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Great and Not So Great (9.30.2022)

d Jack Cush, MD

This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.

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coronavirus,COVID,MISC,mask

COVID-19 Arthropathy and Myalgia

d Jack Cush, MD

An online survey of random COVID-19 infected persons shows that arthralgia and myalgia are common consequences to COVID-19 infection.

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Lasker,award,science,biomedical

2022 Lasker Award Winners

d EurekAlert!

The Lasker Foundation has announced the winners of its 2022 Lasker Awards, widely regarded as America’s top biomedical research prize since its creation more than 75 years ago. Here's a look at the award winners and their important contributions to biomedical research.

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Study of 67 OA TKR pts looked for CPPD - defined as "appears as linear/punctate opacities w/in cartilage, synovium, Jt capsule or tendons/entheses". Xrays had specificity of 92%, sensitivity 54%, PPV 88%, NPV 66% (needs to be distinguished from BCP) https://t.co/i0ZagblzPZ https://t.co/CiusWPzjrK

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Are We Overcautious With TNF Inhibitors in Pregnancy? What may seem like a prudent approach to treatment of IBD in pregnant women actually represents an overabundance of caution, suggested researchers who found no increased risk from TNF inhibitors. https://t.co/gYqJDBHTBQ https://t.co/aBXl49wJzM

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Long term results of KEEPsAKE 1 and 2, RCTS of SKYRIZI (IL-23 inhibitor) in active #PsA pts were presented at EADV mtg in Milan. At wk 100, showed more than half of PsA patients achieved PASI 90 & ACR 20 responses. https://t.co/ZJsR0R5WNW https://t.co/2GU5aaSwDZ

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IL-18 is a proinflammatory cytokine involved in innate &adaptive immune responses. IL-18 is a key mediator in autoinflammatory diseases, MAS, Still’s disease. Serum IL-18 levels may be useful in diagnosis and monitoring of disease activity https://t.co/P8ecLAtNx5 https://t.co/3mo1vcYKUr

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Cancer Risk with Scleroderma Spanish Scleroderma Registry examined a large cohort of systemic sclerosis (SSc) patients showing an increased cancer risk, especially breast, lung, hematologic and colorectal cancer. https://t.co/2sCI6AejRn https://t.co/estX9D39tZ

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Is PMR the Next Indication for Tocilizumab? About half of patients with steroid-dependent PMR were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, a randomized phase III trial showed. https://t.co/fe8d6LNMOh https://t.co/RLhnaEPOVK

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This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow. https://t.co/8hICpPVC8b https://t.co/GDHaBb6fFC

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A Rheum & Derm Conversation on Treating PsA and Moderate-to-Severe PsO Sponsored by Lilly USA Listen to Drs Mease and Armstrong discuss a multidisciplinary approach and important considerations when treating patients with joint and skin concerns. https://t.co/ZAVA83QNa3

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2 open-label reports of JAK inhibitors in Systemic sclerosis (SSc) - 59 SSc pts: significant decr in mRSS in 88%. 28/29 w/ ILD had no progression. Overall responses better in treatment naïve SSc patients. 20% had side-effects. More studies needed https://t.co/JtaBxVjoak https://t.co/k34P6SjC6L

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Proposed modified SRI (SLE Responder Index) - Reduction in SLEDAI-2K ≥4 (w/ no worsening in MD global (PGA) ≥0.3). mSRI responders had signif lower Dz activity & pred dose, More LLDAS & remission, less damage accrual (p<0.001) https://t.co/lwsZpnRz3l https://t.co/V7pDYswM7b

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Five Senses of Medicine - nice graphic download on Clinical Skils (from Annals of Internal Medicine) https://t.co/zeA0bK2Xpe https://t.co/vCasZmRaOY

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Interesting read on "The art of paying attention" Narrative medicine: "attention, representation, and affiliation" “noticing the words we usually ignore” “taking the temperature of the conversation.” “meta-questions”, like “How are we doing so far? https://t.co/Pvx2GOQTgd https://t.co/wswf7Enaie

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Be wary when you seen new drugs described as “cutting edge,” “game changing,” and “ground breaking” - as this is more likely advertising than reality. https://t.co/oB9xDFqCg6 https://t.co/wfVyR0P4bS

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RCT of allopurinol in 183 #gout pts. After 6.5 yrs 30% (60) were dead. Survivors 82% Rx w allopurinol, 4% febuxostat, 8% not on ULT. Urate levels only available in 72%!! & only 58% achieved SU T2T <6 mg/dl (<0.36 mmol/L) Dont you think we should do better? https://t.co/NwS6I2A9M8 https://t.co/xvarJQJG2N

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Joint Flares extend disease & show joint specific memory. Study of 95 JIA pts, 12.5 yrs F/U: 95% got to inactive dz, 81% flared 1+ times. 74% flares in prior joints, usual side 83%, contralateral 17%, 40% new Jt; more likely off meds https://t.co/20UEtZXUIW https://t.co/yDt7WXvkB0

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Uncommon Misdiagnosis of Rheumatoid Arthritis Using long-term patient data from the BARFOT study of early RA patients, researchers at the Karolinska Institute have shown that use of the ACR-1987 classification criteria was highly precise. https://t.co/aHI0KW35Q2 https://t.co/Nk0vRNGYBI

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#Gout Guidelines--> great outcomes! French study of 300 pts; 95% followed French Rx Guidelines, T2T SU < 6 mg/dL in 59% @6mos, 79% @24 mos & @2 yrs hald were Rx w/ allopurinol (313 mg/d) and 48% febuxostat (84 mg/d) https://t.co/iQ9NvHJXd8 https://t.co/2tkBWrHY32

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