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ACP/AAFP Guidelines on Managing Musculoskeletal Pain
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line therapy in a new guideline for treating acute, non-low back pain from musculoskeletal injuries in outpatient settings.
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Is Mortality Improving in Systemic Sclerosis?
Systemic sclerosis (SSc) is a progressive autoimmune disorder that causes premature death, usually from lung, GI, or renal disease. While treatment efforts have been frustrating advances in care may have altered the risk of death according to population data showing that while SSc mortality increased from 1968 through 2000, it has declined since 2001.
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Rheumatic Diseases, Drugs and COVID-19 Guidelines
Several recent publications have focused on the risk and outcomes of rheumatic disease (RDD) and autoimmune patients who become infected with SARs-CoV-2.
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Infliximab Use Near Surgery is Safe
Risk factors for perioperative infections include age, comorbidity, rheumatoid arthritis and steroids to name a few; whether concurrent use of TNF inhibitor (TNFI) therapy adds to this risk has been debated. In a study of elderly patients receiving infliximab infusions, infliximab use prior to surgery did not change the risk of post-operative infections.
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Secukinumab Effective in Non-Radiographic Axial SpA
The PREVENT trial was a one year, phase III study that showed significant benefits when secukinumab (SEC) was given to patients with active non‐radiographic axial spondyloarthritis (nr‐axSpA) for 52 weeks.
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ACR Applauds E/M Coding Changes, Telehealth Expansion in CY 2021 Physician Fee Schedule Proposed Rule
The American College of Rheumatology (ACR) today applauded the Centers for Medicare and Medicaid Services (CMS) for taking steps to appropriately value cognitive care and expand telehealth access in its CY 2021 Physician Fee Schedule (PFS) Proposed Rule.
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RheumNow Podcast – Why Do We Love Rheumatology Fellows? (8.7.20)
Dr. Jack Cush reviews why we all love our rheumatology fellows and our best advice for them stemming from these articles.
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Thromboembolic Risk with Tofacitinib in RA, PsA and UC
An analysis of the tofacitinib (Xeljanz) drug development program in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ulcerative colitis suggests a low level risk for venous (VTE) and arterial thromboembolism (ATE).
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Methotrexate Not Associated with Interstitial Lung Disease
A case-controlled study shows that methotrexate (MTX) use in rheumatoid arthritis (RA) is not associated with interstitial lung disease (ILD) according to a report in the European Respiratory Journal.
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IL-1 Blockade: A Treatment at Last for Osteoarthritis?
The interleukin (IL)-1β inhibitor canakinumab (Ilaris) showed promise for preventing the need for hip or knee replacement among patients with osteoarthritis in an exploratory analysis of data from a randomized clinical trial, investigators reported.
Among patients enrolled in CANTOS, the pooled incidence rate for total hip replacement/total knee replacement was 0.31 events per 100 person-years for those receiving the monoclonal antibody every 3 months for up to 5 years compared with 0.54 per 100 for those given placebo, according to Paul M. Ridker, MD, of Harvard Medical School in Boston, and colleagues.
Wearable Technology to Measure Arthritis Outcomes
In this lockdown, virtual medicine, post-COVID world, wouldn't it be ideal to have an reliable digital readout on patient activity as a measure of health?
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Fighting Hydroxychloroquine Misinformation
JAMA Internal Medicine has posted an Editor's note on the use of hydroxychloroquine for COVID-19; noting the sequence of dysfunction since the president promoted its use on March 21, 2020, when he said “What do you have to lose? I’ll say it again: What do you have to lose? Take it.”.
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RheumNow Podcast - Top 13 Rheumatology Centers (7-31-20)
Dr. Jack Cush reviews the news and TOP 13 list of Best Rheumatology Hospitals.
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Colchicine Benefits COVID-19 Patients
A proof-of-concept study published in Annals of Rheumatic Disease suggests that colchicine significantly improves COVID-19 outcomes.
Efficacy and safety must be determined in controlled clinical trials.he outbreak of COVID-19 posed the issue of urgently identifying treatment strategies. Colchicine was considered for this purpose based on well-recognised anti-inflammatory effects and potential antiviral properties.
Methotrexate Improves Pegloticase Efficacy and Tolerability
The efficacy of intravenous pegloticase (PEG) therapy in gout can be limited by its toxicity, but when coadministered with weekly methotrexate, higher response rates and less toxicity was observed.
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The Burden of Gout
Danve and Neogi have an editorial in the current Arthritis & Rheumatology about the burden of gout that affects 41 million adults worldwide, according to the Global Burden of Disease Study 2017 (GBD 2017) also published in the same issue.
This makes gout twice as prevalent as rheumatoid arthritis (19 million). This prevalence of this most common inflammatory arthritis is undermined by numerous challenges in the diagnosis and examples of insufficient disease management. The editorial points out the magnitude of the disease and the many challenges facing rheumatologists.
Serial DEXA May Not Be Advisable
Does repeat bone mineral density (BMD) measurement predict subsequent fracture risk in postmenopausal women?
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SEMIRA Study: Best to Continue Low Dose Steroids in RA
The SEMIRA trial studied the tapering vs continuing oral glucocorticoids in rheumatoid arthritis (RA) patients who achieved a low disease activity state (with tocilizumab) were more likely to show safety and better disease control with continuing steroids - even though two-thirds of patients were able to safely taper their glucocorticoid dose.
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GI Perforations with Tocilizumab Greater than Other Biologics
A study from a Swedish population shows the real-world risk of gastrointestinal (GI) perforations in rheumatoid arthritis (RA) patients taking biologics finds that the risk was greatest in RA patients taking tocilizumab (TCZ), compared with RA patient taking tumour necrosis factor inhibitors (TNFi) and other non-TNFi biologics.
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ACR Advice on Reopening Strategies
The American College of Rheumatology (ACR) has issued a guidance document for rheumatologists and rheumatology health professionals to consider as practices, business and patient care begins to reopen in this next phase of the COVID-19 pandemic.
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