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RA Disease Activity Drives Lung Complications
A longitudinal study from the BRASS registry shows that increase rheumatoid arthritis disease activity increases the risk of RA-associated interstitial lung disease (RA-ILD).
RA patients without RA-ILD at baseline, enrolled in the Brigham RA Sequential Study (BRASS, 2003–2016), were followed from 2003-2016 with serial clinical, DAS28, serologic and imaging assessments.
Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA
A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.
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RheumNow Podcast – More Than a Spot of Tea (8.2.19)
Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com:
MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.
Abatacept Disappoints in Systemic Sclerosis
A 12‐month, Phase 2 trial has shown that subcutaneous abatacept was well tolerated in patients with diffuse cutaneous systemic sclerosis (dcSSc), but failed to significantly change the skin outcomes as measured by the change in modified Rodnan skin score (mRSS)
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RheumNow Podcast – FDA Hyperactivity (7.26.19)
Dr. Jack Cush reviews the news, journal reports, and FDA releases and deliberations covered this past week on RheumNow.com
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A Potential Biomarker for Chronic Fatigue Syndrome Patients
Myalgic encephalomyelitis/chronic fatigue syndrome affects at least 2 million people in the United States and bears tremendous overlap with fibromyalgia - both being difficult to diagnosis because the symptom complex is often unrecognized and these conditions have no biomarker test.
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Be ‘on point’: Guidelines for rheumatic complications of immunotherapy
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. At EULAR 2019, Madrid, several recommendations including RA, SLE, and Sjogren’s syndrome have been developed. Agreement for principles with respect to the treatment of immune mediated adverse events from cancer immunotherapy are lacking.
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EULAR 2019 - Day 1 Report
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Here are a few of the highlights from day 1 EULAR in Madrid, including another IL-23 inhibitor, BTK inhibition, abatacept in Sjogren's syndrome, don't repeat the ANA, and drug free remission in systemic JIA.
Borrelia burgdorferi Peptidoglycan Shedding Drives Lyme Arthritis
Research published in PNAS has shown that long after active Lyme infection in the joint, a peptidoglycan (PG) of the the spirochete Borrelia burgdorferi can be found in the joints of those with late-stage Lyme disease.
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Preview of EULAR 2019 Abstracts
EULAR 2019 begins today in Madrid and features over 2000 presentations. After an initial review of titles and abstracts, I’ve compiled a hit list of presentations of interest to me and hopefully other practicing rheumatologists.
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Management of Hemophagocytic Lymphohistiocytosis (HLH) in Adults
Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome induced by activated macrophages and cytotoxic T cells. HLH manifests recurrent fever, cytopenia, liver dysfunction, and a sepsis-like syndrome that may complicated by multiple organ failure.
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Proinflammatory Diets May Increase CRP and RA Onset
Despite the lack of good evidence, there has been great speculation about the role of diet in causing or alleviating inflammation. Now there's new research suggesting that proinflammatory diets can increase serum C-reactive protein levels and also the risk of rheumatoid arthritis onset.
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Might IL-17 Inhibition Be Effective in RA?
Interleukin 17 (IL-17) inhibitors are highly effective and FDA approved for use in psoriasis, psoriatic arthritis and ankylosing spondylitis. However, many of the initial trials were done in rheumatoid arthritis (RA) where it was projected to be effective, but was not. A recent metanalysis examines how effective IL-17 inhibition was in two RA populations: biologic-naïve or tumor necrosis factor inhibitor inadequate responders (TNF-IR).
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RheumNow Podcast – Rituximab Monitoring (5.31.19)
Dr. Jack Cush presents the news and best of rheumatology and medicine from the past week on RheumNow.com
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2019 EULAR Guidelines on Antiphospholipid Syndrome Management
A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.
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Predictors of Serious Infections with Rituximab
The risk of serious infectious events (SIE) with rituximab (RTX) is similar to that seen in other biologics (e.g., RA: 2% or 4.3/100PY), but with prolonged use the risk may change. Recent research says that low IgG levels, RTX induced neutropenia, prior SIE and comorbidities can significantly augment this risk.
A retrospective longitudinal single center study of 700 rheumatic and musculoskeletal diseases (RMDs) treated monitored serum immunoglobulins (at baseline and 4–6 months after each cycle), clinical outcomes and SIE over time.
Nintedanib May Benefit Systemic Sclerosis Related Interstitial Lung Disease
The NEJM reports a randomized placebo controlled trial of nintedanib, a tyrosine kinase inhibitor, in systemic sclerosis patients with interstitial lung disease (ILD) resulted in less pulmonary decline, but had no effect on other features of systemic sclerosis.
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Risk Score Predicts Thrombosis Recurrence in APS
A combination risk score helped predict recurrent thrombosis -- particularly arterial -- among patients with antiphospholipid syndrome (APS), an international study found.
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