Anti-phospholipid Antibodies and Myocardial Infarction.

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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

RheumNow Week in Review – Vitamin D Falls Again (10.4.18)

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Dr. Jack Cush reviews the news from the past week on RheumNow.com. 

Quarterly Canakinumab Reduces Gout Risk Without Affecting Uric Acid

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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. 

New Classification of Idiopathic Inflammatory Myopathies

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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

RheumNow Week in Review – Medical School Advice (9.7.18)

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Dr. Jack Cush reviews news and journal articles from the past week on RheumNow.com.

Usual Allopurinol Doses Insufficient in CKD Patients

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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.

CRA Recommendations for Lupus Assessment and Monitoring

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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

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The British Society of Rheumatology has produced a set of NICE accredited guidelines for the use of biologic therapies in patients with inflammatory arthritis.

Treatment Preferences in Still’s Disease

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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.

Not All Hyperuricemia Leads to Gout

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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. 

Cardiovascular Benefits of Maintaining Biologic Therapy

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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).

The RheumNow Week in Review – Lupus in the News (7.27.18)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

Latin American Clinical Practice Guidelines for Lupus

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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

Predicting Autoimmune Progression in ANA+ Patients

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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).

Biomarker Combo Predicts TNF Inhibitor Responses

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Based on clinical trial data, patients starting tumour necrosis factor-alpha inhibitors (TNFi) have roughly a two-thirds chance of achieiving a good clinical response. French investigators have studied a series of potential biomarkers and surmised that the combination of baseline prealbumin, platelet factor 4 and S100A12 can predict a 78% response to TNFi in rheumatoid arthritis (RA) patients.

The RheumNow Week in Review –Fateful Outcomes in Rheumatology (7.13.18)

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Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Fateful outcomes in Rheumatology, what happens to Seronegatives, IL-23 fails, MRI progression, Not all inflammatory back pain becomes SpA:

The Diverse Fate of Seronegative Rheumatoid Arthritis

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A Finnish Rheumatology Center followed 435 early, seronegative rheumatoid arthritis (RA) patients for 10-years and found that only 3% became erosive or seropositive RA.

Obesity, Hypertension and Diuretics Drive Gout Risk

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A recent metanalysis suggests that obesity, hypertension and diuretic use are associated with a two-fold increased risk of incident gout.

From a potential of 9923 articles, researchers analyzed 11 studies with data suitable for the meta-analysis.

Hydroxychloroquine Being Over-Dosed with New Guidelines?

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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).

Best of 2017: Are ANA Tests Unreliable?

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Pisetsky and colleagues have reported in the Annals of Rheumatic Disease that ANA tests done on established SLE patients may yield surprisingly disparate results.

While ANA negative lupus was a problem of old assays and the loss of ANA positivity may be seen with chronicity or age, most rheumatologists believe that ANA positivity is an absolute requirement for the diagnosis of systemic lupus erythematosus.