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Dr. Eder delivered an illuminating talk at RheumNow Live 2024 on sex differences in psoriatic arthritis; the disease may manifest differently in men and women, and therapeutic responses may differ between the sexes.
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Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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A study from a large metropolitan registry of psoriatic arthritis (PsA) patients showed several racial and/or ethnic groups are underrepresented and demonstrate differences in disease activity.
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US commercial insurance claim analysis of laboratory screening and monitoring practices in chronic inflammatory skin disease (CISD) patients shows that < 60% received the recommended pretreatment testing when starting systemic immunomodulatory treatment.
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Low back pain is a major cause of disability around the globe, with more than 570 million people affected. In the United States alone, health care spending on low back pain was $134.5 billion between 1996 and 2016, and costs are increasing.
Dr. John Cush
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Sex Disparities in PsA/SpA
https://t.co/3pmFyo6Ztm https://t.co/zanPiI7GT5
Dr. John Cush
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Korean Database study of 1796 #AS pf (vs 7184 controls 1:4 ratio); 9.3% develeoped cancer; AS pts have no overall increase in cancer risk (aHR 1.1); AS pts had higher risk ofupper GI cancer (HR: 1.51) & hematologic CA (aHR: 2.36). Is there an NSAID effect? https://t.co/6W68upVQrn https://t.co/RWlhLFV9EJ
Dr. John Cush
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16% of patients with nr-axSpA progressed to r-axSpA within 5 years. Male sex, fulfillment of the imaging arm of the ASAS criteria, and good response to nonsteroidal anti-inflammatory drugs were predictors of radiographic progression https://t.co/2qCynSGQjv https://t.co/eogKGacpqH
Dr. John Cush
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Rheumatologists and the Early Diagnosis of Spondyloarthritis
SPACE study of adults referred to rheumatology with less than 2 years of chronic back pain (CBP), shows that only one-third can be reliably diagnosed with axial spondyloarthritis (axSpA).
https://t.co/nUappTl0wG. https://t.co/oouir55CO6
CRUS-SURC
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#RNL2024 @RheumNow SPA spectrum Q and A 🔥 - @lihi_eder 👏advocating for #POCUS #mskus and enthesitis - we agree @CrusSurc - confirming the concept of #pocus as an extension of the clinical exam and to be kept in the hands of the clinician - doesn't seem an area yet for AI 🤖
Dr. Rachel Tate
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Dr. @lihi_eder approaches enthesitis both clinically and with imaging *highly recommended.
NSAIDs and local steroids may be useful with caution. Advanced tx strongly recommended if initial tx fails/other domains involved.
#RNL2024 @RheumNow https://t.co/SKrWmp115M
Richard Conway
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Advanced therapies in enthesitis. Don't believe the spin, they all work, no clear evidence that any agent is better than others. @lihi_eder @RheumNow #RNL2024 https://t.co/FwLMUmmClB
Dr. Rachel Tate
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@JointMD updates us on nomenclature. "AS" is out and "AxSpA" is in.
#RNL2024 @RheumNow https://t.co/gdmZeuMNpW
Eric Dein
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#RNL2024 @RheumNow
@lihi_eder on enthesitis
- ~1/3 PsA, SpA
- Enthesitis precedes onset of PsA in PsO, high u/s score ass. w/ RFs (BMI, nail dyst)
- Exam: tenderness (non-specific), as swelling uncommon. U/s helpful, but non-specif
- Marker of severity, higher risk of damage
Dr. Rachel Tate
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Dr. @lihi_eder recommends enthesial evaluation with POC ultrasound if available in addition to her clinical evaluation. #RNL2024
@RheumNow https://t.co/LQiyFK5VB1
Eric Dein
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AS v nr-AxSpA for TNFi - no diff in response
@JointMD @RheumNow #RNL2024
ADA: ASAS20 AS 58%, nr-AxSpA 52%, ASAS40 AS 39%, nr 36% (ATLAS, ABILITY-1)
ETN: ASAS 20 59%/52%, ASAS50/40 44%/33% in p3 AS study v EMBARK
CZP: RAPID-AxSpA - no diff bw AS & nr-AxSpA response in same trial https://t.co/Rau2CDYbY4
Eric Dein
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#RNL2024 @RheumNow
@JointMD on AxSpA
SPEED study: roughly 1/2 AS have AxSpA, 1/2 have nr-AxSpA
Are they similar:
- Yes, but r-axSpA less F and more abnml CRP
= Low progression of nr-AxSpA to AS - only 26% progressed in mean 10.6 yrs https://t.co/Vwf5HaMcgu
Nouf Al hemmadi
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Disease activity indices may perform differently in man and women.
@lihi_eder
#RNL2024
@RheumNow https://t.co/8G1D0pGKe8
Nouf Al hemmadi
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Diagnostic delay in SpA
2.3 years longer delay in diagnosis in women with PsA.
@lihi_eder
#RNL2024
@RheumNow https://t.co/d9ao8vvpa5
Nouf Al hemmadi
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Amazing talk by @lihi_eder on sex differences in PsA.
#RNL2024
@RheumNow https://t.co/PW5fYLYmu5
