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Axial Psoriatic Arthritis and Ankylosing Spondylitis with Psoriasis
A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis.
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What to do with "no-shows"
A current Medscape article on patient "no shows" in private medical practice examines the cause and approach to the problem.
The most common reason for no shows is lack of knowledge about the scheduled appointment. Here are other common causes of no-shows, and how to address the problem.
Anti-rheumatics drug market accounted for $57 billion in sales in 2018 and is expected to reach nearly $72 billion by 2026, registering a CAGR of 2.9% from 2019 to 2026. https://t.co/X77cx5QM4G https://t.co/eNCvemksWK
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Look-alike Humans identified by facial recognition algorithms identify found to share common genetic sequences such as face trait variants. DNA methylation & microbiome profiles only contribute modestly to human likeness. https://t.co/2KjFAmhPvi https://t.co/RBjHObv2RU
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73 #RA pregnancies w/ live births. 88% were in remission/low disease before conception. RA flares occurred in 37% (in 1st &2nd trim). Preterm assoc w/ Flares; flares more likely if bDMARD D/C @ +Preg test (55% w/ flare vs. 30% w/o flare, p 0.03, OR 2.9) https://t.co/hVtUuX3lfr https://t.co/bFbyQZbcim
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Chinese study of 215 Bx proven #SLE pts - all rx w/ IV CTX+steroids. Responders were given either AZA or leflunomide. Renal outcomes were same w/ LEF or AZA as maintenance. Flares (16% vs 18%), Time to flare (16 v 14 mos), AE, proteinuria https://t.co/Ad7Ec4OPco https://t.co/NoKAgiMKrK
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Survey of 3357 retired Olympians (45 yrs) shows same OA rates as 1735 gen population (41yrs) - #OA in 23% (knee 7.4%, hip, ankle). OA from Injury, age, obesity. Prior knee/hip injury increased OA rates significantly (aOR 1.51/4.03) https://t.co/JwaAidkGG1 https://t.co/30Zm7bDWUG
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Cochrane review of Stem cell transplantation in systemic sclerosis (3RCTs w/ 125 pts). Non‐myeloablative & myeloablative selective HSCT had moderate evidence for improved survival, skin thickness & function. But these had high Serious AE rates. https://t.co/sGzWYLwcAZ https://t.co/7JiR0fe3GY
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JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY
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Study of 209 Early RA (<1yr) pts found 23 (11%) with Drug Free Remission (DFR) after 74 mos of F/U; DFR maintained x 48 mo (18–82). DFR was assoc w/ early persistence on Therapy (HR 3.84). Adhering to prescribed treatment may lead to DFR https://t.co/WAX6RWhToU https://t.co/ChlbHDDKCZ
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Favorable Pregnancy Outcomes in Spondyloarthritis
Pregnancy often occurs in women with axial spondyloarthritis (axSpA), and a recent cohort study suggests outcomes are generally better than what had been reported in the literature.
https://t.co/piAjx1Ugsu https://t.co/N6SGYOM6F1
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Cluster analysis of 649 #GPA patients (age 60 yrs) finds 3 clusters:
1)Limited dz w/ ENT + cough(n=426) - many evovle to gen dz @ yr 1
2) Generalised non-renal Dz (176) )
3) Renal dominant Dz(47)
Mortality in #1, signif lower than mortality in #2 & #3 https://t.co/XgZVt9b73n
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HIgher mortality in thos with lower serum uric acid levels, is partly explained by low SUA assoc w/ sarcopenia and weight loss. NHANES study (1999-2006) of 13,979 people shows low SUA assoc w/ low lean mass, underweight BMI, & weight loss https://t.co/YC2a6eXqCb https://t.co/aZ18jbCcn4
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Rituximab Efficacy in Systemic Sclerosis
The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.
https://t.co/8wWrt8GQ5v https://t.co/CIQKUyngN5
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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 SLE.
https://t.co/PNOp3Zdc8M https://t.co/B8DmUs5iuH
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Gout T2T: Rheumatology societies target urate <5 mg/dl (0.30 mmol/l) or <6 mg/dl (<0.36 mmol/l) - below point of urate saturation -->MSU crystal dissolution. Achieving target reduces flares & tophi; but these clinical benefits take time. https://t.co/bR0vh01mvP https://t.co/JFJ1EWAhoF
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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.
https://t.co/72w2dp9tfc https://t.co/dALeVbzOwo
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NEJM Clinical Images: 74-yoF with psoriatic arthritis has swelling of the fifth finger; found to have nontender, subcutaneous nodules in the hypothenar region and over the fifth finger. https://t.co/9fJ6Ci1rDm https://t.co/IkAKBtPRJ3
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JUNIPERA Study - Secukinumab in Juvenile PsA & ERA
JUNIPERA study evaluated SEC in children with ERA and JPsA and was found to be safe and effective in patients with active ERA and JPsA who previous failed to respond to conventional therapy. https://t.co/ncvG8ZIcdE
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