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Pain and Opioid Updates
Today, the CDC and FDA provided new updates on the scope of pain in the USA and guidance on the use of opioids.
MMWR April 14, 2023
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RA Patients on Biologics and tsDMARDs are still High Risk
A new Swedish ARTIS registry study of key safety outcomes in rheumatoid arthritis (RA) patients receiving either targeted synthetic or biological disease-modifying antirheumatic drugs (b/ts DMARDs, including Janus Kinase inhibitors (JAKi)), has been updated and affirms previously held risks.
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Best Treatments for Immune Checkpoint Inhibitor-associated Arthritis
A retrospective study of cancer patients who developed immune checkpoint inhibitor-associated inflammatory arthritis (ICI-IA) shows that biologic DMARDs were more effective than conventional synthetic DMARDs (csDMARDs) in rapid control of arthritis.
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Olmstead Co. population study: Clinically Isolated Aortitis (CIA) saw 8 cases over 20 yrs; incidence of 8.9 per 1,000,000over age 50 yrs. 6 of 8 were female, mean age 76yrs; all Dx @ ascending aortic aneurysm repair. Having CIA did not affect mortality. https://t.co/ruxOX4Pxg9 https://t.co/NlpF5uXWNV
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Dr. John Cush RheumNow ( View Tweet)
We developed a list of shared decision making resources that can help health care care providers and patients learn more about the process, available patient decision aids, decision coaching, and more! You can access these resources on our website here. https://t.co/t5Wua8olVA https://t.co/WdVQI72pcV
Karine Toupin April toupinak ( View Tweet)
Predictors of RA-ILD include smoking, Dz activity, steroid use and obesity. @jeffsparks @UTSW_Rheum https://t.co/VRQc9igHWW
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Methotrexate-induced pneumonitis (0.3% risk) is different than RA-ILD. MTX does not increase odds of RA-ILD. @jeffsparks @UTSW_Rheum https://t.co/JV1CcB0sLP
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Japanese cohort study shows Lung cancer is more common in males w/ elder-onset dermatomyositis - risk increased by Smoking, anti-TIF1-γ-Abs and elevated MLR (monocyte to lymphocyte ratio) https://t.co/LlTkiWp7pb https://t.co/Bu9atnI8je
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Disease activity increases the risk of future RA-ILD. For every one point increase in DAS28, theres a 35% increase risk of RA-ILD @jeffsparks @UTSW_Rheum https://t.co/P3dNDVanuL
Dr. John Cush RheumNow ( View Tweet)
MUC5B is a common genetic variant (~12%) that is strongly assoc w/ IPF, but also RA-ILD (3.1-4.7 fold risk) @jeffsparks @UTSW_Rheum https://t.co/t1Kgmj8a3x
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Survival in RA-ILD is reduced (data from two different eras) @jeffsparks @UTSW_Rheum https://t.co/7eGgGnEgwW
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Risk of RA-ILD is 15% (or 1 in 6) according to Mayo clinic (Olmstead county) data. @jeffsparks https://t.co/KynitLCsK7
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#RA with ILD portends poor outcomes, especially if seropositive. Visiting professor Dr. Jeff sparks @jeffsparks @UTSW_Rheum https://t.co/fbVyDMUm6L
Dr. John Cush RheumNow ( View Tweet)
Rheumatologist - Work-Life Survey Results
Last week, registered Rheumatologists responded to an email survey regarding work-life balance. The following are the results from 190 respondents - 53% were male (47% female) and 94% were from the USA.
https://t.co/2g7oL6ltAo https://t.co/uYv7sDyO9o
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Dr. Megan Clowse discusses the differences in pregnancy planning for men and women with rheumatic disease, with particular focus on medication use. Watch now.
https://t.co/Ine8CdbZR4 https://t.co/7UnanlnQcC
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FDA FAERS study of IL-17 inhib & colitis: 388 pts w/ suspected IL-17i assoc. IBD. Median age - 42 yrs; Initial Sxs= diarrhea 91%, Abd pain 58%, bloody diarrhea 51%), & fever 36%, ^WBC 87%; Time to onset=2.9 mos. Time to remission after IL-17i D/C =4 wks https://t.co/adrtUhFj9C https://t.co/61GC5hvzYV
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Retrospective study of 42 pts w/ cocaine-induced midline or systemic vasculitis; Current cocaine use common (20/23 + urine tox, including pts who prev. deniedcocaine). Found: septal perfs (75%), oronasal fistula(15%), less(27%) systemic Sxs, 56% PR3-ANCA+https://t.co/z1Z4INRSj5 https://t.co/v9ZyZD1Lrb
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With AI and GPT-4... "The cognitive speed limit has just been lifted." - John Nosta https://t.co/mMXos8LLt6 https://t.co/imBfp37J1l
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Spanish Society of Rheumatology (SER) study finds w/ retirement of many older (male) Rheums; there are workforce shortages. Most (59.7%) of rheums in Spain are women, the majority below age 54 yrs. https://t.co/DPs0S63Aqc https://t.co/ig4kOQWmkn
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vit D shows no change in Fx Risk. Study of 20,326 Australians given placebo or vit D3 60K IU/mo. 46% women, age 69 yrs. W/ 5.1 yrs F/U - no effect on Fx risk (HR 0·94; 0·84–1·06). Fx in 5.6% of Vit D vs 5.9% in PBO (non-vertebral, major OP & hip Fxs https://t.co/cSbTS3xWrX https://t.co/Jipzw28Wn8
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