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Update to Axial Spondyloarthritis Guidance
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MedPage Today
EULAR and the Assessment of SpondyloArthritis International Society (ASAS) has updated their guidance on axial spondyloarthritis (axSpA) management.
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New ACR/EULAR Guideline Expands RA Remission Definition
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MedPage Today
Newly released guidance for defining remission in rheumatoid arthritis (RA) is expected to increase the number of patients achieving it while maintaining its ability to predict good objective outcomes.
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Increasing Prevalence of RA, PsA and AS in the UK
Electronic health record (EHR) database analysis from the United Kingdom suggests an increasing number of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritits (SpA) patients in England.
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Increasing Risk of Lupus Nephritis
Population based study from Minnesota shows that the incidence of lupus nephritis (LN) in the US has increased in the last four decades and that LN patients have poorer outcomes with high rates of ESRD and mortality rates six times that of the general population.
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Pre and post-COVID-19 assessment of 78 FM pts by Fibromyalgia Impact Questionnaire-Revised (FIQR). While COVID affected FM pts, there was no statistically significant change in FIQR scores (65% had no improvement or deterioration on FIQR) https://t.co/S1clBCvzWm https://t.co/ZApmgvKM2c
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2022 ASAS-EULAR Guidelines for Axial Spondyloarthritis
Assessment of SpondyloArthritis international Society (ASAS) and EULAR have published their 2022 update and recommendations for the management of axial spondyloarthritis (axSpA).
https://t.co/oX8oXm0adU https://t.co/JyzT6VxMSQ
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TNF inhibitors Dont Increase Cancer Risk! 4592 RA pts:TNFi Rx (2296) vs matched DMARD Rx (2296) pts. TNFi had a lower cancer risk than DMARD Rx (IR 6.5 vs. 15.6 /1000PYs]). TNFi had Lower HR GI CA (0.432), breast CA (0.146), GU CA (0.220) https://t.co/F5ToHLJULn
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Mayo Clinic Biobank matched case-control study (1:3) of 212 incident RA cases Active work physical activity lowered risk of RA (aOR 3.00), while 3-5 servings high-fat foods, fruits/vegetables lowered risk (OR 0.45; OR 0.54). https://t.co/AAQ1nRfJXq https://t.co/72yLQUllDV
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1915 Rheumatic (RMD)pts w/ COVID (42% RA. 15% SLE, 1/2 comorbidities); Outcomes: 28% hospitalized, 8% to ICU & 4% died from COVID-19. Poor COVID-19 outcomes seen w/ age, male, Hi Dz activity, steroids & RTX, & 1+ comorbidity https://t.co/ztBiJc9nxV https://t.co/RVOKyjseFJ
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Acute Hot Joint? A systematic review of 49 articles, looking at SF & serum markers to distinguish septic vs non-septic joints. They found 8 discriminatory SF tests w/ WBC esterase highest sensitivity (0.94)& specificity (0.74) https://t.co/SamgBwyBrL https://t.co/t9JOiRMMHI
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#Gout clinic study of 223 gout pts on allopurinol ≥300 mg compared Pt & MD gout control assessments (0-10). Better agreement & higher scores seen w/o flares (3 or 12 mos) & SUA w/in target. Disagreement (22%) w/ recent flares & tophi https://t.co/a0WsMLvfYk https://t.co/zZwV4XVJzS
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Metanalysis of emergency department Rx of opioids for MSK pain - 42 articles, 6128 pts - Short term (2hr) benefits of ED opioids were statistically but not clinically more effective than PBO or Tylenol, but not better than NSAIDs. Safety uncertain. https://t.co/Lmf8Ubuacw https://t.co/prP6Ei3wqA
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Will we see you there? #ACR2022
What are you most looking forward to on the agenda? https://t.co/6nUMBmqnTy
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Predictors of serious infection (SIE) in SLE? A prior SIE conferred the highest risk of subsequent SIE. Study of 346 SLE pts shows SIE rate of 3.8/100 Pt-Yrs. Other risk factors:
Damage accrual, comorbidity, Dz activity, CTX use https://t.co/t65XzmFzQG https://t.co/78jiUnaq7d
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https://t.co/QlcUIxqY8A https://t.co/k2ybeeYGz5
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Pregnancy Outcomes with Belimumab
A study of SLE pregnancies exposed to belimumab (BEL) shows and expected rate of pregnancy loss but a variable rate of birth defects.
https://t.co/kybCgu3Rlp https://t.co/ckshcgDZbD
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FDA has approves RINVOQ (upadacitinib) for the treatment of Active Non-Radiographic Axial Spondyloarthritis https://t.co/0HexNAJbtw https://t.co/agSzUVaXSF
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Metanalyses have shown polypharmacy incr risk of dementia. New Wales study of 33,451 dx'd dementia pts. Freq of polypharmacy (3+ meds) grew over 20 yrs before DDx - from 5.5%, to 41%, to 70%, and 82% just before dx of Dementia. https://t.co/2sz38MYeCl https://t.co/WUdFMcmtTQ
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Hyperuricemia is assoc w/ adverse CV events in cardiac pts. ALL-HEART study Rx 5721 ischemic heart pts (no gout) w/ usual care of allopurinol. After 4·8 yrs F/U, there was no difference in cardiac outcomes. No allopurinol benefit in IHD https://t.co/1vS94pDs1B https://t.co/koAGpPrX7H
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Analysis of WHO Safety Vigibase found 625 cases of drug-induced SLE - mostly female (78%), 59 yrs old, w/ half suspecting only PPI. Most common was Omeprazole (30%). Another 800K French database ID 39 pts w/ PPI CLE, half SCLE, 5% DLE https://t.co/vfAArCfWW1 https://t.co/3xQc5NZhvQ
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