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ACR/EULAR Classification Criteria for IgG4 Related Disease

d Jack Cush, MD

IgG4-related disease (IgG4-RD) is a relatively new disorder since 2003, and may present as a diagnostic challenge as it can cause fibroinflammatory pathology in nearly any organ. 

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Variations in First Biologic Use in Rheumatoid Arthritis

d Jack Cush, MD

A Canadian analysis shows that rheumatoid arthritis (RA) patients are more likely to receive biologic DMARDs earlier if they are younger, female, and living in urban areas closer to prescribers.

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Link Between Obstructive Lung Disease and Developing RA?

d Janet Pope, MD, MPH, FRCPC

We all know that the microbiome in the gut may be very important for multiple immune diseases. However, new findings from the ACR, 2019 in Atlanta reinforce how important the interface is between the lungs and developing rheumatoid arthritis.

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Steroids Use in Lupus Linked to Damage Accural

d Jack Cush, MD

A report from Lancet Rheumatology shows that glucocorticoid use contributes to damage accrual in systemic lupus erythematosus (SLE) independent of disease activity.

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Abarca, a pharmacy benefits manager, reports Amgen has agreed to give its health insurer clients an additional discount (amount$$??) on Enbrel, if patients discontinue taking it after three months - to help health insurers save costs if pts d/c Enbrel https://t.co/uhyAiJTcAj

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American College of Cardiology review of Colchicine (biology, hx, pharmacology, use) in the treatment of pericardial disease (acute/chronic/recurrent pericarditis, pericardial effusion, Post-cardiac Injury Syndrome). Full read review available. https://t.co/8Yz0J1KCyV

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J Rheum metanalysis of 12 studies & 3,234 SLE pt vs 288,336 control subjects shows a significant association between SLE occurrence and current-smoker (not former) (OR 1.54) https://t.co/shL8LT6Kbj

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S American study of #SLE compared Latin American (LAM) vs European caucasian SLE pts - LAM had more myositis, hemolytic anemia, nephritis, Sm, Ro, RNP & more disease activity, hospital admissions, but damage index, mortality or co-morbidities https://t.co/o8hFQrCZp6

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Biosimilar Tote-Board in Rheumatology: 4 Infliximab biosimilars - Inflectra, Renflexis, Ifixi, Avsola 5 Adalimumab biosimilars - Amjevita, Cyltezo, Hyrimoz, Hadlima, Abrilada 2 Etanercept biosimilars - Erelzi, Enticovo 2 Rituximab biosimilars - Truxima, Ruxience

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FDA has approved Amgen’s infliximab biosimilar, Avsola (infliximab-axxq),for use in Crohns, UC, RA, AS, PsA and psoriasis, based on a 566 pt trial in RA. This is the 4th infliximab biosimilar in the US, joining Inflectra, Renflexis, and Ixifi. https://t.co/nFhyMM1OnK

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46 #RA pts on DMARDs +/- biologics received 3 part Hepatitis B Vaccination - those on biologics and DMARDs had less seroprotection vs controls (50% vs. 100% [p = 0.02] and 69.7% vs. 100% [p = 0.09], respectively). HBV vaccine well tolerated & without flare https://t.co/3XuQhYquMy

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BEST JOURNAL TITLE OF THE WK - "The Giants (biologicals) against the Pigmies (small molecules), pros and cons of two different approaches to the disease modifying treatment in rheumatoid arthritis." https://t.co/9ncBmDbd6B

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Comparison of radiographic (r-axSpA) & non-radiographic axSpA (nr-axSpA) pts from the DESIR study shows a higher prevalence of males in r-axSpA, but no significant differences in peripheral arthritis, extra-rheumatic Sxs, PROs, Sick leave between groups https://t.co/nIndsJuFCN

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Those with prior partial knee arthroplasty (AKA medial unicompartmental knee arthroplasty) who undergo total knee replacement have a 3-fold higher risk of revision vs primary TKA. https://t.co/PIJICbfkoG

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Serum Calprotectin levels were higher in the 157 RA pts who relapsed with DMARD withdrawal in the IMPROVED and RETRO Studies https://t.co/LBHDwuFuvM

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Achilles tendinitis Risk factors: 1) prior lower limb tendinopathy or Fx, 2) quinolones, 3) moderate alcohol, 4) cold weather training, 5) decr plantar flexor strength, 6) abnormal gait, 7) lateral foot roll-over 8) CrCl <60 in heart transplant pts. https://t.co/AS05AjDJ2C

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TB is highly endemic in https://t.co/EbxAucKT9Y. S. African registry reports 97 TB cases in biologic users w/ TB rate 1240/100000 PYs vs zero in biologic naive pts. 1/3 were extra-pulmonary. TB risk highest w/ TNFi Mabs (1683) vs 861 ETN or 681 other MOAs. https://t.co/VUNHVjzkex

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The RheumNow Podcast is up! Monitoring Methotrexate Safety, Palmoplantar pustulosis, diet in SLE, enthesitis Rx, & benefits of smoking cessation..... Listen here>> https://t.co/zoFp2vc7EB

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Newly Dx #SLE patients have a 62% higher risk of hip fracture. Canadian matched cohort study of 5,047 incident SLE vs and 25,235 non-SLE showed more hip fractures in SLE (HR=1.62 [95% CI; 1.06-2.48]). Implications for OP prevention in SLE patients? https://t.co/oDbYZPwMXD

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ACR MTX monitoring guidelines from 1994 (Alarcon et al) -pts should be screened for HBV, HCV, Alb. At AST, ALT should be checked at intervals of every 4-8 weeks. MTX should be stopped/adjusted or liver Bx if AST abnl in 5 of 9 (or 6/12) in 12 mos. https://t.co/8lcPz7sH3F

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