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Do biologics help taper steroids in Adult Still’s Disease?
A Japanese large scale claims data study was able to collect 5-year data to study the treatment patterns in Still’s. In May 2019, intravenous tocilizumab was approved in Japan for Still’s disease. The study was designed to see patterns of steroid exposure before and after the approval of this therapy.
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How do Pts check Temps? Paired oral & temporal temps in 2031 Blacks & 2344 Whites: / whites showed no diff (36.97 vs 36.95°C), but signif diff in blacks (36.98 vs 37.05). Fever seen in 10.2-10.8% Whites, but 10.1% (temporal), 13.2% (oral) in Blacks https://t.co/D4XowfsYXD https://t.co/LmvEnAVGbr
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Anakinra in Pericarditis: A Systematic Review (comprehensive, full read) -Options include steroids, colchicine, NSAIDs, pleuropericardial window, IL-1 inhibitors. ANAKINRA - 11 studies, 259 pts, all showing significant rapid resolution. https://t.co/rcnTPkDTjq https://t.co/RbW1fPSjfU
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2 HIV+ pts with HLH (MAS) successfully Rx w/ JAKi - ruxolitinib. Both had high fevers, severe pancytopenia, hypofibrinogenemia, hypertriglyceridemia, & increased ferritin, BMBx Hemophagocytosis, splenomegaly. https://t.co/yGs7e4Ftgp https://t.co/cv9NX31bZr
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IL-18 is a proinflammatory cytokine involved in innate &adaptive immune responses. IL-18 is a key mediator in autoinflammatory diseases, MAS, Still’s disease. Serum IL-18 levels may be useful in diagnosis and monitoring of disease activity https://t.co/P8ecLAtNx5 https://t.co/3mo1vcYKUr
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Great and Not So Great (9.30.2022)
This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.
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ASBMR 2022 study shows Patients w/ serum ferritin > 1000 µg/L or Dx hemochromatosis or thalassemia — were 60% more likely to have an osteoporotic fracture (2X risk vertebral Fx) during an up to 10-year follow-up https://t.co/uLf8zTiMml https://t.co/9KnApUxxTF
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Heavy Metal Rheumatology (9.23.2022)
Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website.
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Dr. John Cush RheumNow ( View Tweet)
Retrospective study of PFAPA < 18yrs, 336 pts, Boys=Girls, peak onset ~age 1 yrs (less w/ yrs); 90% 1st Sxs under 5 yrs & <3% after age 10 yrs, Common Sxs: pharyngitis w fever, Cx adenitis, aphthous stomatitis, atyp skin rash. Incidence 0.86/10K/Yr https://t.co/1Mrp9bMnuE
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Dr. John Cush RheumNow ( View Tweet)