RheumNow Podcast – Tricked Up Lupus Criteria (8.9.19)

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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including new SLE criteria, ULT in gout and MSU reductions, IVIG in ANCA vasculitis and non-TNF biologics outperform the TNF inhibitors.

Increasing Lung Disease in Systemic JIA

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A single-center cohort analysis shows that lung disease is increasingly seen in children with systemic juvenile idiopathic arthritis (SJIA), especially those complicated by macrophage activation syndrome.

Prior to 2013, reports of pulmonary disease in SJIA were rare, but since there have been increasing reports of alveolar hypertension, interstitial lung disease and pulmonary alveolar proteinosis; often with a high mortality rate.

As such, since 2014, the Cincinnati Children’s Hospital Medical Center has seen an increase in lung disease and severe lung disease in SJIA.

RheumNow Podcast – More Than a Spot of Tea (8.2.19)

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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.

War on RA - Part 2: It's All About You

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Part II of this series is a direct message to rheumatologists. If we’re doing such a great job in RA, then why do we need a war on RA? Why is this conflict being laid at the feet of good soldier rheumatologists, those who toil daily at winning therapeutic battles one patient at a time? The reasons are blunt and true.

Tofacitinib Gets a New Boxed Warning for Blood Clots and Death with Higher Doses

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The U.S. Food and Drug Administration has approved new warnings about an increased risk of blood clots and of death with the 10 mg twice daily dose of tofacitinib (Xeljanz, Xeljanz XR), which is used in patients with ulcerative colitis. 

FDA AAC Splits Vote in Favor of Nintedanib for Scleroderma Interstitial Lung Disease

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The FDA convened Arthritis Advisory Committee to consider nintedanib for the treatment of systemic sclerosis-associated interstitial lung disease (SSc-ILD) and voted 10-7 in favor of approving the drug for this new indication.

Increased Risk of Cardiovascular Death in Hip and Knee Osteoarthritis

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Hip and knee osteoarthritis patients have been shown to have increased mortality rates from cardiovascular events when compared to the general population.

CRP Utility in COPD Exacerbations

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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.

Allopurinol Fails to Curtail Hypertension

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Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Disparities in Lupus Survival

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MMWR has published the outcomes from the Georgia Lupus Registry between 2002 and 2016, finding that black women were not only more likely to die from lupus than white lupus patients; but they died on average 13 years earlier (mean age 51.8 and 52.3 years, respectively) than whites (mean age 64.4 and 65.0 years, respectively).

Black women with lupus were 3.34 times more likely to die than black women in the general population, while white women with lupus were 2.43 times more likely to die than white women in the general population. None of the white women with lupus died within 5 years of diagnosis, while mortality was elevated for black women from the date of diagnosis on.

DMARD Success in Myositis-Related Interstitial Lung Disease

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It is estimated that up to 50% of patients with idiopathic inflammatory myopathy will be complicated by interstitial lung disease, and having ILD may impart a poor prognosis. A recent review of the Johns Hopkins myositis-related ILD cohort has shown that azathioprine and mycophenolate mofetil use is associated improved lung function and less prednisone use.

Lupus Patients at Risk for Heart Failure

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Patients with SLE are at increased risk for HF, not just of MI and stroke, with risk similar to that of patients with diabetes, researchers found in an analysis of Medicaid data.

Allopurinol Fails to Curtail Hypertension

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A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Excess Non-CV Mortality Persists in Gout

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Patients with gout not only have a well-recognized increased risk of dying from cardiovascular (CV) disease, but also have higher all-cause mortality and die prematurely from other diseases, a Swedish study indicated.

RheumNow Podcast – Rituximab Monitoring (5.31.19)

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Dr. Jack Cush presents the news and best of rheumatology and medicine from the past week on RheumNow.com

RheumNow Podcast – Medical Selfies (5.24.19)

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

Lung Disease in RA: Which Factors are Linked With Mortality?

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Among patients with rheumatoid arthritis (RA) who had interstitial lung disease (ILD), the pattern of ILD did influence mortality, but other pulmonary factors also contributed, a meta-analysis suggested.

Nintedanib May Benefit Systemic Sclerosis Related Interstitial Lung Disease

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The NEJM reports a randomized placebo controlled trial of nintedanib, a tyrosine kinase inhibitor, in systemic sclerosis patients with interstitial lung disease (ILD) resulted in less pulmonary decline, but had no effect on other features of systemic sclerosis. 

RheumNow Podcast – Richer or Poorer (5.17.19)

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

Risk Score Predicts Thrombosis Recurrence in APS

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A combination risk score helped predict recurrent thrombosis -- particularly arterial -- among patients with antiphospholipid syndrome (APS), an international study found.