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Gout - Hot Topics in March 2023
A number of new reports this month shed new light on old issues in Gout.
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Atopic Disease Increases Osteoarthritis Risk
Analysis of commercial insurance claims suggests that patients with asthma or atopic dermatitis have a significantly increased risk of osteoarthritis.
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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).
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Docs' Liking for Knee Injection Tied to Industry Payments
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MedPage Today
Physicians accepting payments from drug and device companies administered significantly more hyaluronic acid (HA) injections to Medicare beneficiaries for knee osteoarthritis, researchers found.
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Small trial of MTX vs Apremilast in PsA from India. OL, MD blinded RCT of 31 pts (26 completed). 15 APR vs 16 MTX (had more enthesitis, dactylitis); wk 24 responses favored MTX for major cDAPSA (37% vs 20%; p=0.4), ACR20 (56 v 47%;NS) w/ no diff in AE https://t.co/KIItKgCq4w https://t.co/FG3NV2yLuc
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Single center study of 320 Difficult to Rx RA (D2TRA) pts, found 76 EULAR-D2TRA pts (24%). D2TRA more likely to be lower socio-economic, RF+, have ILD, higher DAS28-CRP and were more likely to respond to rituximab and JAK inhibitors https://t.co/aEvP6WDvQu https://t.co/FQJvo81FbM
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30 consecutive seropositive (CCP or RF+) early RA pts - 60% had pulmonary abnormalities (PA). PA correlated with presence of neutrophil activation, parameters of inflammation and RF titres. https://t.co/T7CRLzhOMD https://t.co/nYPEw72zOJ
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Join RheumNow during the month of April as we discuss Women in Rheumatology, the XX Factor.
Sign up to attend our series!
https://t.co/m1E4WkK9Cx https://t.co/8RZNgoqzEI
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Dr. John Cush RheumNow ( View Tweet)
386 pts w/ NPSLE (cerebritis); half (194) were Rx w/ intrathecal MTX+dexamethasone(iMTX); iMTX grp had higher SLEDAI (17 vs 14) & more pulse IV steroids (72% vs 50%). iMTX grp had better survival & NPSLE remission((P=0.042); best w/ ^CSF protein or SZ https://t.co/JsqUrYEwTK https://t.co/np6ntCR9xp
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Study of 28,544 gout pts examined fracture risk based on achieving T2T w/ urate-lowering therapy (ULT). The 5 yr risk of hip Fx was 0.5% in those achieving target SU level, but was 0.8% for not achieving SUA target (HR 0.66; 95% CI: 0.46 to 0.93). https://t.co/Yw2zOS0g2v https://t.co/VkGSemlIE4
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199 psoriasis Pts Rx w/ MTX monotherapy. Drug survival at 1, 2, & 5 yrs was 47, 36, & 29%; Avg MTX duration was 10.1 mos. Discontinuation mostly for AE (39.2%), ineffective (38.5%), PSO remission (12.2%). Durability best w/ ^age & dose >15 mg https://t.co/zKP0QCDzE2 https://t.co/35neGlhpE5
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NHANES US population survey of 3101 adults (age 50yrs) wearing accelerometer in 2005 - looked at mortality in 2019. Compared to non-walkers (<8000 steps), mortality signif lower for walkers (> 8000 steps) 1-2 days/wk (−15%) or 3 - 7 days/wk (−16.5%) https://t.co/o8ved3gfsW https://t.co/pHAOYO6I2X
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Triad of Trouble: A case of joint, skin and GI woes
Sara Faghihi Kashani, MD, presents her poster at RWCS 2023.
https://t.co/Y7YbgqbfzY https://t.co/EX1kTIiSRt
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#RNL2023
Dr. Stanley Cohen: possible adverse effects of JAKi
-Herpes zoster, other infections
-Malignancy
-Occasional cytopenias
-LFTs (with DMARDs)
-Incr Cr or CPK
-Acne
-Incr lipids
-GI perf
-VTE
Which do you counsel with your patients? https://t.co/E74Qovuk0m https://t.co/vTAfWu0lta
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"My eye is swollen": an underrecognized mimic of IgG4-related disease
Artem Minalyan, MD, presenting his poster at RWCS 2023.
https://t.co/9Dd8A9yry1 https://t.co/C0hgLV2r2W
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Updated AAV Treatment Recommendations
AAV is a multi-organ disease, which can be complex and may vary from person to person. Types of AAV include GPA, microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA).
https://t.co/gQr92GpE5j https://t.co/SGDh1uNg2b
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Study of 3804 runners from 2019, 2021 Chicago marathon looked at assocn betw marathons running and arthritis. Prevalence of hip / knee arthritis was 7.3%. Hip/Knee OA was assoc w/ prior injury/surgery, older age, FamHx, & BMI (not #marathons, mileage) https://t.co/P91dR9kSgY https://t.co/p7hFKEbGOw
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Autoimmune-Rheum Dz (AIRD) flares occur in 10% w/ COVID vaccination, esp in pts w/ comorbidities, autoimmune morbidities & mental health disorders & Moderna vaccine. 3453 AIRD pts who recv Vax 9.5-11.3% had clinical flares (Arthritis 62% & fatigue 59%) https://t.co/RCtQnA9vc9 https://t.co/G5cXukkpUB
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Anti-mesangial autoantibodies in IgA nephropathy
IgA nephropathy (IgAN) is a kidney disorder characterized by the buildup of immunoglobin A (IgA) in the glomeruli, which are bundles of capillaries that filter blood in the kidney.
https://t.co/owOoAMrtxW https://t.co/RZMGkagcWJ
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Tofacitinib May Reduce Interstitial Lung Disease Risk in RA
Tofacitinib (Xeljanz) in patients with RA stood out among several other biologic and targeted sDMARDs when it came to the incidence of ILD, a retrospective cohort study showed.
https://t.co/XKjuxLWAKH https://t.co/M7ri9AL2wH
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Dr. John Cush RheumNow ( View Tweet)