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Best of 2018: Hydroxychloroquine Being Over-Dosed with New Guidelines?
Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice.
A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).
TIF1-Ab in Dermatomyositis Linked to Higher Cancer Risk
Several epidemiological studies have reported that a diagnosis of DM or PM may be associated with increased cancer risk. The association appears stronger for DM than PM.
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Genetic Diagnosis for Previously Undiagnosed Disorders
The NEJM has reported the NIH's Undiagnosed Diseases Network (UDN) study results of genetically identifying new diseases from prospectively followed persons with undiagnosed disorders.
The UDN was formed in 2014 as a network of seven clinical sites, two sequencing cores, a coordinating center, central biorepository, a metabolomics core, and a model organisms screening center. It was established to apply a multidisciplinary model in the evaluation of the most challenging cases and to identify the biologic characteristics of newly discovered diseases.
RheumNow Podcast – To Needle or Not to Needle (11.30.18)
Dr. Jack Cush updates the news and reports from the past week at RheumNow.com:
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RheumNow Weekly Podcast – 3 Wiseguy Rheumatologists (11.9.18)
Dr Jack Cush reviews the News and Journal reports from the past week on RheumNow.com. Be sure to check out our upcoming meeting in March 2019 - RheumNow Live.
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Spotlight on Interstitial Lung Disease at ACR 2018
Here are a few important advances in our understanding of interstitial lung disease (ILD) from the ACR 2018 meeting last week.
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Anti-phospholipid Antibodies and Myocardial Infarction.
The Annals of Internal Medicine features a communique from the Karolinska Institutet in Sweden demonstrating that elevated levels of antiphospholipid antibodies may be found in patients with myocardial infarction without any autoimmune co-morbidity, published in Annals of Internal M
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RheumNow Week in Review – Vitamin D Falls Again (10.4.18)
Dr. Jack Cush reviews the news from the past week on RheumNow.com.
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Quarterly Canakinumab Reduces Gout Risk Without Affecting Uric Acid
The Annals of Internal Medicine reports that interleukin-1 (IL-1) inhibitor treatment is associated with a reduced risk of gout attacks - such are the findings of an anlysis of the CANTOS study previously reported at the Annual ACR 2017 meeting in Washington, DC.
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New Classification of Idiopathic Inflammatory Myopathies
Using an observational cohort analysis of patients in the French myositis network, researchers have proposed a new classification of idiopathic inflammatory myopathies (IIM) with four subgroups: dermatomyositis, inclusion body myositis, immune-mediated necrotizing myopathy, and antisynthetas
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RheumNow Week in Review – Medical School Advice (9.7.18)
Dr. Jack Cush reviews news and journal articles from the past week on RheumNow.com.
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Usual Allopurinol Doses Insufficient in CKD Patients
Uric acid (sUA) control may be a challenge in patients with chronic kidney disease (CKD). A cohort study shows that conventional dosing recommendations for allopurinol are unlikely to reach target serum sUA goals.
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CRA Recommendations for Lupus Assessment and Monitoring
A Canadian Rheumatology Association SLE Working Group was established to develop recommendations for the assessment of people with systemic lupus erythematosus.
A panel that included 23 adult rheumatologists, 4 pediatric rheumatologists, 1 immunologist, 4 general internal medicine and rheumatology trainees, and a patient representative, used GRADE methodology to assess the literature and develop guidelines.
New BSR Guidelines on Biologic Safe Use with Inflammatory Arthritis
The British Society of Rheumatology has produced a set of NICE accredited guidelines for the use of biologic therapies in patients with inflammatory arthritis.
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Treatment Preferences in Still’s Disease
In July 2018, RheumNow launched a “Live Vote” survey of US and non-US rheumatologists that asked how they diagnose and treat systemic juvenile idiopathic arthritis (sJIA), also known as “Still’s disease”. It appears that many prefer to start therapy with an IL-1 inhibitor, after a course of steroids and MTX/DMARD. Yet, these findings suggest there are significant unmet needs in the diagnosis and management of sJIA patients.
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Not All Hyperuricemia Leads to Gout
Dalbeth and colleagues studied 4 large prospective cohorts and found that rising levels of serum uric acid (SUA) leads to a non-linear increased risk of incident gout, but only half of those with SUA ≥10mg/dL developed clinically evident gout.
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Cardiovascular Benefits of Maintaining Biologic Therapy
An Australian prospective study of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) has shown that sustained use of tumour necrosis factor (TNFi) inhibitors or biologics can reduce the risks of cardiovascular events (CVEs).
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The RheumNow Week in Review – Lupus in the News (7.27.18)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Latin American Clinical Practice Guidelines for Lupus
The Annals of Rheumatic Disease have published the recently developed Latin American clinical practice guidelines for systemic lupus erythematosus (SLE) addressing the best pharmacologic interventions for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, hemat
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Predicting Autoimmune Progression in ANA+ Patients
Positive tests results for antinuclear antibodies (ANAs) are frequently referred to rheumatology despite their poor predictive value, even in individuals who are ‘At Risk’ for autoimmune connective tissue diseases (AI-CTDs).
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