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Lupus Worries (3-25-22)

d Jack Cush, MD

Dr. Jack Cush Reviews the news and journal reports from the past week in RheumNow.com.

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Comorbidity Drives Risk of Death in Gout Patients

d Jack Cush, MD

A study of men with gout from the US Veteran’s Health Administration (VHA) shows that excess mortality in gout could be attributed to comorbidities.

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CV,risk,MI,heart,cardiac

Stable Low Risk of Acute Coronary Syndrome in RA

d Jack Cush, MD

A Nordic multinational collaborative study examined the risk of acute coronary syndrome (ACS) in rheumatoid arthritis and found a less than 2 fold increased risk of ACS patients initiating biologic disease-modifying antirheumatic drugs (bDMARDs) with little risk variation with short-ter

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hospital,surgery

SLE Higher Risk of Postoperative Cardiac Events

d Jack Cush, MD

ACR Open Rheumatology reports that systemic lupus erythematosus (SLE) patients have a higher risk of postoperative major adverse cardiac events (MACE) that can be identified by common cardiac risk measures.

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malar lupus

Poor Outcomes in Lupus Patients Not at Target

d Jack Cush, MD

A prospective, longitudinal systemic lupus erythematosus (SLE) cohort study examined outcomes and showed that failure to control SLE was common and associated with poorer outcomes including organ damage, glucocorticoid exposure, poor quality of life, and increased mortality.

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Effect of Intraarticular Steroid Shots on Knee OA Outcomes

d MedPage Today

In patients with osteoarthritis (OA) of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.

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Are Shoulder Conditions Incited by Vaccination?

d Jack Cush, MD

A retrospective cohort study from Kaiser Permanente Southern California intramuscular vaccination given between 2016 and 2017 shows a small but significant increase in shoulder conditions, reported as an adverse event (AE) following intramuscular vaccination in the deltoid muscle. 

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Adalimumab Addition vs. Methotrexate Escalation in Psoriatic Arthritis

d Jack Cush, MD

An interesting study in Lancet Rheumatology shows that psoriatic arthritis patients not responding to methotrexate alone can respond after adding or escalating adalimumab (ADA) on top of methotrexate (MTX) to reach minimal disease activity (MDA) response. 

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High disease trajectory despite disease control (^HAQ > DAS28) in RA is more likely with higher pain, fatigue & depression. 10 ys study of 2500 RA pts from NOAR, ESPOIR, ERAN) https://t.co/mrB7fog6PD https://t.co/tqm3LPkOdM

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98 axial SpA women with 335 pregnancies (279 live births) shows preterm birth ( (12.5 v 5.2%), preeclampsia(6.8 v 2.8%) & LBW (8.2 v 2.9%) more prevalent in axSpA, possibly due to incr disease activity during pregnancy & postpartum https://t.co/Bp8QjBXg2K https://t.co/j0xKVvSPIH

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TENS does not work! Multi-centre, trial in 220 active Knee OA pts pitted TENS vs placebo TENS for 3 Wks. Using WOMAC pain scores there was no difference between TENS and placebo TENS (mean diff -0.06; P=0.74). No diff in AE or 2ndary outcomes https://t.co/4Aw9s1zfBQ https://t.co/gwdK6nbKLB

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Poor Outcomes in Lupus Patients Not at Target A prospective, longitudinal SLE cohort study examined outcomes and showed that failure to control SLE was common/associated with poorer outcomes including organ damage, glucocorticoid exposure, and more. https://t.co/wQMmPgbmWF https://t.co/ROeZU56cfy

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Effect of Intraarticular Steroid Shots on Knee OA Outcomes In patients with osteoarthritis of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said. https://t.co/KlNj1GABlb https://t.co/2npPTNSlSA

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Having the MUC5B promoter variant increases odds of RA-ILD w/ earlier onset in RA, esp w/ older age of RA onset. Mass Gen Biobank study of 1,005 RA pts; MUC5B found in 15% w/ incr risk of RA-ILD (OR 3.34) & RA onset after 55 yrs (OR 1.52) https://t.co/5odVWnpuxo https://t.co/zeKxADTSBZ

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Montreal General Hosp SLE cohort study of 489 SLE pts - 35% have Raynauds phenomena; RP in SLE assoc. w/ Female (OR 2.43), White (OR 1.85), CNS disease (OR 1.98), RNP Abs (OR 3.0); negatively assoc w/ hemolytic anemia & cellular casts https://t.co/dUxAAIIyya https://t.co/ttIt9pDsTh

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Aging & Inflammatory Rheumatic Dis is a growing Problem: - Multimorbidity drives polypharmacy & compounds safety risks - More malnutrition, sarcopenia & frailty - Phenotype of Rheum Dz changes w/ age - Tx differs for the elderly - Elder RA is undertreated https://t.co/J2q0mEOqDd https://t.co/VfolGeYx6V

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New download available. DMARD and Biologic Safety Prescribing https://t.co/zXE7HwgAYU https://t.co/pMQGPU6KCM

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Swedish study found 1774 systemic sclerosis (SSc) pts in 2015 w/ median age 65 yrs (84% women) = prevalence=22.7 per 100,000 . Incidence (2004-2015) was 11.9 per 1,000,000 PYs - incidence remained stable; F were 5x more common than M. https://t.co/eqpBmbatSm https://t.co/nq4AFrTAfQ

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10 yr Spanish study evaluated PET/CT in newly dx inflammatory myositis (except IBM); /77131 IIM pts had PET/CT screening for occult cancer with AUC ROC of 0.87; those not evaluated for OC did not develop cancer after median 3.3 years https://t.co/425o2cEhbJ https://t.co/5EWQzL07he

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MTX-Sparing in myasthenia gravis. 18-mo OL RCT of MTX vs PBO in 35 recently Dx, pred Rx MG pts (MGFA Class II/III) showed @ 18 mos MTX reduced Pred use (5,663 vs 6,684 mg total), w/ shorter pred reduction times and less daily dose mos 6, 9–18 https://t.co/8t2sJMwBnx https://t.co/3G0wd1FQ2s

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