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RheumNow Podcast – Great Associations (3.19.2021)

d Jack Cush, MD

Dr. Jack Cush rants on the journal reports, news and FDA actions featured this past week on RheumNow.com.

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Are You a Super Rheum?

d Jack Cush, MD

Several weeks ago, at the Rheumatology Winter Clinical Symposia, an interesting debate between Drs. Orrin Troum and Marty Bergman hashed over the concept of whether rheumatologists should sub-specialize with a practice, research or career devoted to one disease ("Super Rheum"), or be "selective" about what disorders and diseases they would treat or just be a generalist. 

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Apremilast Equals MTX in Palmoplantar Psoriasis

d Jack Cush, MD

Palmoplantar psoriasis (PPP) is a therapeutically challenging variant of psoriasis; nonetheless, a prospective, randomized, active-controlled trial from India suggests that apremilast is effective and safe in patients with PPP.

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Potent Topical Corticosteroids and the Risk of Osteoporotic Fractures

d Jack Cush, MD

JAMA Dermatology has published a Danish national cohort study showing that potent topical corticosteroid use was associated with an increased risk of osteoporosis and major osteoporotic fractures with a dose-response association for cumulative use.

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MDA-5 Antibodies and Juvenile Dermatomyositis

d Jack Cush, MD

A multicentre, retrospective study examined MSA profiles (by immunoprecipitation) from 96 juvenile idiopathic inflammatory myopathies (JIIM) at nine pediatric rheumatology centres in Japan. MSA were found in 85 of 96 cases with over 90% of patients having one of the following three MSA

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News Feature: MDA-5 Antibodies and Juvenile Dermatomyositis https://t.co/vxyXZyO0gs https://t.co/GgzhnhlmdR

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SPIRIT‐P3 RCT treated biologic‐naive PsA with ixekizumab x36 wks; those w/ MDA x 3 mos were randomized to continue or withdraw IXE (blinded). There were significantly more relapses when IXE was stopped; most regained control when started https://t.co/lhQ8X1Ef48

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RCT shows Stepped Exercise Program to be effective in Knee Osteoarthritis. VAMC study of 345 knee OA pts given either STEP-KOA (internet based progr) or an arthritis education (control). WOMAC scores at 9 mos were 6.8 points lower in the STEP-KOA group.https://t.co/EuoPyJkTif

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There's still time to sign up. Attend RheumNow Live this weekend. We have a robust schedule planned with top professional. https://t.co/LJ3qClHTKh

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Hydroxychloroquine studied vs Vitamin C (PBO) prophylaxis to households (n=671) exposed to COVID-19. 89% were COVD1-9 test neg at baseline. HCQ did not protect against progression to COVID (53 vs 45 events; adj HR, 1.10 [95% CI, 0.73 to 1.66]. A vit C Win! https://t.co/S5qjdIYaXq

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The Reflecting Rheum: Top Publications from 2020 Covering SpA and Still’s Disease Sponsored by Novartis Medical Affairs Listen to a panel of experts share their views on top spondyloarthritis and Still’s disease publications from 2020. View Now: https://t.co/rxTAwQNalx https://t.co/y8wnHSmBug

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Phase III RCT of apremilast showed no benefit in ankylosing spondylitis pts. 490 AS pts recv placebo or apremilast 20 mg or 30 mg bid 24 wks. The ASAS 20 was the same in all groups (PBO: 37%; 20 mg 35%; 30 mg 33). 2 yrs Xray changes were equal too. https://t.co/ILYtVMZp80

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Concise overview of Ehlers-Danlos syndrome from Medscape...FYI https://t.co/acHSoEhVVF

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News Feature: Enthesitis Responses to Secukinumab in Spondylitis Patients https://t.co/U7qfwwA2as https://t.co/lFa5LdfkIZ

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Epi study of Scleritis in the UK (1997-2018) shows incidence declined from 4.23 to 2.79/100K persons/yr. Scleritis pts have 2 fold incr risk of IMIDs- esp GPA, Behçets Sjögrens, ReA, RA, SLE, Crohns, SLE & AS (OR 51 to >3). https://t.co/FzaCLRvmEX https://t.co/98M5o66fpD

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Great full read NEJM review of Extrahepatic manifestations of Chronic HCV Infection; 1) mixed cryo vasculitis; 2)20-30% w/ HCV related Sicca (w/ SSA, SSB); 3) fatigue & FM; 4) AutoAbs: 70% RF+, <40% ANA+, 15% ACL Abs, 7% smooth muscle Abs https://t.co/YrIJbs8P8k

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Charcot (neuropathic) arthritis: often manifests as exaggerated bony hypertrophy w/o joint pain. Common causes(sites): diabetes (TMT ankle), tabes dorsalis/syphilis (hip or knee), syringomyelia (Shoulders, elbows) . Also CPPD, steroids, alcohol, amyloid https://t.co/SrYYrVjSq3

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BC Canada population study shows newly diagnosed #SLE patients (n=5,169) have a higher rate of 1st serious/sever infections (1.8-fold), and more total severe infections (2.1-fold) and infection-related mortality (1.6-fold) vs general population. https://t.co/acDk0WYSby

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Rinvoq (upadacitinib) was slated for a psoriatic arthritis indication this month, but now that has been pushed back ~90days, pending further FDA review of the benefit-risk profile for upadacitinib in psoriatic arthritis https://t.co/FeBOrNIbTo

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Have you listened to this week's podcast? We answer listener questions. https://t.co/LXW8uyFGNP

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