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RheumNow Podcast – World Going to Pot (7.23.2021)
Bicycles, Tramadol, biologics - these are but a few of my favorites things in today's broadcast. Join me as I review the news and journal articles from this past week on RheumNow.com.
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Fracture Risk with Low Dose Steroid
A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures.
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Tofacitinib Efficacy in Ankylosing Spondylitis
Deodhar and colleagues have published the results of a study showing that in adult patients with active ankylosing spondylitis (AS), oral tofacitinib was effective (versus placebo) and is safe.
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Dutch study of 644 t Early Psoriatic Arthritis pts shows that 17% had no psoriasis (PASI = 0), 71% had mild psoriasis (PASI < 7), 9% moderate psoriasis (7–12) and 4% had severe psoriasis (PASI > 12). PASI didnt fluctuate much in 1st year https://t.co/XW3QhJ65Oz
Links:
Dr. John Cush RheumNow ( View Tweet)
#ClinicalPearl Palmar erythema in #SLE #lupus is sometimes painful, may not be fixed and also may have erythema of distal fingers on flexor side https://t.co/C5mysB8pFS
Janet Pope Janetbirdope ( View Tweet)
ICYMI: Metanalysis of Tramadol efficacy & safety in knee or hip #OA. 6 RCTs (3,611 pts) showed little clinical benefit w/ 100/d or 200 mg/d; only 300mg/d was better vs PBO at pain & functional improvement. All doses had higher risk of GI, CNS AEs & W/D https://t.co/wDLHFQWFOe https://t.co/l4B83eUQrW
Links:
Dr. John Cush RheumNow ( View Tweet)
ICYMI: New-Onset IBD & IL-17 Inhibitors: What’s the Risk?
https://t.co/zXDQotDiWV
Patients w/ inflammatory/autoimmune diseases who initiated treatment w/ IL-17 inhibitors didnt have a higher risk for development of IBD, but only based on the severity of their underlying disease https://t.co/w3IpQkzmn7
Links:
Dr. John Cush RheumNow ( View Tweet)
ICYMI: FDA Approves IVIG in Dermatomyositis
https://t.co/BZsl8a6ArW
The FDA has approved Octagam 10% [Immune Globulin Intravenous (Human)], as the first and only intravenous immunoglobulin (IVIg) formulation to be approved for adult dermatomyositis (DM). https://t.co/VFF0QMqbin
Links:
Dr. John Cush RheumNow ( View Tweet)
Fracture Risk with Low Dose Steroid
https://t.co/HcYpx8IDcB
A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures. https://t.co/1bc5nyZUzG
Links:
Dr. John Cush RheumNow ( View Tweet)
Tofacitinib Efficacy in Ankylosing Spondylitis
https://t.co/SEKa5OnB50
Deodhar and colleagues have published the results of a study showing that in adult patients with active ankylosing spondylitis (AS), oral tofacitinib was effective (versus placebo) and safe. https://t.co/Wb19EJQZHN
Links:
Dr. John Cush RheumNow ( View Tweet)
Growing Cannabis Use in Arthritis Patients
The National Databank for Rheumatic Diseases reports a significant increased in cannabis use amongst arthritis patients between 2014-2019.
https://t.co/9YyYB75GuN https://t.co/Xs24kBLmeg
Links:
Dr. John Cush RheumNow ( View Tweet)
New-Onset IBD and IL-17 Inhibitors: What Is the Risk?
https://t.co/zXDQotDiWV
Patients w/ inflammatory/autoimmune diseases who initiated treatment w/ IL-17 inhibitors didnt have a higher risk for development of IBD, but only based on the severity of their underlying disease https://t.co/hbWf45pQWt
Links:
Dr. John Cush RheumNow ( View Tweet)
Steroid (GC) withdrawal studied in T2T RA cohort of 207 RA pts (F/U 39 mos); Only 60% discontinued GC, w/ low risk of flare. BUT D/Cs were SLOW w/ only 9.7%, 26.6%, 48.0% & 58.6% at 6 mos, 1, 2 & 3 yrs - median time to cessation = 27 mos https://t.co/h02aueYKwN
Links:
Dr. John Cush RheumNow ( View Tweet)
COAST-Y - an extension study of 155 spondyloarthritis pts in remission on ixekizumab; they either continue or had IXE withdrawn. After 40 weeks, 83% on IXE vs 55% of PBO (WD) pts remained flare free. Most flares >20 wks of IXE withdrawal https://t.co/DDzCoFxt0d https://t.co/jgTxFCgQIq
Links:
Dr. John Cush RheumNow ( View Tweet)
Retrospective cohort study of 1719 Psoriasis only pts (F/U 14721 py) were Rx w/ topicals (81%), cDMARDs (13%), bDMARDs (6%). Overall, 239 patients (14%) developed PsA - Lower risk of PSA if Rx w/ biologics (IRR=0.26 vs topicals; not csDMARDs) https://t.co/BqJWPxG7xf
Links:
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of Tramadol efficacy & safety in knee or hip #OA. 6 RCTs (3,611 pts) showed little clinical benefit w/ 100/d or 200 mg/d; only 300mg/d was better vs PBO at pain & functional improvement. All doses had higher risk of GI, CNS AEs & W/D https://t.co/wDLHFQWFOe
Links:
Dr. John Cush RheumNow ( View Tweet)
While myeloperoxidase (MPO) Abs are seen in idiopathic pulmonary fibrosis (IPF), only 7–23% develop vasculitis. Study of 58 pts w/ IPF & MPO Abs - UIP most frequent ILD pattern, 13 had rheumatic dz; MPO Abs did not change survival of UIP/IPF pts https://t.co/RXXIPUBMBT https://t.co/v3KhEaefZD
Links:
Dr. John Cush RheumNow ( View Tweet)
Anti- neutrophil extracellular traps (NET) Abs were elevated in 328 COVID-19 pts, 27% IgG & 60% IgM. Net Abs assoc w/ circulating NETs, impaired O2 ventilation, high D-dimers. They likely impair NET clearance and may worsen thromboinflammation. https://t.co/xRNKqKjxzS
Links:
Dr. John Cush RheumNow ( View Tweet)
NEJM Image: Salt-and-Pepper Skin Changes in Systemic Sclerosis. 68yoM with skin changes of chest and back and with shortness of breath. Exam:showed “salt-and-pepper” skin changes, w/ CT evidence of lung fibrosis. https://t.co/Pz7mKUD2Yx
Links:
Dr. John Cush RheumNow ( View Tweet)
A study of 7459 adults with diabetes, shows that regular bicycling is associated with a 22-32% reduction in all cause mortality and CVD mortality - with a loss of benefit to those who stop. https://t.co/wjEJXAu0zx
Links:
Dr. John Cush RheumNow ( View Tweet)