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Heavy Metal Rheumatology (9.23.2022)
Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.
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Clinical Profiles Seen with NXP-2 Antibodies
A recent review of the myositis associated autoantibody NXP-2 profiles its clinical associations with dermatomyositis (DM), calcinosis, severe myositis and, in some reports, with cancer.
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Does Methotrexate Use Lead to Melanoma?
A systematic review suggests that low-dose methotrexate (MTX) use is associated with an increased melanoma risk, but the absolute risk increase could be considered negligible.
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Disease Activity Drives Adverse Pregnancy Outcomes in RA
Two large RA registries have shown that pregnancy outcomes in rheumatoid arthritis (RA) patients is more related to RA disease activity rather than treatments use to control RA.
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Does Fibromyalgia Need B12? (9.9.2022)
Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.
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Pirfenidone Potential in RA-Related Lung Disease
Rheumatoid arthritis patients with existing interstitial lung disease (ILD) had less decline in lung function when receiving the antifibrotic agent pirfenidone (Esbriet) relative to placebo in a randomized trial, researchers reported here and in a simultaneous journal publication.
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Voclosporin Efficacy and Safety in Lupus Nephritis
An integrated analysis of two pivotal trials of voclosporin, a calcineurin inhibitor, in lupus nephritis patients saw significant improvement in complete renal responses (CRR) at one year.
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Goofy But True
Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on RheumNow.com.
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Genetic Testing for Autoinflammatory Disease
Not all patients with periodic fevers fit neatly into diagnostic categories. Some can be diagnosed as Still’s disease (based on criteria) while others can be classified as autoinflammatory diseases (AID) and some may be unclassifiable, clinically or genetically.
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EULAR/ACR Classification in MDA5+ Myositis Patients
The diagnosis of idiopathic inflammatory myopathies (IIMs) can be informed by the 2017 EULAR/ACR classification criteria, but their utility in patients with clinically amyopathic dermatomyositis (CADM) and anti–melanoma differentiation–associated protein 5 (anti–MDA-5)–positive IIM
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NICE Guidelines on Gout Diagnosis and Management
NICE (UK) has systematically reviewed current medical evidence and delivered a set of recommendations with consideration of cost effectiveness.
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Disease Activity Scoring in Adult-onset Still's disease
Still's disease in adults (AOSD) or children (sJIA) can have dramatic symptom severity, making it easy to gauge disease activity and response to therapy, especially at the outset. However, a validated measure of disease activity has not been agreed (for clinical trial and treatment assessments). A new study compares two such activity measuresin a large cohort of Still's patients.
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Bullous Systemic Lupus Erythematosus
Bullous systemic lupus erythematosus (BSLE) is a rare blistering cutaneous manifestation of systemic lupus erythematosus (SLE).
As goes SLE, bullous disease typically affects women, especially those of African descent.
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Managing JDM with Calcinosis
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.
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Low Dose IL-2 Therapy in SLE
A multicentre, proof-of-concept trial of suggests that low-dose IL-2 therapy may be effective in moderate-to-severe systemic lupus erythematosus (SLE).
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Drug-Induced Lupus from Proton Pump Inhibitors
A wide range of therapies have been implicated in causing drug-induced lupus erythematosus (DIL); now it appears that proton pump inhibitors (PPIs) can be added to the list of causative drugs.
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Black Adults Have a Higher Gout Risk
In a cross-sectional study of US adults, gout was more prevalent in black adults compared to white adults; possibly explained by sex-specific dietary differences and social determinants of health and clinical factors.
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Hit Parade Review (8.12.2022)
We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on popularity, measured by rheumatologist engagements on the website and social media.
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Cytomegalovirus Increases Thromboembolism Risk in ANCA-associated Vasculitis
Infection may play an important role in the genesis of vasculitis and ANCA seropositivity; this report suggests that past cytomegalovirus infection may be a risk in the occurrence of venous thromboembolism (VTE) in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis.
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ASBMR 2022 study shows Patients w/ serum ferritin > 1000 µg/L or Dx hemochromatosis or thalassemia — were 60% more likely to have an osteoporotic fracture (2X risk vertebral Fx) during an up to 10-year follow-up https://t.co/uLf8zTiMml https://t.co/9KnApUxxTF
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