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The Inflammation Reflex (5.20.2022)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.
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Biologic Persistence in Psoriatic Arthritis and Psoriasis
Two recent studies examined the durability and persistence of biologic agents in patients with psoriasis (PSO) and psoriatic arthritis (PsA) and while some differences were noted overall persistence was low 3 years later.
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Inflammatory Arthritis Spread by ATP and Neural Crosstalk
A novel study from the Journal of Experimental Medicine suggests that a reflex neural signaling at sites of inflammation may lead to spread to other inflammatory sites via and ATP-mediated neural crosstalk.
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Wiki Guidelines Approach to Pyogenic Osteomyelitis
https://t.co/4HD60dbPkk https://t.co/t4xHSWKXys
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Data from Scleroderma Lung Study (CTX vs MMF in PSS) shows that early progression of ILD by CXR scoring (≥ 2% at 12 or 24 months) experienced significantly worse long-term survival than those with stable Xrays (P = .014). https://t.co/hv2WNJ4Chr https://t.co/W5RIhoIGtT
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Multimorbidity Burden in Rheumatoid Arthritis
Crowson and colleagues at the Mayo Clinic have shown that rheumatoid arthritis (RA) patients have a higher prevalence of multimorbidity with as many as 44 different morbidities of interest in RA.
https://t.co/O5U6VXalwa https://t.co/BzXyMGz0ms
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Many have quoted and shown this image of Ankylosing Spondylitis in a young military recruit at age 25, 35, 45, 50 & 51yrs. This may be the MOST used slide in rheum! It comes from the work of Toronto's Dr. Hugh Little, who sadly passed away at age 58 yrs. https://t.co/e3Zf1OUqtX https://t.co/zOhnQf3ep9
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Rising Incidence of Systemic Lupus Erythematosus
Data from Olmstead county, MN over the past four decades shows that the incidence and prevalence of systemic lupus erythematosus (SLE) is increasing.
https://t.co/GUakRwwWQw https://t.co/LPnVMTT8Ro
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Join us on May 24 at 7pm for Tuesday Night Rheumatology: RA - Best Management
We’ll focus on:
Drug Cycling Vs Switching in RA
Janet Pope, MD, MPH, FRCPC
Multimorbidity in RA
Elena Myasoedova, MD, PhD
Preventing RA
Karen Costenbader, MD
https://t.co/Vc5uECptIo https://t.co/fu3qACdHkL
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Watch: The Music of Rheumatology with Dr. Ronan Kavanagh
What does music have to do with rheumatology? Quite a lot, actually.
https://t.co/R9n0vEYB2J https://t.co/M8Jpg1g6QI
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Relevance of Raynaud’s in Systemic Sclerosis
A recent analysis suggests that RP should be characterized based on color change and the presence of other symptoms to know whether RP portends more serious manifestations.
https://t.co/rLo6Ju5LV1 https://t.co/gAQAYxe9rL
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Israel study of 171 kids w/ MIS-C (med age 8 (5-12): Dx#s - 59 during Alpha , 79 Delta , & 33 Omicron waves. All Rx w/ IVIG + steroids. 6-15% prev recv COVID VAX, none ICU admitted. Worse Dz & higher incidence during alpha wave (54.5/100K) https://t.co/wAby8uKIH4 https://t.co/zc19zeUKpq
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From 4 Nordic Registries, 24083 RA patients starting 41K courses of bDMARDs shows RA patients had an 80% higher risk of acute coronary syndromes than in the general population. ACS risk on bDMARDs did not improve at 3yrs or 5 yrs https://t.co/TX3jnIXkrW https://t.co/I34UvWH3qd
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Ontario population study shows that musculoskeletal disorders account for 12.3% of all adult emergency dept. visits and 28.5% outpatient physician visits https://t.co/Sq9n7RkIYK https://t.co/lKtQqR5Ja3
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Watch: The Almighty ANA
Dr. Lipsky discussed how our thinking and use of ANA and serologic testing has evolved and is crucial to outcomes and trials in his lecture, The Almighty ANA, presented during the at #RNL2022 in March. #lupus
https://t.co/Xxxj18badY https://t.co/5pwV4xSGDx
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Local cryotherapy in adjuvant-induced arthritis in rats given bid resulted in lower arthritis scores, structural damages, less vascular inflammation/endothelial activation (less mRNA CXCL-1, IL-6, IL-1β, leukocyte infiltration, lower IL-17A and OPG https://t.co/b4cAa9E4PJ https://t.co/vhwWoY8Ujw
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RCT (WBC) whole body cryotherapy (-130C x 3 min; 6 WBC in 14 d) in 56 RA pts. Pain at 2 wks was signif better in WBC than controls (-2 vs -0.88 ; p=0.003) & remained lower x 12 weeks (w less pain meds); Dz activity & Function improved but not signif @wk 12 https://t.co/K7a7CQ7rGj https://t.co/a8QgiDeJS6
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Many have quoted and shown this image of Ankylosing Spondylitis in a young military recruit at age 25, 35, 45, 50 & 51yrs. This may be the MOST used slide in rheum! It comes from the work of Toronto's Dr. Hugh Little, who sadly passed away at age 58 yrs. https://t.co/PGrwBEtrQd https://t.co/948G3SUHvV
Links:
Dr. John Cush RheumNow ( View Tweet)
Watch: Pregnancy Paradox: How Stopping Drugs Leads to Greater Harm
Uma Mahadevan, MD talks about the pregnancy paradox and how stopping medications in pregnancy to protect the fetus can actually lead to greater harm.
https://t.co/HYO5BdjwzZ https://t.co/IGeZ3O8Dno
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Large Granular Lymphocyte Leukemia rarely assoc w/ #RA. LGL accounts for 2-5% of lymphoprolif. disorders; often assoc w/ Autoimmune Dz (mostly RA). RA w/ LGL presents with leukopenia, anemia, splenomegaly, onset after mean 6 yrs of RA https://t.co/AIz2edHDXp https://t.co/DoHKm3KS7d
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