Dr. Jack Cush reviews EULAR 2018 and the past week's news and reports from RheumNow.com, including DMARDs in OA, the price of Penicillamine, Infections when ANCA+, CV outcomes in gout, NSAIDs in Pregnancy and Seropostive vs. Seronegative Outcomes.

A cohort study of 241 DMARD-naive rheumatoid arthritis (RA) patients, meeting either 1987 ACR or the 2010 ACR/EULAR  classification criteria for RA, compared the baseline status and long term outcomes of seronegative (SNRA) and seropositive (SPRA).

Highlights from Day 2 of the EULAR meeting in Amsterdam include high MBDA scores in ACPA negative RA predicts remission; characterization of difficult RA; and gender differences in psoriatic responses to TNF inhibitors. 

Dr. Jack Cush discusses the past week's news and journal articles featured on RheumNow.com - including reports on advance practice clinicians, baricitinib, gout, disease activity, hypomagnesemia and upadacitinib.

The development and progression of interstitial lung disease in systemic sclerosis can be an ominous finding.

Patients with systemic lupus erythematosus (SLE) who were assessed as being in a low disease activity state during more than half of clinical visits had a decrease in organ damage events of approximately 50%, a retrospective study found.

The genetics and heritability of gout has suggested a higher risk in certain families.  A UK cohort study examined the prevalence of gout and monosodium urate (MSU) crystal deposition among those at risk (sons of gout patients) for gout and found a high incidence of hyperuricemia and MSU crystal deposition.

Researchers from the Toronto Lupus Clinic have described an atypical “monophasic” course in a small number (7.5%) of systemic lupus erythematosus (SLE) patients who achieved and sustained clinical remission, with most off of all medications for an average of 18 years.

A study of MPO-ANCA positive patients followed serially over 2 years shows that reappearance of MPO‐ANCA may predict  relapse in patients with MPO‐ANCA positive AAV and that routine MPO‐ANCA monitoring is warranted. 

Both high and low levels of uric acid were linked with increased risks of death, showing a U-shaped association between serum uric acid levels and all-cause, cardiovascular, and cancer mortality, Korean researchers reported.

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

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

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Highlights includes manpower shortfalls, comorbidities in AA Lupus, certolizumab pregnancy safety, which Shingles vaccine is best and the power of combination biologics in severe refractory  SLE.

One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs). 

I spent this past week seeing hepatitis C patients with our hepatologists, and being a rheumatologist, I was looking forward to seeing extra-hepatic manifestations of HCV that we read about in text-books - cryoglobulinemic vasculitis, sicca syndrome, porphyria cutanea tarda and many others. I suppose I should not be surprised that the week passed without seeing a single one of these. 

Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoi

A large cohort study of pregnant and non-pregnant women with systemic lupus erythematosus has shown that lupus flares are increased during pregnancy and in the 3  months follwing delivery.

Dalbeth and colleagues have published that among gout patients without palpable tophic and despite long term allopurinol, nearly half have monosodium urate (MSU) as detected by Dual-energy CT (DECT).  The total body urate deposition is even greater in those with higher sUA and evidence

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.