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Substandard Therapy in Rheumatoid Arthritis
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Medpage Today
Clinicians could improve outcomes in their patients with rheumatoid arthritis (RA) by paying attention to certain markers of care quality, such as early referral to certified rheumatologists and prescribing standard drugs for RA, new research suggested.
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2022 ACR/EULAR Giant Cell Arteritis Classification Criteria
Giant cell arteritis (GCA) has historically been a clinical diagnosis (visual loss, headache, jaw pain, scalp tenderness, etc) supported by labs and histopathology.
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From a cohort of 689 SLE pts, prevalence of lupus pericarditis was 16.4% Pericarditis was signif assoc w/ renal dz (p 0.003), lymphopenia (p <.0001), thrombocytopenia (p 0.004), +APL Abs (p = 0.002) https://t.co/BndDu21aXF https://t.co/Umbq3rsF1y
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207 JIA pts to rheumatology studied. Initially 61% seen by Pediatrics but only 28% referred to rheumatologist. Mean time to Dx was 56 days, but longer for polyarticular & ERA/SPA (~114 d). Faster dx w/ Younger age & fever; longer w/ sm jts https://t.co/5D8wiGxnC2 https://t.co/1n9S4JUdfF
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Retrospective study in RA shows Red cell distribution width (RDW) & absolute lymphocyte count (ALC) predict 10 yr mortality (P < 0.001); highest with both high RDW and low ALC. Data developed on 327 VA RA pts & validated on national cohort (13,914) https://t.co/aBGECUfKGH https://t.co/qkvv1PmvSB
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Review of the Rheumatic causes of Pericarditis and their management. Causes: SLE, RA, MCTD, Myositis, EGPA, GPA, IgG4-rel Dz, FMF, TRAPS, CAPS, AOSD, JIA, Sarcoidosis, Kawasakis, GCA, Takayasu's https://t.co/h6zpTOIuyu https://t.co/Gy3Eaqz8sM
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Study 119 SLE pts w/ SLEDAI-2K of 13.5 @Dx & 2.8 @ 1st birth. Half had 1+ flares at mean of 9 mos after birth. Pts in remission had less flares (37% vs 61%; p=0.008). SLE flares during pregnancy had more flares in F/U (76% vs 47%; p=0.019) https://t.co/3u3agu9wDj https://t.co/twj4YYclRz
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Inflammatory Arthritis and Hidradenitis Suppurativa
Aa 2021 meta-analysis of 7 studies (200,361 HS patients and 385,599 controls), showed that HS patients have an increased risk for inflammatory arthritis (OR 3.44; 95% CI, 1.92–6.17)
https://t.co/JQqosM26fZ https://t.co/bXr1SSeo3p
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Dr. John Cush RheumNow ( View Tweet)
Rheumatology was one of 6 specialties to fill > 95% during fellowship Match in 2022. Rheum filled 96.9% of 127 programs & 97.8% of 265 spots with 40 US foreign applicants (15.1%), 123 MD grads (46.4%), 66 foreign (24.9%), & 36 DO grads (13.6%) https://t.co/EqfCbkxEbS https://t.co/c12m5FrAll
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Syphilis has risen 5 fold since 2001, 38 992 cases, or 11.9 per 100K in 2019. The USPSTF recommends screening in persons at increased risk. Most labs rec “reverse sequencing” w/ automated treponemal test (eg EIA), instead of RPR or VDRL1st https://t.co/vL2rkP2rO1 https://t.co/FAcijAl8LB
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Dr. John Cush RheumNow ( View Tweet)
Tight control of proteinuria in newly diagnosed lupus nephritis
The last 3 years have been exciting times in the field of lupus nephritis (LN) with two new licensed therapies, belimumab (BAFF-inhibitor) and voclosporin (calcineurin-inhibitor).
https://t.co/InkX6I7qUm https://t.co/U1M1DtF8Id
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Dr. John Cush RheumNow ( View Tweet)
Inadequate Dosing of Hydroxychloroquine Leads to Hospitalizations in SLE
https://t.co/ZktIKo1eVl https://t.co/dtxVXZFXpk
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Xeljanz Cancer Risks Detailed
The degree to which the oral rheumatology drug tofacitinib (Xeljanz) seems to promote new malignancies is now fleshed out in the latest, and at least somewhat reassuring, report from a landmark safety study.
https://t.co/4dNRsNP7IJ https://t.co/KOjJudfdcw
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Bimekizumab Efficacy in TNF-Refractory PsA
Bimekizumab, a selective inhibitor of IL-17F and IL-17, has shown superior efficacy and safety in a 16 week trial in patients with active PsA who previously failed therapy with TNFi inhibitors.
https://t.co/78whpnLkhd https://t.co/yxwSGR3hTV
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Dr. John Cush RheumNow ( View Tweet)
3388 pts in J Hopkins Scleroderma study found 29% w/ calcinosis (13.5% these w/ heavy burden calcinosis/HBC). Calcinosis assoc w/ diffuse SSc, disease severity (PH, ILD, CVD, GI, renal crisis, myopathy)(OR 2.9- 6.9) & PM/Scl Abs (OR 17.31) https://t.co/VsRDg5Utik https://t.co/AMqHUveJ6e
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Dr. John Cush RheumNow ( View Tweet)
Top 10 Pharma Revenues 2021:
1 J&J $93.77 billion (USD)
2 Pfizer $81.29 B
3 Roche $68.7 B
4 AbbVie S$56.2 B
5 Novartis $51.63 B
6 Merck $48.7 B
7 BMS $46.4 B
8 GSK $43.57 B
9. Sanofi $44.67 B
10. AstraZeneca $37.47 B
https://t.co/UBVjw2xBUF https://t.co/3MhhQzdyxG
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Review of 120 pts w/ Catastrophic antiphospholipid syndrome showed that 54% had skin involvement & was 1st APS sx in 35%. Findings: livedo racemosa (45%), necrosis/ulcers (42%), splinter hemorrhages (29%), distal edema (23%), purpura (14%). https://t.co/HsVWlebfL2 https://t.co/dixoeHNkFQ
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The Top 10 Research Priorities in Psoriatic Arthritis
A survey of 317 carers and clinicians focused on psoriatic arthritis has set an agenda of the top 10 research questions for psoriatic arthritis (PsA).
https://t.co/qvcB3OkJUS https://t.co/EuD3qhOb5a
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Why treatment of pre-RA isn't ready for prime time
The ACR Great Debate was on "To treat or not to treat in pre-RA?" and it was stressed that autoimmunity may start well before clinical symptoms occur.
https://t.co/TcKRc0w4i9 https://t.co/OkmlxTiAbm
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Dr. John Cush RheumNow ( View Tweet)
Spondyloarthritis: Novel Therapies, Diagnostic Dilemmas and Depression
Dr. Lianne Gensler ( @lianegensler discusses the following abstracts presented at #ACR22. Abstracts 1597, 1598, 1599 (treatment) and 1613, 1609 and 1614 (diagnosis and outcomes)
https://t.co/f7o8UARKNl https://t.co/ryVmD86UoI
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Dr. John Cush RheumNow ( View Tweet)
