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ICYMI: RheumNow Podcast – Tofacitinib Safety Concerns

d Jack Cush, MD

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

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ICYMI: Anti-inflammatory Diet Control of Rheumatoid Arthritis

d Jack Cush, MD

The TOMORROW study assessed the relationship between diet and disease activity in rheumatoid arthritis (RA) patients and has shown that RA patients are more likely to have higher inflammatory diets, but that a change to an anti-inflammatory diet resulted in lower disease activity s

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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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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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Comparison of MSU crystal ID, DECT scanning and US to Dx gout - study of 147 pts. Compared to the gold standard (MSU ID), Feet/ankles (87% sensitivity; 100% specificity) or knees DECT (91%; 87%) alone had best Dx accuracy. US was inferior to DECT. https://t.co/2Hiu7YhLo8

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Hands-Down Rheumatology - Sarcoidosis usually presents as a monarthritis or oligoarthritis. Late sarcoid arthritis affects knees, ankles, fingers (dactylitis). Bony lesions show honeycomb trabecular pattern). https://t.co/lmXBbJz6ts https://t.co/oDYrBiPuIX

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Pirfenidone, studied in 127 pts w/ CVD/CTD ILD, fibrotic interstitial pneumonia, chr hypersensitivity pneumonitis, & asbestoslung fibrosis. Pirefenidone had significantly less FVC% decline compared with placebo (p=0·043) https://t.co/H1s6ut4NhG

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263 RA patients with ILD were treated w/ Abatacept (ABA mono, ABA+MTX or ABA+nonMTX) - all improved their DAS28, stablized their FVC, DLCO, CHest CT; Only difference was that steroid sparing best when ABA used in combo. https://t.co/1dGufcKsha

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Vaccinated COVID-19 pts appear less contagious; report from Israel - among 650,000 received two-doses of Pfizer vaccine, 2,897 later tested positive for COVID-19, but nasal swab samples showed 4-fold less virus - hinting protection https://t.co/UBE4q5T2Ht https://t.co/OOgWoqdkdt

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Rifampin is safest! 2 RCTs of 6485 latent TB pts compared 9 mos of isoniazid vs 4 mos of rifampicin. RIF had half the adverse events compared to INH; roughly half the rate of rash (1.5% v 2.7%); No grade 3-4 hepatotoxicity w/ RIF, compared 6%) w/ INH https://t.co/n1cVKyEPf6

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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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These companies do auto-inflammatory gene testing in the USA. @RWCSmtg https://t.co/89bWd0SiAI
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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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