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"Don't You Know Who I am?" (5.17.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?
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Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://t.co/CXdcEdWXhW https://t.co/j0ktehf9Sm
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MGH study compared 1148 acute CPPD vs 3730 controls (mean 73 yrs) found 2 fold more fractures (mostly wrist); 11.7 vs 5.5/1000 PYs (HR 1.8) in pseudogout pts (also had more steroids & OP) https://t.co/HhCV6fYubF https://t.co/3bcbvSzzPo
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RISE study of 700 Pegloticase users (14 mos F/U) found 18% on immunosuppressive (MTX, MMF, LEF), these had signif less PEG D/C (HR 0.52-0.69). Immunosuppressives not assoc w/ more lab abnormalities https://t.co/4ytot7HOMh https://t.co/0wrjvnZur3
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Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD https://t.co/ZkhpzaTjjI https://t.co/e3BO813b30
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Rheum Chapter Notes (4.26.2024)
Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.
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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes
A population-based cohort has demonstrated tha SGLT2i use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients withT2D.
https://t.co/QZ7bt39zEW https://t.co/Wlo9SF0hPF
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Canary in a Coal Mine (4.19.2024)
Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes
A population-based cohort has demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients with type 2 diabetes (T2D).
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Of 375 #Gout pts D/C pegloticase after a median of 8 infusions (taken 112days (max 1,240d). Only 73% had SUA < 6 during pegloticase. After D/C 84% went on ULT (63% allopurinol; 34% febuxostat; after mean 92d); after ≥ 30 days), 51% achieved SUA < 6 https://t.co/unkvt1whrs https://t.co/DgVpBgKXcm
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Burnout or Retire (4.12.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?
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Primary care pop. study pts shows poor health literacy in gout pts assoc. w/ more gout flares. Study of 551pts; 30% w/ 2+ flares in 12 mos; 9.4% w/ poor health literacy. pts had more flares (OR 4.1) & hx of oligo/polyarticular flares (OR 1.93) https://t.co/tDiFqixbLV https://t.co/Kb75iJwTZE
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Pearl: 40% of acute gout attacks will have a normal serum uric acid (that will elevated during intercritical phase) - Draw the lab during and after the attack. https://t.co/CynZOal9jc
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Research on SGLT2 inhibitors in #gout is needed. They have been shown to reduce uric acid & gout flares, and may be uricosuric or be antiinflammatory. Also decreased incident gout (by half) among at-risk patients with type 2 diabetes (HR 0.54) https://t.co/CGG9aFsgoD https://t.co/5O2f3MFL8C
Dr. John Cush RheumNow ( View Tweet)
Research on SGLT2 inhibitors in #gout is needed. They have been shown to reduce uric acid & gout flares, and may be uricosuric or be antiinflammatory. Also decreased incident gout (by half) among at-risk patients with type 2 diabetes (HR 0.54) https://t.co/ZEmhwqyDOv https://t.co/58YKD6pFyt
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4873 gout pts w/ High SUA renally typed: UA overproduct. (ROA 9%); underexcreter (RUE 61%); combined (23%) or normal (7%)
ROL: older, lower SUA, tophi & DM
RUE: lower BMI, No DM
Combined: younger, HighBMI/SUA/eGFR & smoking
Normal: older, Low SUA/eGFR https://t.co/sfcIoR0YTN https://t.co/ulqP6XyKMa
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Naysayers & Disrupters (3.22.2024)
Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.
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Depression and RA
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.
https://t.co/nJZD4D2ByC https://t.co/ET3Xp9cK62
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Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/a3XeAa2lcG https://t.co/dTZa2uQF97
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Depression and RA (3.8.2024)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.
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