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ICYMI: Carpal Tunnel - Steroid injection vs. Night Splinting

d Jack Cush, MD

A prospective, pragmatic, open-label, randomized trial conducted by the UK National Health Service, studied interventions in patients with carpal tunnel syndrome (CTS) and found no advantage to either CTS corticosteroid injection (CSI) or night splinting (NS) as the initial treatment of CTS.

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ICYMI: New Laboratory Insights for the ANA+ Consult

d Jack Cush, MD

A new study suggests that use of ELISA assays for CXCL-10 and IFN-α can predict which ANA+ individuals may progress to developing a systemic autoimmune rheumatic disease (SARD).

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ICYMI: RA Disease Activity and Alcohol Use

d Jack Cush, MD

Despite its well known toxicities, alcohol is known to be antiinflammatory. The effects of alcohol use in rheumatoid arthritis (RA) is less known, but a recent study suggests that alcohol consumption was dose-dependently associated with lower disease activity and higher health-related quality of life in RA patients.

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RT @Janetbirdope : #Top #EULAR learnings #SLE #recommendations 1 Limit #prednisone 2 use #biologics early if poor prognosis 3 #lupus #nephritis - treat early with #belimumab or #voclosporin and more Rx in #RCTs #gamechanger

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Metanalysis of 62 RCTs, 16 LTEs, 82 366 Pt-Yrs JAK exposure. JAKi malignancy incid rate = 1.15/100 PYs in RCTs (1.26/100PYs overall). Network meta-analyses show no diff betw JAK & PBO or MTX in NMSC, but signif increased malignancy risk (IRR 1.50) https://t.co/ANa7zYmhPx

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JAK inhibitors have been effective in refractory inflammatory myositis, all open label, but no controlled trials. #EULAR2023

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Treatment of IIM, MTX or AZA or IVIG are 1st line (with steroids). #EULAR2023 https://t.co/0B1zzeqm1L

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Check SSc-ILD Patients on Nintedinib for Malnutrition During nintedanib treatment for interstitial lung disease associated with SSc-ILD, clinicians prescribing the drug should be watchful for an unusual, indirect side effect, trial data suggested. https://t.co/TmN71qSCb2 https://t.co/TVU2qcPdZE

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2022 of fibromyalgia Year in review discusses possible causes (inflammation, gut dysbiosis, neuroinflammation), new Rx (kinin antagonists, neurostimulation, mind-body Rx; but more needed on ketamine, vitamin D, and hormonal therapy https://t.co/sya8fSCbFX https://t.co/F2HDcp2XYb

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Paradoxical PsO (PP) studied in 2867 RA & 5316 SpA pts. 136 (1.7%) had paradox. Rxn, median 12 mos post TNFi [pustular (60%) or palmoplantar (31%)]. 73% PP favorably switched to other TNFi 46% or non-TNFi 27%. RA PP took SSZ, HCQ, LEF; SpA PP more smokers https://t.co/w1EQEvHbeG https://t.co/aAwKxdNYk1

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Paradoxical Psoriasis in Kids Taking TNF Inhibitors A multicenter cohort study reported a large cohort of pediatric patients receiving TNF inhibitor therapy complicated by psoriasis, regardless of treatment indication or the specific TNF inhibitor. https://t.co/9WxkAt8NnS https://t.co/sGvb1eZWE0

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TitAIN Study: Secukinumab Efficacy in Giant Cell Arteritis A phase 2 trial has demonstrated the efficacy of secukinumab, an anti-interleukin-17A monoclonal antibody, in patients with active giant cell arteritis (GCA). https://t.co/rmYBXBV3RP https://t.co/q1CfhuGSj7

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Belimumab in adult inflamm myositis (IIM)? Small study 15 IIM pts recv ≥ 5 doses of belimumab or placebo; Treatment success (TIS ≥ 40) was more common with BEL (55% vs 33%) as was defined improvement (DOI: 33% vs 17%); not signif, but interesting! https://t.co/3xL0ylJbcs https://t.co/Oerf0yI4Jg

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FDA has approved a 2nd JAK inhibitor for Alopecia areata - Pfizers Ritlecitinib (Litfulo) is approved for Adults and Adolescents (>12 yrs) With Severe Alopecia Areata (based on ALLEGRO trial, pub in Lancet) https://t.co/Uods58glJG https://t.co/Uods58glJG https://t.co/syCqnG6sLg

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PRE-CLINICAL RA: What do you need to better manage pre-clinical (at-risk) Rheumatoid arthritis Patients? Rheumatologists vote here >>https://t.co/lt38vJMEIA

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RheumNow’s new Poster Hall features sponsor-generated clinical trial posters designed to educate and inform. Posters addressing vasculitis, AxSpa and nrAxSpa, and PMR now available. https://t.co/38foNET3j4 https://t.co/8CjXwzyGab

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In pts seeking care for MSK pain cannot assume that improving pain/function will result in improved depression, but substantial improvements are required to effect anxiety. Study of 11 236 Ortho pts in JAMA https://t.co/5vvoPs31GU https://t.co/gEwZNW35xB

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Study of FDA review times for New Indication Approvals of Drugs and Biologics (2017 - 2019) finds FDA approved 107 drugs for 146 new indications [99 small molecules (68%) & 47 biologics (32%)]. Median regulatory review time was 6 mos (IQR, 6-10) https://t.co/3P6T4R4FCF https://t.co/avl65W3kvr

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UK MHRA reminder that NSAIDs are: - contraindicated in the 3rd trimester of pregnancy (>28wks) - >20 wks - assoc w/ increased risk of oligohydramnios & fetal renal dysfunction MDs should avoid NSAIDs in pregnancy after wk 20 https://t.co/u3fTnuoF17 https://t.co/b2b5XThe1i

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Predictors of Cardiovascular Events in ANCA-Associated Vasculitis A large, retrospective, multinational study of patients with ANCA-AAV shows they may be at risk for CVEs. https://t.co/k9XPolEXKc https://t.co/0nxai3Eqe2

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