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Best of 2022: Allopurinol Safety in CKD Patients
A study in the Annals of Internal Medicine reports chronic kidney disease (CKD) patients can be safely treated with allopurinol without an increased risk of mortality.
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Best of 2022: Emerging Therapeutics for Lupus
Impressive data on novel treatment for SLE were presented at the EULAR22 Congress. A disease that is difficult to study due to its pleomorphic presentation, unpredictable disease course, and high mortality rates, SLE is considered the dragon of all autoimmune diseases. Here are highlights of four exciting abstracts presented at the meeting with emerging therapeutics designed to slay the beast.
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Drugs causing Scleroderma (DASSc) - Anticancer rx made up 42% DASSc & 62.3% case reports. Included: taxane-based agents, bleomycin, vinblastine, imatinib, dacarbazine, pembrolizumab pemetrexed; also HRT romiplostim & eculizumab https://t.co/jPNIuaYdnJ https://t.co/efZG5kG2Yd
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2 open-label reports of JAK inhibitors in Systemic sclerosis (SSc) - 59 SSc pts: significant decr in mRSS in 88%. 28/29 w/ ILD had no progression. Overall responses better in treatment naïve SSc patients. 20% had side-effects. More studies needed https://t.co/zjxZtTFnlS https://t.co/XTwip2wv1n
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Rituximab Efficacy in Systemic Sclerosis
The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.
https://t.co/cqlVo104Y9 https://t.co/dYgBsj65BJ
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AVOID THE WEEKEND! Study of high-impact rheumatology journals (Rheumatology, J Rheum, & Seminars A&R) shows higher risk of "desk rejections" by editor (avoiding peer review) for manuscripts submitted Saturday (OR 1.23) or Sunday (OR 1.13) https://t.co/rWIkiYgh8Y https://t.co/kPSJmfWSUl
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Treatment of pyoderma gangrenosum is clinically empiric. Full read ref w/ Graded Rx Recommendations:
- 1st line: Steriods or Cyclosporin
- Consider biologics: TNFi, IL-1, IL-12/23, IL-17, IL-23
- Others: MTX, MMF, AZA, Dap, colchic, thalidomide, IVIG
https://t.co/z0XeT0ja45 https://t.co/fWAcryIDJR
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Women Heroes in Rheum:
- Barbara Ansell - JIA
- Nanna Svartz - SSZ
- Gertrude Elion - Nobel Prize for allopurinol, AZA
- Tsai-Fan Yu - gout Rx
- Mary Betty Stevens - lupus & vasculitis
- Marian Ropes - 1st F ARA president
- Fionula Brennan - TNFi
& more
https://t.co/FDRORJ7c1q https://t.co/ZebVagIyQA
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Dr. John Cush RheumNow ( View Tweet)
Best of 2022: Was this a Mistake? HCQ Dose Reductions per AAOS Guidelines
https://t.co/Swf5kq6VtG https://t.co/UTIaCFpAX6
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Good review of Diagnosis and Treatment of Pulmonary Sarcoidosis in JAMA.
- Lung progression (in only 10%) assoc w/ 12-18% 5yr mortality
- Sx Sarcoid w/ Lung: start Pred 20 to 40 mg/d for 2 -6 wks
- Steroid sparing w/ MTX, AZA or TNFi
https://t.co/aVnUXaj0sj https://t.co/JN142hlR6g
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Dr. John Cush RheumNow ( View Tweet)
Approximately 61% of patients with rheumatoid arthritis or psoriatic arthritis who use methotrexate report side effects following weekly dosing, including fatigue and nausea, according to data published in Rheumatology and Therapy https://t.co/k7hhdbIhW1 https://t.co/GiaihMGnWK
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Full read review of advances in bone biology leading to drug development (denosumab, romosuzumab, Burosumab), advances in Pagets and rickets and key regulatory molecules for bone remodeling, RANK, RANKL, OPG, & sclerostin https://t.co/1d6A6MsdbJ https://t.co/IuKEp1PQtr
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Best of 2022: The Enthesitis Challenge in Psoriatic Arthritis
https://t.co/S7OR6zXTiw https://t.co/Mgy4IcoIZj
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JAMA - Update/Review of Hemochromatosis Dx and Rx.
- 5 gene defects in hepcidin. 95% HFE & the C282Y variant
- 90% are asymptomatic
- Suspicion w/ arthralgias, LFTs, hepatomegaly, cardiomyopathy, 1st degr relative
- Untreated, 9% risk of cirrhosis
https://t.co/LWbIbLITK9 https://t.co/xDpA16K0tm
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Hyaluronic Acid Knee Injections Equivalent to Placebo
In the United States, where over $300 million is spent annually on intraarticular hyaluronic acid injections, yet another study shows such therapy to be no better than placebo.
https://t.co/bBEwpId84L https://t.co/5msGqViTpz
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Drug-Induced Lupus from Proton Pump Inhibitors
A wide range of therapies have been implicated in causing drug-induced lupus erythematosus (DIL); now it appears that proton pump inhibitors (PPIs) can be added to the list of causative drugs.
https://t.co/Jp3oNUhP6c https://t.co/AcC4mM0nLM
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Effect of Intraarticular Steroid Shots on Knee OA Outcomes
In patients with osteoarthritis of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.
https://t.co/yqVHPmqzzi https://t.co/k8dMADHg7P
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Dr. John Cush RheumNow ( View Tweet)
JAMA - Update/Review of Hemochromatosis Dx and Rx.
- 5 gene defects in hepcidin. 95% HFE & the C282Y variant
- 90%are asymptomatic
- Suspicion w/ arthralgias, LFTs, hepatomegaly, cardiomyopathy, 1st degr relative
- Untreated, 9% risk of cirrhosis
https://t.co/xFTMqkOMSE https://t.co/CmiokvIGvD
Links:
Dr. John Cush RheumNow ( View Tweet)
Best of 2022: Methotrexate Side Effects
https://t.co/ySFyjwYQPX https://t.co/HjlvUzrG9n
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Dr. John Cush RheumNow ( View Tweet)
#POTS
Postural orthostatic tachycardia syndrome - how it might link to other conditions
https://t.co/Ekn6KtOrC4
#Fibromyalgia #chronicillness #migraine #hypermobility #EDS https://t.co/JX1WDm2KKn
Dr Gurdeep Dulay gurdeep_dulay ( View Tweet)