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RheumNow Podcast - MTX vs. Etanercept in Psoriatic Arthritis (2.15.19)
Dr. Jack Cush discusses the news from the past week on RheumNow.com - including the SEAM trial, MRI guided T2T, biologics and infection, contraceptive use, ANA negative lupus, etc.
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No Added Benefit to MRI-Guided Therapy in Rheumatoid Arthritis
A treat-to-target (T2T) strategy to manage rheumatoid arthritis hinges on clinical metrics to optimize therapy. But investigators from Denmark have shown that using magnetic resonance imaging–guided T2T failed to improve disease activity remission rates or reduce radiographic progression.
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Differing Effects of Smoking and HLA-DRB1 in Seropositive Rheumatoids
Analyses from the Swedish EIRA incident rheumatoid arthritis cohort study shows that smoking and HLA-DRB1 exert differential effects on serologically defined RA subsets - but that the strongest influence was seen in double positive (CCP+, RF+) individuals.
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Biologic High Out of Pocket Costs for Medicare Patients
Specialty tier drugs, including biologics, accounts for nearly half of all medication spending by Medicare Part D patients. High out-of-pocket costs for these patients is a major concern.
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Opioid Use in Osteoarthritis Varies by State
A study in Arthritis & Rheumatology shows that there is substantial statewide variation in rates of treatment with long‐term opioid therapy in osteoarthritis - not fully explained by differences in access to healthcare providers, varying case‐mix, or state‐level policies.
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Update on Pregnancy Management in RA
Two recent reports offer good news to rheumatoid arthritis (RA) women who are planning to become pregnant.
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No Difference in Oral or IV Antibiotics for Bone & Joint Infections
Research from the NEJM shows that oral antibiotic therapy was noninferior to intravenous antibiotic therapy when used during the first six weeks for complex orthopedic infections.
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Multidisciplinary Recommendations for Rheumatoid Foot Problems
Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems.
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Obesity Needs to be Treated in Psoriatic Arthritis
Obese patients with psoriatic arthritis (PsA) who followed a short-term, very low-energy diet showed improvements in multiple aspects of disease activity, a prospective study found.
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Does Seropositivity Change with Therapy?
A subanalysis of the early rheumatoid arthritis (RA) "IMPROVED" study has shown that changes in RA-autoantibody levels are not associated with disease activity or or long-term drug response, but instead reflect intensity of immunosuppression.
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Smoking Doesn't Influence Rituximab Responses in Rheumatoid Arthritis
Alcohol, smoking and obesity have all been shown to influence the risk and activity of rheumatoid arthritis (RA) and may also influence response to therapy. This study assesssed whether smoking would influence response to rituximab (RTX) in RA.
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RheumNow Podcast – FDA Panels Meet on Gout & OP (1.18.19)
Dr. Jack Cush reviews the news, articles and FDA Panel discussions from the past week.
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Combo RA Treatment May Boost Risk for Serious Adverse Events
A current meta-analysis of safety and efficacy of combination bDMARD treatment in RA patients shows that combination treatments increase serious advese event (SAE) risks, and the risk for serious infections in particular.
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RheumNow Podcast – A Grand New Year (1.4.19)
Dr. Jack Cush reviews the news and journals for the beginning of 2019. All from RheumNow.com.
Best wishes for a charmed 2019! My advice: 1. Just show up. 2. If you can, then you must do. 3. Live each day as if it twas your 1st day/last day/make or break day. 4. Teach.
2018 Rheumatology Year In Review
This annual appraisal of hallmark moments, news and research articles from 2018 are gleaned from that published in RheumNow during the last year and filtered by other news sources and literature review. The top 10 list herein is rooted in what rheumatologists should know and what will likel
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Uncertain Long Term Efficacy in Trials of Knee Osteoarthritis
A systematic review and network meta-analysis of 47 randomized clinical trials in knee osteoarthritis finds uncertainty around estimates of effect size for pain scores thereby casting uncertainty over the long-term efficacy of medications for knee osteoarthritis.
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Severe Cutaneous Sarcoid Treated with Tofacitinib
Researchers from Yale have taken a novel approach and shown benefits when using tofacitinib in severe cutaneous sarcoidosis.
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Best of 2018: The Safety of Paternal Exposure to DMARDs and Biologics
Pregnancy and drug safety is a complex issue, often with limited information about maternal drug exposure on the offspring. Greater uncertainty exists when considering whether paternal exposure may also influence fetal outcomes.
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Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices
An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices. By 2016, 28% of all specialty practices employed APCs.
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Best of 2018: Hydroxychloroquine Being Over-Dosed with New Guidelines?
Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice.
A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).
