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Early RA Journey - Patient Perspectives and Uncertainties
Canadian early RA (ERA) patients were interviewd to depict their perspectives from onset and diagnosis to referral and care. This report highlights the importance of patient pain and primary care physician (PCP) intake and referral. PCP and HCP delays in referral to a specialist still exist.
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Biosimilar Slow Growth in USA
A recent Forbes article, "Biosimilars Are Making Inroads In U.S., But It’s Still A Bumpy Ride", reviews the current state and reasons for slowish uptake of these significant cost-savings alternatives to biologic therapy in treating cancer and autoimmune disorders. The following are takeaway bullets from this informative article.
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Systematic review suggests (although not provn) that audiovestibular dysfunction may be from APS. Anti-phospholipid & HSP-70 Abs found 25-33% w/idiopathic sudden sensorineural hearing loss,. ACL Abs seen in up to 27% w/ sensorineural hearing loss https://t.co/GTcLoM0SCZ https://t.co/afFntYnPPG
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FDA has given FDA Breakthrough Therapy designation to Nipocalimab for treatment of adults w/ moderate-to-severe Sjögren’s disease. NIPO is an Ab to neonatal Fc receptor (FcRn), & was tested and shown effective in Sjog in the Phase 2 DAHLIAS study - a plenary presentation at… https://t.co/Nq09iEoxJ9 https://t.co/JG4P8zMw9j
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An Artificial Intelligence-Based Gout Management System Reduced Chronic Kidney Disease Incident and Improves achieving Target Serum Urate levels. AI lowered incid. of CKD stage≥ 3 by 47%, & incr # achieving target SUA <6mg/dl with(59% vs 26%, p<0.001). https://t.co/INULBvaKF9 https://t.co/fkPgbscOXj
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Early Rx doesnt prevent Difficult to Tx RA (D2TRA). Propective study of 722 early RA pts Rx w/ MTX found after 73 mos 29% were D2TRA. 21.5% Rx w/ b/tsDMARD after 19 mos, yet 70% were uncontrolled. 5 yr retention rates were 40%. D2T predicted by pain & swollen joints… https://t.co/veaspuCHIE https://t.co/zjlTWQn4GQ
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NHANES study of 11264 adolescents (12–17 yrs) found Hyperuricemia (≥ 5.5 mg/dL) in 33%, (51% males, 13% females) and was more prevalent with obesity and in non-Hispanic Asians https://t.co/rwUt1Cgg9b https://t.co/dFr1LeX0nC
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Peptic ulcer disease is still assoc w/ signif. hospitalization & mortality (10K deaths in USA/Yr). PUD affects 10% of outpts w/ Upper GI pain. 42% are due to H.pylori, 36% from ASA NSAIDs. Complications bleeding (73%), perforation (9%), pyloric obstruction (3%)- JAMA review… https://t.co/1bgagFVlYN https://t.co/8i2j3r1puf
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Korean database of 43,502 #AS pts found CV events based on Rx exposure. CV event rates were: No bDMARDS (18.66/10K PYs), TNFi (8.92), & IL-17i (12.87). TNFi significantly lowered rate of CVE (aHR 0.69), but IL-17i did not (0.96) https://t.co/LMzPodWI5v https://t.co/rQ0aq1ALgW
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COVID-19 and Long-Term Risk of Autoimmune and Autoinflammatory Disorders
A Korean population based study found that people infected with COVID-19, especially severe COVID-19, had an increased risk of autoimmune and autoinflammatory connective tissue disorders.… https://t.co/zlJrusJDM4 https://t.co/cuumClbN6b
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Genes Linking RA and Osteoporosis
People with rheumatoid arthritis often develop osteoporosis, a more serious condition, as a result of the bone damage caused by immune cells and as a side effect of certain medications.
https://t.co/hEJc77gcln https://t.co/bmsV70riUc
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VA #RA registry study of 263 RA-ILD pts (mean 69 yrs, 95% male, 73% W, 85% smokers), finds the MUC5B promoter variant in 33.5%. While the MUC5B variant is assoc w/ RA-ILD risk, it does not predict survival or mortality. Other genetic & nongenetic factor must be responsible… https://t.co/sr1AtAZRDT https://t.co/KKD7RLnIqR
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Taiwan claims data study of 135 230 patients who received antineoplastic medications, found that immune checkpoint inhibitors use was associated with a 2-fold increased risk of developing psoriasis (HR 2.43).
https://t.co/m5eGT56W12 https://t.co/h5FjQpHOpF
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Memory B cells are dysfunctional in #SLE. They are anergic B cell receptor signalling, but responsiveness to Toll-like receptor (TLR) and type I interferon signalling. BCR hyporesponsiveness of memory B cells may explain failure non-depleting B cell Rx in SLE… https://t.co/naBYtgLBGd https://t.co/5sJibS9esn
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Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/9pET497zjC https://t.co/P8XVlVmmLd
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Overview of Uveitis management of adult & pediatric rheumatology.
- Uveitis accounts for 10% of visual impairment globally
- TNF inhib are effective; w/ IL-6 inhib as 2nd line options https://t.co/CmGuA7W4Ag https://t.co/p5aEQlV7p6
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211 SSc patients, men and younger women, have lower BMD than the population (Osteopenia in 52% & 16.5% osteoporosis; P=0.001). Low BMD in women assoc w/ Finger ulcers, diffuse involvement, older age, & being post-menopausal https://t.co/qyvEJoIbKH https://t.co/zj2Fn1oU5n
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Virtual Yoga Effective in Chronic Low Back Pain
A randomized trial of 140 adults with chronic low back pain (CLBP) demonstrated that virtual yoga instruction resulted in significant improvements in CLBP patients compared to the wait-list control group.
https://t.co/BuYWb1wCXG https://t.co/tQawiZFIJv
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New download available!
Substitute Inflammatory Measures
https://t.co/FiZSvvl5DA https://t.co/QwVefFLcHO
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Serial MRI study of SI & lumbar (LS) joints in 24 early axSpA (Sxs < 5.5yrs) over 3 yrs, showed:
- SIJ developed bone marrow edema, sclerosis & erosion.
- LS: fat lesions decreased & erosions increased.
- Facet joint inflammation (in t0) significantly influenced yr 3. LS bony… https://t.co/COlFAXVE1x https://t.co/4Xs9ngJN4w
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