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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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Opioid Crisis Costs USA $1.5 Trillion

d Jack Cush, MD

Reuters has reported the results of a Congressional report showing the economic toll of the opioid addiction and overdose crisis on the United States reached nearly $1.5 trillion in 2020 alone and is likely to grow.

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JAK Janus

Efficacy and Safety of JAK Inhibitors in Psoriatic Disease

d Jack Cush, MD

There is a growing body of evidence demonstrating efficacy and safety of JAK inhibitors in patients with moderate-to-severe psoriasis and psoriatic arthritis, according to a systematic review in BMC Rheumatology.

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Uncommon Misdiagnosis of Rheumatoid Arthritis

d Jack Cush, MD

Using long-term patient data from the BARFOT study of early rheumatoid arthritis (RA) patients, researchers at the Karolinska Institute have shown that use of the ACR-1987 classification criteria was highly precise.

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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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Dr. John Cush RheumNow ( View Tweet)

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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
#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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Dr. John Cush RheumNow ( View Tweet)
"Double blind" an interesting read (Ann Int Med) of early COVID w/ no known effective therapy, doctor trepidation & and the bravery/will of sick ICU COVID pts as they consent to to enroll in the blinded ACTT trial w/ remdesivir https://t.co/N2bZq0JDmn https://t.co/iPLnNtQoER

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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/Nd9FZKyOHy https://t.co/m9PYofGE04

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Dr. John Cush RheumNow ( View Tweet)
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/5upWNItwGy https://t.co/RMwDYVubOk

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 57 studies, 227,812 RA & 64,290 OP pts. Finds the OP prevalence in RA to be 27.6% (95%CI 23.9–31.3%). Despite significant advances in prevention, treatment & imaging, OP prevalence remain high. https://t.co/SxAJ8cGU8b https://t.co/91D6rtW9bF

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Dr. John Cush RheumNow ( View Tweet)

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