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Does Weight Loss Really Work in Gout?
A clinical trial has shown that obese gout patients will benefit from diet and lowered body weight, but weight loss was not associated with beneficial effects on serum urica acid (SUA), fatigue or pain.
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Best of 2023: Does Biologic Treatment in Psoriasis Reduce the Risk of Psoriatic Arthritis?
Retrospective claims analysis shows that psoriasis patients treated with either an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident psoriatic arthritis, compared to TNF inhibitors or IL-17 inhibitors.
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Best of 2023: EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome
A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary intent to halt disease progression and prevent life-threatening complications from HLH/MAS.
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Best of 2023: Cost-Effective Use of Biological and Targeted Synthetic DMARDs
An international task force of 13 European experts have developed evidence-based points to consider regarding the cost-effective use of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the treatment of inflammatory rheumatic diseases (including rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis).
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Best of 2023: New Laboratory Insights for the ANA+ Consult
A new study suggests that use of ELISA assays for CXCL-10 and IFN-α can predict which ANA+ individuals may progress to developing a systemic autoimmune rheumatic disease (SARD).
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Best of 2023: LAVLI - A New Autoinflammatory Disorder
NIH researchers have have described a novel autoinflammatory disorder called "Lyn kinase-associated vasculopathy and liver fibrosis" (LAVLI), based on a mutation in the LYN gene (that encodes the Lyn kinase protein). They discovered that increased Lyn kinase activity promotes systemic inflammation, by altering microvascular permeability and neutrophil recruitment, while at the same time promoting hepatic fibrosis.
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Best of 2023: Postural Orthostatic Tachycardia Syndrome Review
The Cleveland Clinic Journal has published a full-read review of postural orthostatic tachycardia syndrome (POTS), a condition often seen in clinic with symptoms like fibromyalgia, but is clinically diagnosed with finding sustained tachycardia upon standing without orthostatic hypotension.
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Best of 2023: Colchicine or Prednisone in CPPD?
The COLCHICORT trial in patients with acute calcium pyrophosphate crystal arthritis (CPPD) demonstrated equivalent efficacy for both colchicine and prednisone, yet different safety signals were seen.
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Best of 2023: 2022 EULAR Recommendations for ANCA-associated Vasculitis
EULAR has published the 2022 update on recommendations for the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). AAV recommendations were last published in 2016, and since, research and clinical trials have advanced our understanding of AAV. A EULAR task force of 20 experts from 16 countries, reviewed the literature and developed four overarching principles and 17 recommendations.
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Best of 2023: Time to Risk Stratify Methotrexate Lab Monitoring?
A longitudinal cohort analysis has developed a prognostic model that informs a risk stratified approach to monitoring blood tests during long term methotrexate (MTX) therapy.
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ICYMI: Methotrexate: shall we split up?
Methotrexate is widely used in rheumatic diseases yet poses common tolerance issues, especially for the oral form; and bioavailability is known to be limited for doses over 15mg. In the SMART study, Prasad et al. present the first RCT comparing either single dose (25 mg) or split-dose (10 mg morning, 15 mg evening, same day) once weekly MTX for 24 weeks.
ICYMI: ACR Plenaries: Changing the Practice of Rheumatology
Over the years of navigating the annual meeting, I found the sessions with the most impact to my practice were the Plenary Sessions. During these sessions, the latest research is presented, new ideas are floated, and old myths debunked. Here are the top ACR2023 Plenary abstracts I found impactful for my practice.
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EULAR 2023 Recommendations on Fatigue
Fatigue is highly prevalent in inflammatory rheumatic and musculoskeletal diseases (I-RMDs) patients, is often unaddressed and yet it has significant effects on patient quality of life. A EULAR task force set out to develop recommendations for the management of fatigue in people with I-RMDs.
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ICYMI: Here at Last: Treatment Options for VEXAS
We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.
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CDC: Chronic Fatigue Syndrome 2021-2022
The current CDC report estimates that 1.3% of adults had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), based on the most recent population based National Health Interview Survey (NHIS 2021–2022).
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