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2020 Year Review

ICYMI: 2020 Rheumatology Year in Review

d Jack Cush, MD

2020 was historic, memorable and game-changing. Under the cloud of COVID-19, there were many significant and memorable advances and setbacks for the rheumatology world. In our accounting of most read articles for 2020, (not surprisingly) 17/20 were COVID-related.

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ICYMI: Psoriatic Disease Management - RNL 2021 Highlights

d Robert Chao, MD

This year’s coverage of psoriatic arthritis was once again, both exciting and informative. Topics included an overview of the latest therapeutic options, an excellent discussion on psoriasis specifically, and the epidemiology of psoriatic arthritis. 

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grappa sign treatment recommendations

ICYMI: New GRAPPA 2021 PsO and PsA Treatment Recommendations

d Rachel Tate, DO

The evidence-based recommendations from the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis were presented at #EULAR2021. The goal (as per 2009 recommendations) was “To develop recommendations, based upon the best scientific evidence, for the optimal treatment of patients with PsA” Dr. Laura Coates, Oxford detailed in abstract #OP0229. Since the last update in 2015, there have been multiple changes, which are highlighted here.

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ICYMI: EULAR Guidelines on Intraarticular Therapy

d Jack Cush, MD

EULAR has published evidence-based recommendations on the use of intra-articular therapies (IAT) based on the literature review and recommendations of a multidisciplinary international task force. These IAT recommendations apply to adult patients with peripheral arthropathies.

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ICYMI: Rheumatologists Rank 2nd in Physician Burnout

d Jack Cush, MD

The 2021 Medscape Survey on Physician burnout ranks rheumatology second, just behind Critical Care medicine.

The survey included over 12,000 physcians from 20 specialties. While 42% of MDs claimed to be burnt-out, Rheumatologists claimed this 50% of the time. The top 3 this year were Critical care (51%), Rheumatology (50%) and infectious disease (49%).

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Lungs ILD

ICYMI: Actemra FDA Approved for Systemic Sclerosis Interstitial Lung Disease

d Jack Cush, MD

Genentech announced Thursday that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adul

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Plasmapheresis Indications : TTP, HUS, Cryoglobulinemia, Hyperviscosity, Myasthenia gravis, Goodpastures, Catastrophic APL Syn, Chr inflamm demyelinating polyneuropathy, Removal of drugs/toxins, Alveolar hemorrhage, ANCA vasculitis (questionable) https://t.co/uph9Eprlvc https://t.co/FPLOgzZpfB

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Dr. John Cush RheumNow ( View Tweet)
These companies do auto-inflammatory gene testing in the USA. @RWCSmtg https://t.co/89bWd0SiAI
Dr. John Cush RheumNow ( View Tweet)
Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005). https://t.co/WYcZU7M677

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Textbooks say fever is common in lupus ("36%–86%") BUT IT IS NOT! Lupus is cause of FUO in 5%; Fever is seen in a minority of SLE onsets; Fever occurs w/ SLE complications - vasculitis, pneumonitis/serositis/alveolar hem, CNS, & INFECTION! https://t.co/KvZeo6Q1WY

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Hands-Down Rheumatology - Gout doesnt get to the hands until its done its damage below (MTP, ankle, knee) and usually only in those with severe tophaceous gout Can also present as dactylitis or Carpal tunnel. Women on diuretics w/ CKD can get gout in Nodal OA joints https://t.co/Ri5taWpR0p
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WATCH: Is blindness with Tocilizumab in GCA a worry? Dr. David Liew ( @drdavidliew) weighs in. #EULAR2021 https://t.co/eFrmbkW9Gy https://t.co/imMaEIczb8

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Rituximab Tops Mycophenolate Mofetil for Pemphigus Vulgaris. One year study of 135 moderate-to-severe pemphigus patients saw complete remission in 40% of RTX vs 10% of MMF patients. https://t.co/yAauFRjHCe https://t.co/xhf85kQHq4

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Metanalysis of 9 studies, and 1132 lupus pregnancies shows that hydroxychloroquine treatment significantly reduced the risk of preeclampsia (OR 0.35), pregnancy hypertension (OR0.41)and prematurity (OR 0.55), but no effect on rates of HELLP, DM, Ab https://t.co/P9MXjDpuiO https://t.co/DxVWiUAPpe

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VEXAS is a new somatic mutation disorder with overlap with relapsing polychondritis. Thus older makes with ear/nose defects, MCV >100, Plt<200 could have the VEXAS-RP overlap @RWCSmtg https://t.co/Pqh6rYD96C
Dr. John Cush RheumNow ( View Tweet)
ProDERM Study: IVIG in Dermatomyositis--The ProDERM study show that IVIg is safe, effective and superior to placebo in patients with dermatomyositis (DM). https://t.co/HOB8CYn9yc https://t.co/4nNRRhzHVO

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Is Q-DAPSA the answer to disease activity scoring in PsA? Dr. Rachel Tate ( @uptotate) provides some insight. https://t.co/fbi3Kbd2GS https://t.co/vBhWsbQYlg

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"Arthritis Mutilans" - worse outcome to chronic inflammatory arthritis is due to 5 disorders: 1) RA 2) Psoriatic arthritis 3) Tophaceous gout 4) polyarticular JIA 5) Multicentric reticulohistiocytosis (Ive never seen this!!) https://t.co/XYmBEW1F0R https://t.co/010QYkOO7E

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Serious problem! Pulmonologists believe that MTX causes and/or worsens ILD. MTX causes hypersensitivity pneumonitis, not ILD. RA, lupus DM, PSS cause ILD and they may need MTX to manage their disease. Do your own research, look at this paper to start. https://t.co/vUyCxJP2Mh

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Protective Effects of Colchicine in Non-Hospitalized COVID-19 A press release from the Montreal Heart Institute has announced that the COLCORONA clinical trial has provided evidence of the protective effect of colchicine. Read more: https://t.co/xW5SchMUeK https://t.co/tUoDTJKbVG

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