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Gender Trends in Rheumatology

d Jack Cush, MD

A study of rheumatologists in Ontario, Canada has shown an increasing percentage of women in rheumatology; unfortunately they have lower salaries but see fewer patients than do their older, male colleagues.

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Neuropsychiatric Events Common in Lupus

d Jack Cush, MD

Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.

A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with the Swiss SLE cohort study looked at their population, NPSLE was found in 28.1%. This included cerebrovascular insults, seizures and psychosis.

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New ACR Rheumatoid Arthritis Guideline: Emphasis on Methotrexate

d MedPage Today

The American College of Rheumatology (ACR) has issued new guidelines on the treatment of rheumatoid arthritis, addressing questions about initial treatment with methotrexate and minimizing reliance on glucocorticoids.

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The Potential of Rituximab Efficacy in Systemic Sclerosis

d Jack Cush, MD

Rituximab (RTX) has been in the news a lot lately; more surprisingly for its potential benefits in progressive systemic sclerosis (SSc).

Ebata and colleagues have published the results of a double-blind, randomised, placebo-controlled trial comparing intravenous RTX to placebo in 56 SSc patients. Patients had to have a modified Rodnan Skin Score (mRSS) of 10 or more. The primary endpoint was the change in mRSS at 24 weeks. 

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ACR Stands Against Insurer Mandated Infusion Locations

d ACR

The American College of Rheumatology (ACR) has released an updated position statement on patient safety and site of service for biologics outlining several reasons why the ACR strongly believes infusions should be administered in a monitored health care setting with onsite supervision by a provid

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Ten Things to Tell Patients About Diet and Rheumatic Disease https://t.co/DpBAJwCJCY https://t.co/AVlgHfdP08

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Dr. John Cush RheumNow ( View Tweet)
With the expansion of knowledge regarding the safety of newer agents in pregnancy comes the PreCARA study showing that when pregnancy is planned and patients with RA are treated with a modified T2T approach, superior outcomes can be anticipated. Read on: https://t.co/sV5hJRzPJW https://t.co/ADppVd3CmZ

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The ACR has released an updated position statement on patient safety and site of service for biological. https://t.co/NONozoIIq6 https://t.co/CSbSuXBb8n

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Health care utilization by knee OA pts varies. In nearly 1 million Knee OA (Medicare), 33% ended up with TKR. TKR/arthroplasty assoc w/ more clinic visits; PT, specialist care & intraarticular Rx assoc. w/ less TKR. TKR range 26% to 42% by region https://t.co/d1EQTTie8X

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CDC: as of 5/15/2021; the rates of flu test positivity was 0.051-0.18% for the 2020-21 flu season - compared to usual rate of 10%-19% before COVID. Actual influenza hospitalizations dropped from 44.2 to 0.8/100 000 population https://t.co/N8b1sQWWIh

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Higher rate of Parkinsonism in Osteoarthritis? Taiwan Health Insurance claims analysis of 33,360 OA pts (age 50-64 yrs) vs age matched non-OA - found incr risk of Parkinsons in OA pts (aHR=1.41), esp in knee or hip OA (aHR 1.55) group. https://t.co/SHudF5NnwH

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Stroke risk is increased in arthritis (RR 1.36, 95% CI: 1.27–1.46); esp for RA (RR 1.38), AS (RR 1.49), PsA (1.33) & gout (1.40); but NOT osteoarthritis (RR=1.03). Apparently Inflammation drives this risk. https://t.co/Snb6OrtZJH

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Global metanalysis of 67 studies of T2T in gout shows only 34% on ULT achieve a serum urate target. Thus only a minority of gout receive T2T care worldwide. Thos on ULT, have low rates of continuous Rx, SUA testing, & achieving SUA target https://t.co/zpBRhRaek5

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BRAVE-AA1 - a Phase 2 trial of 110 pts w/ Alopecia areata Rx w/ either PBO or baricitinib (1, 2, 4 mg); showed significantly greater improvement with Bari 2-mg (33.3%, P = .016) and 4-mg (51.9%, P = .001) versus placebo (3.6%). https://t.co/tzDeb4l60H

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Retrospective study of 258 IBD patients, 17% had MRI sacroiliitis (73% w/ bone marrow edema. Sacroiliitis was significantly associated w/ Female gender, back pain, and later age of CD diagnosis. >two-thirds of these pts never seen a rheumatologist. https://t.co/HYhAU6aRIf

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GFR decline in 2269 RA pts (15 mos F/U) - Most RA had a GFR decline w/ age. Pts w/ higher DAS28-CRP had more GFR decline. Pts in remission/LDAS had a slower rate of eGFR loss (−0.817 vs −1.283 cc/min per year; P < 0.001) https://t.co/rnIc080xYb

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Analysis of Ph 3 data Tofacitinib in Ulcerative Colitis shows no increase in Cancer; rates equal to that seen w/ Tofa in RA, PsA & other biologics in UC. In 1124 pts (2576 PtYrs) there were 20 cancers, excluding NMSC (IR, 0.75; 0.46–1.16) https://t.co/xiTIKYAtyY

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Blindness with Tocilizumab in GCA: Is it a Worry? https://t.co/PJYap294jm https://t.co/q1izGlH68j

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EULAR 2021 Lupus Panel Drs. Cush, Dao, Pope, Dein and Yusof discuss a number of lupus presentations as well as abstracts presented at the virtual EULAR 2021 meeting. Lupus nephritis and treat-to-remission presentations were discussed by the panel. https://t.co/yUEXTOatpR

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Alcohol abuse worsens psoriasis. Prospective study of 266 Psoriasis pts (1/2 biologics; 1/2 ; conventional Rx). Poorer outcomes predicted by alcohol abuse (CAGE score) (regression co-efficient 1.40), obesity (1.84) & conventional Rx (4.39) https://t.co/CJGTT0HoV2

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