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War on RA - Part 3: Useless Drugs
We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.
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Joint Surgery Rates Remain High in Psoriatic Arthritis
The incidence rate of joint surgery among patients with psoriatic arthritis (PsA) has remained persistently high, double that of the general population, according to a new Danish cohort study.
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Partial or Total Knee Replacement for Osteoarthritis?
Lancet has reported on a clinical trial comparing total knee replacement (TKR) and partial knee replacement (PKR) in late-stage isolated medial compartment knee osteoarthritis patients finding that both TKR and PKR are equally effective, PKR should be considered the first, because of lower costs
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Mortality from Falls in the Elderly
JAMA reports that there is a trend of increasing mortality from falls in older US adults between 2000 to 2016 and that mortality rates are increased with increasing age.
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Study Looks at Opioid Use After Knee Surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more
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Knee Injuries Increases Osteoarthritis Risk
A systematic review of the medical literature shows anterior cruciate ligament (ACL), meniscus or combined ACL and meniscus injury significantly increases the risk of future knee osteoarthritis (OA).
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RheumNow Podcast – Medical Selfies (5.24.19)
Dr. Jack Cush Reviews the news and journal articles from the past week on RheumNow.com
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Steroids, Not Biologics, Drive Arthroplasty Infections in RA
Medicare and Truven MarketScan administrative data study (2006 through 2015) of rheumatoid arthritis (RA) undergoing arthroplasty found that while that the risks of perioperative infection was similar across biologics, the infection risk with glucocorticoid use, especially at
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RheumNow Podcast – Take it Back Jack! (4.26.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com
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RheumNow Podcast - Death and Surgery (2-22-19)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com:
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TKR - One or Two at a Time?
His would-be surgeon tried mightily to talk him out of a bilateral knee replacement. At 340 pounds, the patient's BMI -- above 43 -- was a significant contraindication.
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Hip Replacements Lasting 25 Years
Lancet reports that, based on a literature review and metanalysis, patients and surgeons can expect a hip replacement to last 25 years in around 58% of patients.
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Guidelines Recommend Against Acromioplasty
Subacromial pain iacounts for up to 70% of shoulder pain. Patients may be diagnosed with subacromial pain syndrome (SAPS), shoulder impingement, or rotator cuff disease and often end up in surgery.
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RheumNow Podcast - Scurvy and Mechanics (2-1-19)
Dr. Jack Cush reviews new journal articles, news reports, and more from the past week on RheumNow.com.
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Vertebroplasty and Kyphoplasty Shown to Be Ineffective
There are approximately 750,000 new vertebral compression fractures each year in the United States, with resultant acute and chronic back pain in over one‐third of patients with vertebral fractures (VF). Both percutaneous vertebroplasty or balloon kyphoplasty have been advocated as useful m
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Multidisciplinary Recommendations for Rheumatoid Foot Problems
Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems.
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Improved Survival with Renal Transplant in SLE
The Annals of Internal Medicine has published a cohort study of lupus nephritis patients with end-stage renal disease showing that renal transplantation is associated with improved survival benefit, and a reduction in death from cardiovascular disease and infection.
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Steroid Injection Superior to Splinting in Carpal Tunnel Syndrome
Lancet has published a comparative effectiveness study examining the the value of night splints (conservative treatment) vs local injection for patients with carpal tunnel syndrome.
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Low Risk of Serious Complications with Meniscectomy
Lancet reports on the safety of over 1 million arthroscopic partial meniscectomies done in the United Kingdom and found a low overall risk in the first 90 days.
They examined Hospital Episode Statistics on 1,088,782 arthroscopic partial meniscectomies (1997-2017); 699 965 of which were eligible for analysis. They sought to identify complications occurring in the 90 days after the index procedure.
Intensive Patient Education Does Not Improve Low Back Pain Care
JAMA reports on a randomized clinical trial of 202 adults with acute low back pain showing the addition of intensive patient education failed to improve pain outcomes.
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