbyterian Unive
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War on RA - Part 2: It's All About You
Part II of this series is a direct message to rheumatologists. If we’re doing such a great job in RA, then why do we need a war on RA? Why is this conflict being laid at the feet of good soldier rheumatologists, those who toil daily at winning therapeutic battles one patient at a time? The reasons are blunt and true.
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Tofacitinib Gets a New Boxed Warning for Blood Clots and Death with Higher Doses
The U.S. Food and Drug Administration has approved new warnings about an increased risk of blood clots and of death with the 10 mg twice daily dose of tofacitinib (Xeljanz, Xeljanz XR), which is used in patients with ulcerative colitis.
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Efficacy of Maintaining or Switching to Baricitinib Monotherapy
A post hoc analysis of baricitinib use in rheumatoid arthritis (RA) patients shows that while many patients respond well to baricitinib monotherapy or to switching to baricitinib monotherapy, those with less disease control respond well to the addition of methotrexate (MTX) to baricitinb.&nb
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FINCH2: Filgotinib in Biologic Refractory Rheumatoid Arthritis
The FINCH2 study has shown that filgotinib, an oral once daily JAK 1 inhibitor, is highly effective in rheumatoid arthritis (RA) patients who failed to respond to prior biologic therapy.
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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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Partial or Total Knee Replacement for Osteoarthritis?
Lancet has reported on a clinical trial comparing total knee replacement (TKR) and partial knee replacement (PKR) in late-stage isolated medial compartment knee osteoarthritis patients finding that both TKR and PKR are equally effective, PKR should be considered the first, because of lower costs
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RheumNow Podcast – Don’t Take My Advice (7.19.19)
Dr. Jack Cush reports the news and new journal articles from the past week on RheumNow.com.
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Intraarticular Capsaicin in Knee Osteoarthritis
A novel compound, synthetic trans‐capsaicin (CNTX‐4975), has been studied as an intraarticular injection and shown to significantly reduce pain in patients with chronic moderate‐to‐severe osteoarthritis of the knee.
A phase II, multicenter, double‐blind study enrolled 172 knee OA patients between the ages of 45–80 years. Patients were randomized to receive either intraarticular placebo, or a high‐purity synthetic trans‐capsaicin CNTX‐4975 0.5 mg, or CNTX‐4975 1.0 mg.
Increased Risk of Cardiovascular Death in Hip and Knee Osteoarthritis
Hip and knee osteoarthritis patients have been shown to have increased mortality rates from cardiovascular events when compared to the general population.
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Upadacitinib Superior to Adalimumab in Methotrexate Refractory RA
Upadacitinib, a JAK1-selective inhibitor, was studied head to head against adalimumab and placebo in rheumatoid arthritis after an inadequate response to methotrexate, and shown to be superior to ADA and PBO in ACR20 and DAS remission level responses.
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Rituximab Safety Concerns when Used in anti-TNF Refractory RA
The SUNSTONE study evaluated the long‐term safety of rituximab in rheumatoid arthritis (RA) previously exposed to ≥1 anti–tumor necrosis factor inhibitors (TNFi) and showed a stable, but high, rate of serious infections, opportunistic infections and an overall higher mortality rate.
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RheumNow Podcast – Boiling Hot MAS (7.12.19)
Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.
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CRP Utility in COPD Exacerbations
NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.
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Be ‘on point’: Guidelines for rheumatic complications of immunotherapy
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. At EULAR 2019, Madrid, several recommendations including RA, SLE, and Sjogren’s syndrome have been developed. Agreement for principles with respect to the treatment of immune mediated adverse events from cancer immunotherapy are lacking.
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