Mortality Predictors in Rheumatoid Arthritis

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A population based study from southern Denmark finds excess mortality RF-positive males with rheumatoid arthritis (RA) and that employment status and comorbidity were independent predictors of mortality.

The RheumNow Week in Review - Nonadherence and Astronomic Costs (5.11.18)

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Dr. Jack Cush reviews highlights, news and journal articles from the past week on RheumNow.com.

Tocilizumab Beats Anti-TNFs for Treatment Retention

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Patients with rheumatoid arthritis (RA) who had previously had an inadequate response to one biologic agent remained on tocilizumab (Actemra) longer than on a tumor necrosis factor (TNF) inhibitor, whether or not conventional disease modifying anti-rheumatic drugs (DMARDs) were given concomitantl

Bisphosphonate Drug Holidays May Result in Fractures

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A report in Endocrine Practice shows that drug holidays from bisphosphonates results in a 15% risk of fractures.  (Citation source: 

The RheumNow Week in Review – Why Comorbidity is Like the Weather (5.3.18)

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Dr. Jack Cush discusses the news and journal articles from the past week on RheumNow.com.

Fish Oil Fails in Dry Eye Trial

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Many topical and OTC products are recommended when treating chronic dry eyes, including omega-3 fatty acids (fish oil or n−3 fatty acids) to relieve symptoms; the NEJM reports that the DREAM trial shows no clinical benefit of n−3 fatty acids for 12 months when compared to placebo.

Tick, Mosquite-Borne Diseases Triple Since 2004

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The Centers for Disease Control and Prevention has a new report showing that from 2004 to 2016, the number of Americans infected by mosquitoes, ticks or fleas tripled from 27,388 in 2004, to 96,075 in 2016. 

From 2015 to 2016, these infections rose by 73 percent. This included new Zika and chikungunya virus infections, (41,680 in 2016), followed by Lyme disease (36,429 cases). This may be an underestimation as as many infections are not reported.

Severe Obesity Worsens Disability in Rheumatoid Arthritis

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A study from the Veterans Affairs clinics and the National Data Bank of Rheumatic Diseases shows that rheumatoid arthritis (RA) patients who were severely obese had a greater risk of progressive disability compared to overweight patients; that was not explained by their arthritis or inflammation.

FDA Advisors Weigh COX-2 Inhibitor Safety

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Should celecoxib (Celebrex) be officially declared as no riskier for the heart than other non-steroidal anti-inflammatory drugs (NSAIDs) naproxen and ibuprofen, and do those other NSAIDs interfere with aspirin for cardiovascular prevention?

FDA Arthritis Panel Split on the Efficacy and Safety of Baricitinib in RA

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On Monday, April 23rd the FDA convened the Arthritis Advisory Committee (AAC) to evaluate Lilly’s resubmitted NDA for the approval of the JAK inhibitor baricitinib for use in rheumatoid arthritis (RA).

FDA Review: Take Two for Baricitinib

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FDA staff remain worried about the safety of baricitinib, an oral JAK inhibitor intended for treatment of rheumatoid arthritis, according to briefing documents prepared for an advisory committee meeting on Monday.

The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

Shared Epitope - Smoking Pathogenic Link Clarified

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Proceedings of the National Academy of Sciences (PNAS) has published new research on the mechanistic link between the rheumatoid arthritis (RA) "shared epitope" (SE) risk alleles and environmental triggers such as cigarette smoke that leads to joint inflammation and bony destruction. 

USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures

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The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use of vitamin D and calcium at doses greater than 400 IU of vitamin D and greater than 1,000 mg of calcium in postmenopausal women.

EMA to Review Methotrexate Overdose and Dosing Errors

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A recent meeting (April 9-12) of the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) considered the problem of dosing errors with methotrexate (MTX), citing "continued reports of overdose." 

Mayo and UAB Awarded $1 million Grant for Patient Research

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CreakyJoints and Pfizer have selected the Mayo Clinic and the University of Alabama at Birmingham (UAB) to each receive a $500K research award (funded by Pfizer Independent Grants) for Learning & Change.

ACR Projects Significant Manpower Shortages for 2030

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Arthritis & Rheumatology has published the results of the 2015 Workforce Study of Rheumatology Specialists, and estimates a current shortage (demand > supply) of 700 (12.9%) full-time rheumatologists and that this deficit will worsen (102%) to 4133 FTE by 2030.

Defining Refractory Rheumatoid Arthritis

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Dr. Maya Buch from Leeds has a thoughtful Viewpoint article in Annals of Rheumatic Disease on how to consider and manage the refractory or difficult rheumatoid arthritis (RA) patient.

Favorable Certolizumab Safety Profile in Pregnancy

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Clowse and colleagues have published an extensive review of the certolizumab pegol (CZP) in pregnancy database, and found no evidence that CZP has a teratogenic effect or contributes to fetal harm when compared to the general population.