CDC: Pneumococcal Vaccination in Adults

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Streptococcus pneumonia is a leading cause of morbidity and mortality in adults; including patients with autoimmune diseases who are at particular risk.

Curbside Consults - July 2017

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Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines. Here are four new cases. 

Long-Term Additive Cardiovascular Benefit of Plaquenil and Aspirin in Lupus

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Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). The cardioprotective benefits of aspirin (ASA) are well known and the ancillary CV and diabetogenic effects of hydroxychloroquine (HCQ) have also been shown.

The RheumNow Week in Review – 14 July 2017

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Dr. Jack Cush reviews highlights from the past week on RheumNow.com:

Statins Improve Survival in Ankylosing Spondylitis

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Systemic inflammation (from underling inflammatory polyarthritis) clearly accelerates atherosclerosis with a resultant increase risk of cardiovascular disease.

Withdrawal of TNF Inibitors Fails in Most RA Patients

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The 12 month POET study analyzed 817 rheumatoid arthritis (RA) patients who achieved remission or low disease activity (LDAS) for ≥6 months and then randomized 2:1 to stopping or continuing their TNF inhibitor.

Alendronate Use in Steroid Treated Patients Lowers the Risk of Hip Fracture

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Among older patients using medium to high doses of the anti-inflammatory steroid prednisolone, treatment with the osteoporosis drug alendronate was associated with a significantly lower risk of hip fracture, according to a study published by JAMA.

Managing Secondary Non-Response to Rituximab in Lupus

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Rituximab, a chimeric anti-CD20 monoclonal antibody, has been effectively used in the treatment of multiple autoimmune disorders for over two decades. But the response to rituximab has been shown to not be as effective in SLE as it is in RA. 

Orencia Approved for Use in Psoriatic Arthritis

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The FDA has approved both IV and SC ORENCIA (abatacept) for the treatment of adults with active Psoriatic Arthritis.

Lymphopenia and Steroids Increase the Risk of Pneumocystis Jiroveci in Systemic Rheumatic Diseases

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It is well-known that patients with systemic autoimmune diseases are at risk for Pneumocystis jirovecii pneumonia (PJP) and although infrequent, it carries a high mortality. A new study shows lymphopenia and steroid use increases the risk of PJP.

Breastfeeding Rates Lower in Lupus

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It is a common practice for rheumatologists to discuss medication-related teratogenicity and disease implications in case of pregnancy.  Yet, discussion of breastfeeding are often omitted.

Highlights from EULAR 2017 - From RheumReports.com

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Dr. Janet Pope reviews her favorite and least favorite presentations and abstracts from EULAR 2017. 

IV Golimumab in Psoriatic Arthritis

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Based on recent clinical trials, the makers of golimumab have petitioned the FDA for new indications in PsA and AS. Trials for PsA (GO-VIBRANT) and AS (GO-ALIVE) were presented at last weeks EULAR 2017 meeting in Madrid, Spain.

Tildrakizumab, an IL-23 Inhibitor, is Successful in Plaque Psoriasis

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Therapeutic options for cutaneous psoriasis (and psoriatic arthritis as well) are rapidly expanding.  Lancet has published the impressive results of two phase III trials of tildrakizumab, a IgG1 antibody against interleukin 23 p19, in patients with active chronic plaque psoriasis.

ACR/AAHKS Guidelines on Perioperative Management

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The American College of Rheumatology has partnered with the American Association of Hip and Knee Surgeons to develop consensus-based guidelines for perioperative management of antirheumatic therapies for patients with rheumatic diseases who plan to undergo total joint replacement.

EULAR 2017 – Day 4 Highlights

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Saturday was a day of big posters and special seminars at EULAR in Madrid.  In the morning, I passed on an interesting session on nailfold capillaroscopy led by Dr. M Cutolo and went to a JIA outcomes session.

EULAR 2017 – Day 3 Highlights

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Friday was a mega-day in Madrid as this day all the late-breaking abstracts were presented, in addition to the bulk of high-impact podium presentations in several areas.

Here are the major presentations from several clinical areas.