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Great and Not So Great (9.30.2022)
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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COVID-19 Arthropathy and Myalgia
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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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/PPAHocDWBj https://t.co/hZDGOF6r9k
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Dr. John Cush RheumNow ( View Tweet)
Five Senses of Medicine - nice graphic download on Clinical Skils (from Annals of Internal Medicine) https://t.co/8RNpqovtVP https://t.co/FkOSZCtv8c
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Dr. John Cush RheumNow ( View Tweet)
Efficacy and Safety of JAK Inhibitors in Psoriatic Disease
There is a growing body of evidence demonstrating efficacy and safety of JAK inhibitors in patients with moderate-to-severe PSO and PsA, according to a systematic review in BMC Rheumatology.
https://t.co/8Y4V1jUlzo https://t.co/eFqknUfGat
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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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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/ZJsR0R5WNW https://t.co/2GU5aaSwDZ
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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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
Links:
Dr. John Cush RheumNow ( View Tweet)
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
Links:
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
Links:
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
Links:
Dr. John Cush RheumNow ( View Tweet)
Five Senses of Medicine - nice graphic download on Clinical Skils (from Annals of Internal Medicine) https://t.co/zeA0bK2Xpe https://t.co/vCasZmRaOY
Links:
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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Dr. John Cush RheumNow ( View Tweet)
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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Dr. John Cush RheumNow ( View Tweet)
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)