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RheumNow Podcast – Cardiovascular Risk in Psoriatic Disease (9.25.20)

d Jack Cush, MD

Dr. Jack Cush reviews the news and Journal articles from the past week on RheumNow.com.

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EULAR Updated 2019 Recommendations for Psoriatic Arthritis Management

d Jack Cush, MD

In June 2020, we failed to report on the ARD publication updating the 2019 update the European League Against Rheumatism (EULAR) recommendations for the pharmacological treatment of psoriatic arthritis (PsA) - these are presented below.

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Romilkimab Effective in Early Diffuse Systemic Sclerosis

d Jack Cush, MD

A phase II study of patients with early diffuse systemic sclerosis (SSc) has demonstrated improvement in SSc skin outcomes by targeting T cells and fibrosis with the bispecific monoclonal antibody romilkimab (RMK).

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Ustekinumab Early Risk for Cardiovascular Events

d Jack Cush, MD

JAMA Dermatology reports a claims-based, case-time-controlled French study of 9290 psoriasis patients suggesting that ustekinumab initiation may be associated with an increased risk of acute coronary syndrome or stroke in high risk cardiovascular patients.

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Young Adults are Driving Up COVID-19 Rates

d CDC/MMWR

CDC reports that since June 2020 individuals infected with COVID-19 have largely been young adults in the 20-29 year age bracket. Moreover, younger adults appeared to be driving community transmission of COVID-19. 

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Livedo, Purpura and Coagulopathy in Severe COVID-19

d Jack Cush, MD

JAMA Dermatology expands the spectrum of complications seen with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection describing cutaneous purpura and livedo lesions in patients with severe COVID-19.

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CDC Reverses Guidance for Asymptomatic COVID Contacts

d Jack Cush, MD

Asymptomatic people who have been exposed to COVID-19 should be tested, the CDC said on Friday, in a reversal of controversial guidance the agency introduced in late August.

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High-risk coronary plaques (LRNC) assessed by Coronary CT scores in 209 biologic naive Psoriasis pts. LNRC correlated w/ Framingham risk & Dz activity. After 1 year those on biologics had signif reduction in LRNC, but those not on biologics had no change https://t.co/8o74pjIs5n

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Rheums Win Big in 2021! According to the estimates from the Centers for Medicare & Medicaid Services (CMS), endocrinologists and rheumatologists are the big winners, at 17% and 16% projected increases, respectively https://t.co/I6etQZnFlv

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Swedish GWAS study of >850,000 individuals shows Genetically predicted BMI (obesity) significantly increases RA riskk, but no correlation of RA risk to waist-to-hip ratios. https://t.co/YkzwjPOVyE

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FDA has issued a new guidance document outlining the inclusion of geriatric information in drug labeling detect; especially noting geriatic studies and when efficacy and safety differs from that seen in younger adults https://t.co/jTLDae3Gff

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The EMAs Committee for Medicinal Products for Human Use (CHMP) has recommended baricitinib for approval in adults with moderate-to-severe atopic dermatitis who are candidates for systemic therapy https://t.co/goEacN1C8X

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Global task force establishes protocols for medical cannabis use to treat pain. Start low (5mg CBD) and titrate up (max 40 mg) - ALL Expert opinion, no good evidence (largely bunk?) https://t.co/HyYU0tGVF5

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Cluster analysis of 168 antiphospholipid pts shows that having arterial thromboses and cardiovascular risk factors was associated with mortality and poorest prognosis in APS. https://t.co/Nb7lZNu4jT

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Pain in Knee Osteoarthritis comes from what?

Dr. John Cush RheumNow ( View Tweet)

Questions or Comments to Cush for the RheumNow Podcast? Weigh in with "Back Talk" wherein Ill discuss your question, query and theory https://t.co/Ngg7XyS6ns https://t.co/DuQHfGnXWO

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Ann Int Med shows again that steroids increase serious infection risk in a dose dependenet manner, but even 5 mg of prednisone or less also gives a small but significant risk of serious infection in RA patients on DMARDs (claims data from Medicare & Optum) https://t.co/bj41SqKP0K

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A machine-learning algorithm was developed using MRI data from the Osteoarthritis Initiative capable of predicting osteoarthritic progressors from baseline cartilage texture maps ; Had a test accuracy of 78% in detecting OA progression 3 y prior to Sxs https://t.co/OPw9KGb4jr

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Outcomes survey of 229 relapsing polychondritis patients shows that 59% had auricular-onset (AO) and 21% had respiratory -onset (RO), 20% w/ miscellaneous-onset (MO- eye MSK CNS). Poorer prognosis seen in RO & MO subgroups than AO subgroups https://t.co/rzVU42z3EA

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6.6% Risk of Late-onset Neutropenia (ANC<1000) in a single center study of 738 Rx w/ Rituximab (107 LON in 71 patients). Incidence was 7.2/100PYs. Higher risk w/ SLE or CTX Rx. 40% had Sxs, Fever 31%, sepsis in 8.5%. Rechallenge in 87% & 21% recurrent LON https://t.co/XXFV1lH9jS

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