Non-Tuberculous Mycobacterial Infections - Diagnosis and Management for the Rheumatologist

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Non-Tuberculous Mycobacterial infections are among the most frequently reported opportunistic infections in the setting of biologic therapy. While there are hundreds of NTM species, only a minority are clinically relevant. In this review, I'll address important NTM diagnosis and management issues relevant to patients receiving biologic therapy.

The RheumNow Week in Review – 11 August 2017

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The RheumNow Week in Review caps the week's news every Friday. Dr Jack Cush reviews the news, journal reports and important events from the past week in rheumatology.

H1N1 Vaccination Triggers TLR Activation and Autoantibody Production in DMARD-naïve pSS

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Increased morbidity and mortality from infectious causes in patients with autoimmune disorders has led to the overall consensus that vaccination of such patients is important and should be widely promoted in clinical practice.

The RheumNow Week in Review – 4 August 2017

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Dr. Jack Cush reviews new FDA decisions on sirukumab and tofacitinib as well as other news items from the past week on RheumNow.com. 

Pediatric Consensus on Comorbidity Assessments

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Comorbidity is a serious consequence or confounder in patients with inflammatory diseases. This has been well described in both psoriatic and rheumatoid disease.

Lupus Hospitalizations are Common

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Patients with systemic lupus erythematosus (SLE) incur substantial morbidity and complications that may lead to hospitalizations and increased cost of lupus care. Researchers from the University Health Network in Toronto have published a review of SLE hospitalizations showing thta while comm

CDC: Outbreak of Arthrocentesis Related Septic Arthritis Cases in New Jersey

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In March 2017, an outbreak of 41 cases of septic arthritis associated with intra-articular injections administered at an single outpatient practice occurred in New Jersey. A public health investigation identified multiple breaches of recommended infection prevention practices during the preparation and administration of PBP products. The intraarticular injections were done using fluoroscopic visualization. The CDC has reported the results of its investigation.

The RheumNow Week in Review – 28 July 2017

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Dr. Jack Cush reviews the news and articles from the past week on RheumNow.com:

CDC: Pneumococcal Vaccination in Adults

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Streptococcus pneumonia is a leading cause of morbidity and mortality in adults; including patients with autoimmune diseases who are at particular risk.

Lymphopenia and Steroids Increase the Risk of Pneumocystis Jiroveci in Systemic Rheumatic Diseases

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It is well-known that patients with systemic autoimmune diseases are at risk for Pneumocystis jirovecii pneumonia (PJP) and although infrequent, it carries a high mortality. A new study shows lymphopenia and steroid use increases the risk of PJP.

Linkage Between Gut and Joint Immunity in Rheumatoid Arthritis

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Pianta, et al have published their findings in the Journal of Clinical Investigation showing that two novel autoantigens, GNS and FLNA, are highly expressed in synovium and share a sequence homology with gut microbesa; thereby providing a potential link between gut mucosal and joint immunity in rheumatoid arthritis. 

ACR/AAHKS Guidelines on Perioperative Management

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The American College of Rheumatology has partnered with the American Association of Hip and Knee Surgeons to develop consensus-based guidelines for perioperative management of antirheumatic therapies for patients with rheumatic diseases who plan to undergo total joint replacement.

Suspending Methotrexate for Influenza Vaccination

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Vaccinating our rheumatoid arthritis patients against influenza every year is a safety priorty. However immunosuppressive therapies pose a challenge to vaccine administration as their use can hamper vaccine immunogenicity.

The RheumNow Week in Review - 26 May 2017

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Dr. Jack Cush Reviews highlights from the past week on RheumNow.com:

The RheumNow Week in Review – 12 May 2017

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Dr. Jack Cush highlights the big stories, news and articles from this week at RheumNow.com.

Increased Comorbidities in Rheumatoid Arthritis

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A population based study from Taiwan examined the frequencies of comorbidities in a rheumatoid arthritis (RA) population.

The RheumNow Week in Review – 31 March 2017

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Dr. Jack Cush reviews highlights from the news and Advances in Targeted Therapies meeting in Mandelieu, France:

Tweeting this week from Advances in Targeted Therapies #ATT2017 in Mandelieu, France.

Steroids, DMARDs and Biologics have Same Low Risk of Infection During Pregnancy

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Low rates of serious infections were observed in pregnant women receiving immunosuppressive therapies. Higher rates may be seen with steroid use in pregnancy and SIE trend towards lowest with DMARD or TNFi use.