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Anti-Drug Antibodies with Biologics (7.14.2023)
Dr. Jack Cush Reviews the news and journal reports on CVA, TKA, PJP, ADA, and more!
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Opioids Ineffective in Acute Lower Back and Neck Pain
EurekAlert!
A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo.
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What is Colchicine Worth? (6.23.2023)
Dr. Jack Cush reviews the news and reports from the past week on RheumNow.com. This week a new colchicine FDA approval, rising rate of IgG4 related disease and what's the safest biologic?
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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.
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Chronic neck pain is associated with increased mortality in individuals with osteoarthritis. NHANES study of 5965 adults, OA in 8.2% and 5.9% had neck pain. Neck pain assoc w/ 2 fold risk OA. OA pts w/ chr neck pain higher all-cause mortality risk (OR ~3) https://t.co/MLzJUa3AnY https://t.co/WB8lhvUOjw
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Structured interviews from 462 pts from Michigan SLE clinic. 22% admit to cost-related non-adherence (CRNA) over 12 mos. CRNA associated signif. higher levels SLE disease activity & more lupus damage. Worse scores in those with Fibromyalgia https://t.co/NHIIqmWVqJ https://t.co/zX4gTFTcW7
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US study shows 1635 adults receiving chiropractic spinal manipulation for radicular LBP receive significantly less gabapentin prescription (OR 0.53; 0.40 to 0.71; p<0.0001) over 1-year follow-up compared with those receiving usual medical care https://t.co/t0uTMdLEzO https://t.co/rCR04sMdRV
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Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
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Research from 12 states with medical cannabis laws looked at 583 820 adults w/ chronic noncancer pain. Data over 3 yres shows < 0.05% change in the use of opioid prescriptions, nonopioid prescriptions, pain meds, or chr pain procedures https://t.co/ArbP4xe4dH https://t.co/MPRBZNIIoS
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In AUSTRALIA, 30% (~ 7million) have a chronic #MSK condition, costing $14.6 billion (10% of all healthcare spending) in 2019-20. Overall, 4 million w/ back problems, 3 million arthritis, 900,000 osteoporosis, 450,000 w/ #RA. https://t.co/TDV50PoRXj https://t.co/EtSUuv6jMA
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Metanalysis of 8 RCT, 188751 pts assessed mortality risk & FM. Overall, all-cause mortality increased in FM (HR 1.27, 1.04 to 1.51), but not in subgroup Dx by 1990 criteria. Increased SMR for accidents, infxn, suicide & decreased for cancer (0.82) https://t.co/Ujv8KP8FJK https://t.co/lNGUM0wB3O
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Pain is the leading cause of disability worldwide. Chronic pain affects 33-50% of the population. High impact chronic pain is seen in 4.8% of US adult population. Chronic pain accounts for 22-50% of GP consultations. More from BMJ.. https://t.co/IRVpJZNS0L https://t.co/YVIM38aWWK
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Opioids Ineffective in Acute Lower Back and Neck Pain
A randomised controlled trial including 347 participants with lower back or neck pain found there was no benefit of taking opioid pain relievers compared to placebo.
https://t.co/96mETyhKyL https://t.co/48ojNCnoZW
Links:
Dr. John Cush RheumNow ( View Tweet)
2022 of fibromyalgia Year in review discusses possible causes (inflammation, gut dysbiosis, neuroinflammation), new Rx (kinin antagonists, neurostimulation, mind-body Rx; but more needed on ketamine, vitamin D, and hormonal therapy https://t.co/sya8fSCbFX https://t.co/F2HDcp2XYb
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In pts seeking care for MSK pain cannot assume that improving pain/function will result in improved depression, but substantial improvements are required to effect anxiety. Study of 11 236 Ortho pts in JAMA https://t.co/5vvoPs31GU https://t.co/gEwZNW35xB
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Why Patients Don't Take Medicines
This report examines the characteristics of adults aged 18–64 who took prescription medication in the past 12 months and did not take medication as prescribed due to cost.
https://t.co/zuPgMjKYbh https://t.co/62cG9LDYWi
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Chronic Pain Management tools
1 Medication
2 Physical Therapy
3 Cognitive-Behavioral Therapy
4 Mindfulness Meditation
5 Acupuncture
6 Massage
7 Heat/Cold
8 TENS
9 Yoga/Tai Chi
10 Support groups https://t.co/VBvYR8VK16 https://t.co/tbfPnL1VEH
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Rheums! Have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
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FAAH and FAAH-OUT - genes involved in pain perception; could these be the target of future therapies? Interesting article in FORBES bout role of FAAH and FAAH-OUT in pain. https://t.co/8FNvkVZy5R https://t.co/8Ldywt2wvq
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275 early RA pts and after 2 years, 32% reported unacceptable pain (UP). Predictors of UP best seen at 3 mos FUV (not baseline) and included #Tender Jts (not swollen), overall pain, patient global assessment, and HAQ. https://t.co/Zlv3919Ucz https://t.co/1K1zPvhUYi
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