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ACR 2020 Reproductive Guidelines - Lactation Guidance
In this third excerpt from the ACR guidelines on managing reproductive health issues in rheumatic disease patients, we present recommendations regarding the use of glucocorticoids and guidance on lactation and medication use post-partum.
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RheumNow Podcast – To Celiac Test or Not? (9.4.20)
Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:
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Treatment Options for Extraintestinal IBD
Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation. A recent review in GUT details the treatment options for patients with EIM.
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Steroid Bursts and Adverse Events
Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy.
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RheumNow Podcast – Rheum Lives Matter (8.28.20)
Dr. Jack Cush reviews the news and journal articles from the past week. Of mice and men in cartilage, the efficacy of JAK inhibitors in patients who are having skin problems, nrAxSpa has its own diagnostic code, metformin, talking about Back Talk, plus so much more.
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Update on Polymyalgia Rheumatica and Giant Cell Arteritis
JAMA has published a clinical update of recent studies on GCA. While PET/CT scanning are novel means of demonstrating activity, they have not changed the diagnostic approach to GCA or PMR and although there are no new proven treatment strategies for PMR beyond glucocorticoids, the FDA has approved tocilizumab as a first-line glucocorticoid-sparing agent.
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Canakinumab Tapering in Still's Disease
You can reduce - but not stop - canakinumab therapy in patients who are in complete clinical remission in children with systemic juvenile idiopathic arthritis.
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RheumNow Podcast - The SARS-CoV-2 Update (8-14-20)
Dr. Jack Cush updates the news and journal articles from the past week on RheumNow.com, with information on enthesitis, nr-Ax-SpA, UAB, Blockbuster Rheum Drugs and use of ACE inhibitors.
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Rheumatic Diseases, Drugs and COVID-19 Guidelines
Several recent publications have focused on the risk and outcomes of rheumatic disease (RDD) and autoimmune patients who become infected with SARs-CoV-2.
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Long-Term Rituximab in ANCA-Associated Vasculitis
The Annals of Internal Medicine reports that biannual rituximab infusions over 18 months was effective at maintaining remission in patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV).
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Methotrexate Not Associated with Interstitial Lung Disease
A case-controlled study shows that methotrexate (MTX) use in rheumatoid arthritis (RA) is not associated with interstitial lung disease (ILD) according to a report in the European Respiratory Journal.
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Uric Acid Targeting in Gout Management
A study from 2 gout clinics implementing different treatment strategies has shown that a treatment strategy that aims to strictly achieve low uric acid (UA) results in a higher a rate of targetd serum UA lowering and less gout flares.
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Methotrexate Improves Pegloticase Efficacy and Tolerability
The efficacy of intravenous pegloticase (PEG) therapy in gout can be limited by its toxicity, but when coadministered with weekly methotrexate, higher response rates and less toxicity was observed.
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SEMIRA Study: Best to Continue Low Dose Steroids in RA
The SEMIRA trial studied the tapering vs continuing oral glucocorticoids in rheumatoid arthritis (RA) patients who achieved a low disease activity state (with tocilizumab) were more likely to show safety and better disease control with continuing steroids - even though two-thirds of patients were able to safely taper their glucocorticoid dose.
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RheumNow Podcast – COVID-19 Responds to Steroids (7.24.20)
Dr. Jack Cush reviews the News and Journal Reports from the past week on RheumNow.com.
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Steroids and Tocilizumab in Cytokine Storm Syndrome
A recent study from the Netherlands has shown that patients with severe COVID-19-associated cytokine storm syndrome (CSS) with high dose steroids and tocilizumab had a faster recovery, less need for invasive mechanical ventilation and fewer deaths when compared to CSS patients receiving supportive care only.
They studed COVID-19 patients with CSS, defined as rapid respiratory deterioration plus at least two of the following biomarkers: a) C-reactive protein >100mg/L; b) ferritin >900 µg/L; or c) D-dimer >1500 µg/L.
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