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Modifiable Risk Factors for Hyperuricemia
Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia.
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Autoantibodies Don't Disappear With Remission in RA
Immunologic remission in rheumatoid arthritis, defined as the disappearance of anti-citrullinated protein antibodies and rheumatoid factor, was seen infrequently among patients achieving sustained clinical remission and did not correlate with the disappearance of symptoms, a long-term Dutch study found.
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Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease
Serologic testing is the principal means of laboratory diagnosis of Lyme disease. Current recommendations include using a sensitive enzyme immunoassay (EIA) or immunofluorescence assay, followed by a western immunoblot assay for specimens yielding positive or equivocal results.
On July 29, 2019, the Food and Drug Administration cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. Thus, serologic assays that utilize a second EIA in place of western immunoblot assay are acceptable alternatives for the serologic diagnosis of Lyme disease.
Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA
A cross-sectional study 48 CCP–positive "at risk" individuals (without arthritis) were shown to have an increased prevalence of periodontitis and P gingivalis when compared to 26 early RA (ERA) and 32 controls.
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RheumNow Podcast – More Than a Spot of Tea (8.2.19)
Dr. Jack Cush reviews the journal articles and news reports from the past week on RheumNow.com:
MMP-7 and Myositis-ILD; Post-surgical gout attacks; CV events and testosterone; and a Boxed warning for tofacitinib.
Fatigue is Driven by Inflammation, Pain, and Chronicity in Psoriatic Arthritis
Correlates with fatigue were assessed in psoriatic arthritis (PsA) patients in the DANBIO registry and found to be associated with clinical inflammatory factors, disease duration, and chronic pain.
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RheumNow Podcast – Boiling Hot MAS (7.12.19)
Dr. Jack Cush reviews this week's news and journal reports featured on RheumNow.com. PsA v. non-PsA pregnancies, Still's disease, lupus, nutritional supplements and dietary interventions, use of cannabis, tanezumab in OA, CBD oils and more.
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CRP Utility in COPD Exacerbations
NEJM reports on the utility of C-reactive protein (CRP) testing in chronic obstructive pulmonary disease (COPD) patients, showing that CRP guided prescribing of antibiotics for exacerbations of COPD in primary care clinics resulted in a lower percentage of patients who reported antibiotic use.
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EULAR 2019 - Day 1 Report
Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. Here are a few of the highlights from day 1 EULAR in Madrid, including another IL-23 inhibitor, BTK inhibition, abatacept in Sjogren's syndrome, don't repeat the ANA, and drug free remission in systemic JIA.
Borrelia burgdorferi Peptidoglycan Shedding Drives Lyme Arthritis
Research published in PNAS has shown that long after active Lyme infection in the joint, a peptidoglycan (PG) of the the spirochete Borrelia burgdorferi can be found in the joints of those with late-stage Lyme disease.
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Preview of EULAR 2019 Abstracts
EULAR 2019 begins today in Madrid and features over 2000 presentations. After an initial review of titles and abstracts, I’ve compiled a hit list of presentations of interest to me and hopefully other practicing rheumatologists.
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Proinflammatory Diets May Increase CRP and RA Onset
Despite the lack of good evidence, there has been great speculation about the role of diet in causing or alleviating inflammation. Now there's new research suggesting that proinflammatory diets can increase serum C-reactive protein levels and also the risk of rheumatoid arthritis onset.
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2019 EULAR Guidelines on Antiphospholipid Syndrome Management
A EULAR task force has reviewed the medical literature and developed evidence-based recommendations for the management of antiphospholipid syndrome (APS) in adults. They note that a high-risk antiphospholipid antibody (aPL) profile is associated with greater risk for thrombotic and obstetric APS.
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Predictors of Serious Infections with Rituximab
The risk of serious infectious events (SIE) with rituximab (RTX) is similar to that seen in other biologics (e.g., RA: 2% or 4.3/100PY), but with prolonged use the risk may change. Recent research says that low IgG levels, RTX induced neutropenia, prior SIE and comorbidities can significantly augment this risk.
A retrospective longitudinal single center study of 700 rheumatic and musculoskeletal diseases (RMDs) treated monitored serum immunoglobulins (at baseline and 4–6 months after each cycle), clinical outcomes and SIE over time.
RheumNow Podcast – Medical Selfies (5.24.19)
Dr. Jack Cush Reviews the news and journal articles from the past week on RheumNow.com
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Coexistent Gout Increases Risk in Rheumatoid Arthritis
It his often said that gout and rheumatoid arthritis (RA) cannot coexist and where confusion exists, a good history and testing for serum urate (SUA) and rheumatoid factor (RF) can usually clarify the dominant disorders. A recent study shows that hyperuricemia and gout are uncommon in RA, but when present shows an increased risk of comorbidities and cardiovascular (CV) mortality.
Risk Score Predicts Thrombosis Recurrence in APS
A combination risk score helped predict recurrent thrombosis -- particularly arterial -- among patients with antiphospholipid syndrome (APS), an international study found.
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Biomarkers Predict Thrombosis in Lupus
A composite risk score that included three biomarkers predicted thrombotic events among patients with systemic lupus erythematosus (SLE), a cross-sectional study found.
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