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Global Mortality Rates for PsA, SpA and Colitis
Global age-standardized mortality rate (ASMR) for 1000000 was for 0.13 for AS, 0.04 for PsA, 0.86 for CD and 0.76 for UC.
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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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Let’s look at the timeline of major discoveries in AxSpA genetics, starting with HLA-B27 in 1972 https://t.co/f3AvYJodQj
ASAS Official_ASAS ( View Tweet)
Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study https://t.co/1fiNgBQUbr looks like lower ab response and drops over 6 mths - boosters important in our patients
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Peter Nash drpnash ( View Tweet)
Global Mortality Rates for PsA, SpA and Colitis
Global age-standardized mortality rate (ASMR) for 1000000 was for 0.13 for AS, 0.04 for PsA, 0.86 for CD and 0.76 for UC.
https://t.co/0cZ9kZsiEM https://t.co/hDHojKBeRQ
Links:
Dr. John Cush RheumNow ( View Tweet)
NEJM - Lupus Pernio in Sarcoidosis - 71 yoM w/ red nodules on his nose, ears, fingers, and toes. The lungs were clear on auscultation. Angiotensin-converting enzyme level of 102. https://t.co/Vy9XQlRVKl https://t.co/wlyx3D9FzC
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Dr. John Cush RheumNow ( View Tweet)
Utility of Repeat ENA Antibody Testing
Repeat serologic testing is not uncommon, but is it warranted? A retrospective study shows that repeated testing for autoantibodies to extractable nuclear antigens rarely changes the result or adds a new diagnosis.
https://t.co/ncXqSMz0Qo https://t.co/FxHKjJsga3
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Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 99 Henoch-Schönlein purpura (HSP) pts complicated by GI bleeding (61 mild; 38 severe). Severe GIB assoc w/ sufmmer Onset, facial rash, HI D-dimer (>0.89 mg/L) & neutrophil-to-lymphocyte ratio (NLR >10.56). https://t.co/sI5LoONWGf https://t.co/ySdswRfkMg
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Dr. John Cush RheumNow ( View Tweet)
Should you do sural nerve biopsy (SNB) to Dx vasculitis? Study of 91 pts undergoing SNB suggests the SNB must be off sufficient length to improve Dx yield. 40/91 (44%) showed vasculitis. +SNB assoc w/ longer SNB sample, other organ Sxs & +ANCA https://t.co/6S00ySj0fL https://t.co/WbY400YsWX
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Dr. John Cush RheumNow ( View Tweet)
More Bad Safety News for Xeljanz
Another analysis of the mandatory postmarketing safety study for tofacitinib (Xeljanz) has confirmed what most observers expected: that rates of infection with the drug in RA are higher than with TNF inhibitors.
https://t.co/iCrEofMjBR https://t.co/wAr1AuNGUw
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Dr. John Cush RheumNow ( View Tweet)
Prospective study of 189 new non-infectious anterior uveitis pts, found a high prevalence SpA (56%), 93% w/ axial SpA, few (7) w/ peripheral SpA. 74/106 were newly Dx SpA. SpA predictors: psoriasis (OR 12.5), B27+ (OR 6.3),^CRP (OR 4.8) & male (OR 2.1) https://t.co/5UvH1oTFTb https://t.co/Zi6hH8q5VY
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Dr. John Cush RheumNow ( View Tweet)
Lilly has announced that Taltz (ixekizumab) is now available as a Citrate-Free Formulation to reduce injection site pain for patients with psoriasis, psoriatic arthritis, spondyloarthritis & nonradiographic axial spondyloarthritis. https://t.co/mTBl9siLED https://t.co/TCFqdK58dA
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Dr. John Cush RheumNow ( View Tweet)
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.
https://t.co/ctEQBEQpMn https://t.co/rLB6z2bhWc
Links:
Dr. John Cush RheumNow ( View Tweet)
Arthritis - a Leading Chronic Condition Among Young Adults (18─34 Yrs)
MMWR from last week focused on chronic conditions in young adults showing they are common, costly, and major causes of death and disability.
https://t.co/cIxmMqUrqK https://t.co/TbVpLXd7Zw
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Dr. John Cush RheumNow ( View Tweet)
CMV 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 CMV infection may be a risk.
https://t.co/K8HzolqLJ9 https://t.co/2VUasoinnL
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Dr. John Cush RheumNow ( View Tweet)
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/qUOfMVSxGZ https://t.co/4icaRdC2EI
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Dr. John Cush RheumNow ( View Tweet)
Of 38 childhood SLE (12-25yrs) pts, 65% were non-adherent to meds. Those taking MMF, 33% had MPA drug level < 1 (nonadherent). 17% non-adherent by pharmacy refills rate. 46% pts c/o side effects; 33% remembering & 25% could not afford. https://t.co/vL6LtYzJWe https://t.co/RAwwg40Lfz
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Dr. John Cush RheumNow ( View Tweet)
Cogan's syndr is a rare autoimmune dz, all ages (20-30s) & races (whites) w/ ocular (interstitial keratitis) & audio/vestibular Sx (deafness, vertigo). Less: HA, fever, myalgias, aortitis, heart. No Dx test; 1/3 have another systemic dz. Rx: steroids https://t.co/e3sstsxO5R https://t.co/CQ3UfBqO0e
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Dr. John Cush RheumNow ( View Tweet)
Study of >1million people/17 countries shows prevalence of NAFLD (fatty liver) to be 32·4% - higher than prev estimates & growing fast rate. Prevalence increased from 25·5% (2005) to 37·8% (2016); NAFLD incidence is 46·9 cases per 1000 person-years https://t.co/npESZ2YWgd https://t.co/podfxma5vo
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Dr. John Cush RheumNow ( View Tweet)
Network metanalysis & review looked at Biologics & remission in Crohns disease (25 RCTs; 8720 pts). -Compared to PBO Rankings were #1) infliximab 5 mg/kg (RR=0.67), #2) risankizumab 600 mg, #3) upadacitinib 45 mg. RIZ was 1st in biologic-naïve pts https://t.co/JFTEpqSJ6c https://t.co/65vbZkLmpC
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Dr. John Cush RheumNow ( View Tweet)