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English for the Biologically-Challenged (8.4.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  This week highlights Veterans, Vegetarians and Antenatal Corticosteroids.

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Rheumatology Journals Rife With Faulty Conflict-of-Interest

d MedPage Today

More often than not, conflict-of-interest disclosures in three major rheumatology journals didn't match records in the U.S. government's Open Payments database, researchers found.

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Antenatal Corticosteroids and Serious Infection in Offspring

d Jack Cush, MD

A claims data study shows that maternal use of antenatal corticosteroids may be associated with an increased risk of serious infection in the offspring's first 12 months. 

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2023-2024 Best Rheumatology Hospitals

d Jack Cush, MD

Johns Hopkins Hospital in Baltimore has been named the top hospital for rheumatology by U.S. News & World Report. This is the 6th year in a row they have held this spot.

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Bifunctional B-cell Targeted Therapy in IgG4-related Disease

d Jack Cush, MD

A novel B-cell depletion trial, using obexelimab (a bifunctional, monoclonal antibody that binds CD19 and Fc gamma receptor IIb), has shown efficacy and safety in patients with active IgG4-related disease.

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2023-2024 Best Rheumatology Hospitals Johns Hopkins Hospital in Baltimore has been named the top hospital for rheumatology by U.S. News & World Report. This is the 6th year in a row they have held this spot. https://t.co/4k6DNJie4n https://t.co/BbPlEFAGH3

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Paradoxical Rxns (PR) & biologics in TReasure database: 2867 RA & 5316 SpA pts; 5-yr FUV found 136 pts (1.7%) developed the PRs; 60% w/ 1st biologic, after median 12 mos, 93% psoriais (pustular 60%, palmoplantar 31%), many better w/ another TNFi https://t.co/5tybXZZVKW https://t.co/1nQaXQOEDD

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HEALTH DISPARITIES: Lancet study shows from 2000-2019, all-cause mortality was signif. higher in the American Indian/Alaska Native (1028/100K) & Blacks (953·/100K) compared to Whites (802); but lower in Asians (442) & Latinos (595) https://t.co/g8Z3h6BYw8 https://t.co/Ckz1L3O0W7

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Bifunctional B-cell Targeted Therapy in IgG4-related Disease A novel B-cell depletion trial, using obexelimab has shown efficacy and safety in patients with active IgG4-related disease. https://t.co/JTfOrOLrrY https://t.co/ANY2YL25jT

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Johns Hopkins & Univ Pittsburgh Scleroderma compared autoantibodies in 676 SSc pts w/ hx of cancer to 687 SSc controls without CA. Anti-POLR3 & anti-Ro52 assoc w. significantly increased cancer risk; Centromere & U1RNP had a decreased cancer risk https://t.co/z6HfRR7PWs https://t.co/zISZlgHGjd

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Rheums: Have a rheumatology question or case for Dr. Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/uY9Mwyrsn3

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Tofacitinib in Polymyalgia Rheumatica (EAST PMR Study) An open-label, uncontrolled pilot trial has shown that JAK signaling is involved in the pathogenesis of PMR and that tofacitinib is as effective as glucocorticoids (GC) in patients with PMR. https://t.co/sJcq9lMP1l https://t.co/zvmPs3SdCw

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Altered Gut Biome in Inflammatory Arthritis Another study has confirmed that the intestinal microbiome's composition in people with inflammatory arthritis differs from that in other people, and in potentially unhealthy ways. https://t.co/NIqCkxf1Mp https://t.co/6LChrYmKuX

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RABBIT Registry Study 2470 pts (1,245 axSpA; 1,225 PsA) - moderate depressive Sxs in 8% & 21% w/ severe Sxs. Depressive Sxs were assoc w/ fatigue, not engaging in sports, & greater functional limitation - may affect perception of disease activity https://t.co/XTyzLF98BC https://t.co/8TLfRBK4lX

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Spinal CT study of 40 ankylosing spondylitis pts shows the most common site and region of intervertebral fusion were the posterior vertebrae of the middle thoracic region >50% halffused posterior vertebrae Th4–Th5 to Th7–Th8, followed by Cx, last lumbar https://t.co/Zxchr4yUGI https://t.co/QD554Yo7cV

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Vegetarians have a significantly higher hip fracture risk (HR 1.50) than regular meat-eaters, partly (28%)explained by BMI. UK Biobank compared meat-eaters (n=regular 258,765, occasional 137,954), pescatarians (9557), & vegetarians (7638) https://t.co/EyL1PPpfYE https://t.co/n0wNDVWMuP

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Predicting Inflammatory Arthritis in At-Risk Persons The Annals of Internal Medicine has published a predictive score to distinguish low-risk from high-risk IA and who may benefit from risk stratification and preventive measures. https://t.co/I5sLbkvNdT https://t.co/YpOiDYiajW

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Hong Kong study shows Very low dose prednisolone (<5 mg/d) doesn't confer excessive CV risk. 2 233 RA pts (105 826 Pt-years FUV; mean duration 8.7 yrs) - 7% developed MACE. MACE risk incr 7% per month in those taking ≥5 mg pred. https://t.co/lcehOgaqCQ https://t.co/AhWGnUuYcc

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High mortality risk predictors in patients with anti-MDA5 dermatomyositis include: - rapidly progressive interstitial lung disease - anti-Ro52 antibody - age > 57 years (based on study of 126 MDA-5+ DM pts) https://t.co/VCyLhStFgX https://t.co/y3CyzOlwDt

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Spanish study of 518 #SLE patients, 7% of whom received at least one dose of rituximab(26) or belimumab (11). RTX given for either hemolytic anemia or ITP (11 pts), nephritis & CNS SLE (5 pts ea). BEL mostlyfor arthritis (8 pts) https://t.co/IqCVfOL5rb https://t.co/ocLj7Ejs7A

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