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Ethnic and Behavioral Drivers of Gout Risk
Gout is common but disproportionately affects certain groups (e.g., the elderly, Pacific Islander, Blacks). Ethnic links to gouts were also shown to be linked to modifiable behavioral factors and such information maybe useful in managing gout patients.
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Undifferentiated Arthritis Does Not Follow an RA Course
Undifferentiated arthritis (UA) is common in medical practice and many advocate early use of DMARDs; yet a recent study shows that despite DMARD use, UA patients do not fair well with this approach.
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Tocilizumab Works Best in Non-Mechanical Ventilated COVID-19 Patients
JAMA has published a meta-analysis of 15 studies of hospitalized patients with COVID-19 treated with tocilizumab and corticosteroids, showing that a clinically meaningful mortality benefit from tocilizumab (and steroids) was best seen in those not requiring invasive mechanical ventilation (IMV).
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ACR Guidelines for the Treatment of Systemic Juvenile Idiopathic Arthritis
The ACR has updated its clinical guidelines for the management of JIA, with this update focusing on oligoarthritis, TMJ arthritis, and systemic JIA.
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COMPLETE-PsA Trial studied MTX vs MTX + leflunomide in 78 active untreated PsA pts. MTX+LEF was superior to MTX alone at wk 16 (PASDAS 3·1 vs 3·7; p=0·025). Combo group had more N/V (44% v 28%), ^ALT (31% vs 18%). https://t.co/Hc4rNrlQzP https://t.co/UPosZIc4C0
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Drug Survival Differences in RA, PsA, SpA and PsO
https://t.co/aBRhTbVmCM https://t.co/ZDGiKlowoV
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Rheumatoid Arthritis and Eosinophilia
Considerations when eosinophilia is seen in RA patients.
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New Download Available!
Autoimmune Disease in the USA
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2021 Top Articles from Arthritis & Rheumatology
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CORVITAS RA registry shows poor biologic responses in Severe obesity (BMI >35) & underweight (<18.5) w/ no diff between 2891 TNFi vs 3010 non-TNFi users. Severe obesity lower odds of LDA, MCID, CDAI ~10-20% UnderWt ~50-70% https://t.co/iMvlyo4UKx https://t.co/JTQ6aRVTpH
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ICYMI: Spondyloarthritis in Early Crohn's Disease
Analysis of a German Crohn's disease cohort finds that in patients with early CD, SpA was present in nearly one out of five patients and was associated with HLA-B27 positivity and a highly active CD.
https://t.co/ExAHSCw5v2 https://t.co/UDZHbg9ySY
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ICYMI: Increased SLE Flares with HCQ Reduction
Concerns about the long-term safety of HCQ often results in dose reduction or drug discontinuation; study shows that, for those in remission, HCQ taper/discontinuation resulted in a higher rate of SLE flares.
https://t.co/l0Xh1oQzQA https://t.co/HyDbqKrEFp
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ICYMI: NEJM case - Whats the diagnosis? 31yoM w/ 10yr hx of clubbing, arthralgias, nailfold hyperpigmentation, Tender DIPs, toes; xrays showed bony proliferation. Labs and PET were normal. Rx w/ NSAIDs and improved w/ specific Rx? https://t.co/gJ922ToXe9 https://t.co/vyuxLA5SkL
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ICYMI: INBUILD Study of 170 pts with autoimmune related ILD showed nintedanib signifi. slowed the rate of FVC decline in FVC decline over 52 wks (NIN -75.9 mL/yr vs PBO -178.6 mL/yr). AE's (mostly diarrhea) leading to D/C was NIN 17.1% vs PBO 10.2% https://t.co/1h2recxnqn https://t.co/d930Xij3Zv
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ICYMI: FDA approved 2/28/22
IV (intravenous) Actemra for GCA: dose 6mg/kg q4 weeks (don't exceed 600 mg/dose)
https://t.co/QhIq6dHGSf
TheDaoIndex KDAO2011 ( View Tweet)
ICYMI: Psoriatic fingernail onycholysis and hyperkeratosis, rather than nail pitting, are significantly & independently assoc w/ PsA. Study of 1985 pts w/psoriasis, 11.5% were Dx w/ PsA. Only onycholysis (OR 2.34) and hyperkeratosis ) were assoc w/ PsA https://t.co/5K8L5WKQXs https://t.co/InDPhLrIUK
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Download this week’s podcast titled “When Less (Drug) is More (Activity) “
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French GAZEL study of 20,625 pts showed a confirmed RA Dx was significantly assoc w/ increased CV risk (HR 3.03; 1.13–8.11) independent of usual CV risk factors. RF or ACPA (+) without RA was not associated with CV events https://t.co/DG8o5d9hHE https://t.co/5n9uDAhSrF
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When Labs and Exam are Discordant
A patient whose labs are way scary but her exam is not
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Spondyloarthritis in Early Crohn's Disease
Analysis of a German Crohn's disease cohort finds that in patients with early CD, SpA was present in nearly one out of five patients and was associated with HLA-B27 positivity and a highly active CD.
https://t.co/q3w0hy0mzw https://t.co/P6EdggUxM8
Links:
Dr. John Cush RheumNow ( View Tweet)