2020 ACR Gout Management Guideline

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In May, the American College of Rheumatology (ACR) released the"2020 Guideline for the Management of Gout"reflecting new clinical evidence since the last guideline published in 2012.

RheumNow Podcast – In Times of Trouble (4.24.20)

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Dr Jack Cush reviews the news, journal reports, twitter feed and COVID developments from the past week on RheumNow.com

Lower Risk of Diabetes with Abatacept

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 Patients with rheumatoid arthritis (RA) treated with abatacept (Orencia) had a lower risk of developing diabetes mellitus compared with those receiving certain tumor necrosis factor (TNF) inhibitors, a large cohort study suggested.

Updates on Psoriatic Arthritis at ACR 2018

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I think 2018 was the year that belonged to psoriatic arthritis (although some may argue in favor of immune conditions induced by Checkpoint inhibitors). Many years ago the late Professor Verna Wright in Leeds (UK) was a lone voice for many years describing the clinical subtypes of Psoriatic arthritis as something distinctive from rheumatoid arthritis. For a long time we thought that the treatments for PsA were just the same as RA since we were treating the same problem of synovitis.

A Role for SGLT2 Inhibition in Gout?

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The antidiabetic medication canagliflozin (Invokana) lowered serum urate and reduced the risk of gout flare in a post-hoc analysis of data from two large clinical trials.

ACR 2018 - Day 1 Report

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Highlights from Tuesday and Wednesday (days 3 and 4) from the ACR annual meeting include: the important and impactful abstracts covered by the Rheumatology Roundup session; upadacitinib clinical trials; and the baricitinib CV and VTE safety analysis.

Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement

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JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.

Weight Loss Cuts Hospital Stays for Obese TKA Patients

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Morbidly obese patients who lost 20 lbs before total knee arthroplasty (TKA) cut their hospital stays by about 1 day, and were 76% less likely to have an extended hospital stay, research showed. 

A Potential Biomarker for Chronic Fatigue Syndrome Patients

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Myalgic encephalomyelitis/chronic fatigue syndrome affects at least 2 million people in the United States and bears tremendous overlap with fibromyalgia - both being difficult to diagnosis because the symptom complex is often unrecognized and these conditions have no biomarker test. 

RheumNow Podcast – Gout Spot Light (1.11.19)

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Dr. Jack Cush discusses the highlights from the past week on RheumNow.com:

Sleep Apnea Increases Gout Risk

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Both Gout and obstructive sleep apnea (OSA) comingle with a wide range of serious comorbidities. A matched retrospective cohort study from the UK Clinical Practice Research database shows those with OSA are at a higher risk of developing gout.

Pre-Diabetes Associated Risk for Arthritis, Obesity and Physical Inactivity

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The current MMWR reports that arthritis is seen in nearly one-third of adults with prediabetes and that more than half of such patients are obese and not engaged in regular physical activity.

Activity Trackers May be Helpful in Arthritis Patients

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Use of wearable activity trackers was associated with increases in the number of daily steps among individuals with rheumatic and musculoskeletal disorders, a meta-analysis found.

Dietary Recommendations for Psoriatic Disease

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A systematic review by the Medical Board of the National Psoriasis Foundation examined the role of diet in managing adult patients with psoriasis and/or psoriatic arthritis and suggest that dietary interventions to reduce disease severity.

Severity of Lupus Nephritis is Declining over Time

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A retrospective follow-up study of 499 lupus nephritis (LN) patients over three successive eras shows that LN has become less severe in recent years and thus, better long-term survival is possible.

Rising Need for Weight Loss Counseling in Arthritic Patients

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The CDC's May 4th MMWR reports that from 2002 to 2014, the prevalence of health care provider counseling for weight loss among adults with arthritis and overweight or obesity increased by 10% (from 35% to 45%).

Among the 54.4 million adults with doctor-diagnosed arthritis in the United States, 32.7% are overweight and 38.1% are obese. Moreover obesity is more prevalent among persons with arthritis than among those who do not have arthritis.

Increased Comorbidity Burden in Lupus African Americans

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Researchers from Vanderbilt University Medical Center used electronic health records (EHR) to perform a phenome-wide study comparing African American (AA-SLE) and Caucasian (C-SLE) with systemic lupus erythematosus (SLE) and found more comorbidities in AA-SLE, especially renal, cardiovascular, an

Leflunomide May Sensitize the Insulin Receptor and Have an Anti-Glycemic Effect

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An animal model study in the Journal of Endocrinololgy reports the potential use of leflunomide in the control of hyperglycemia in male mice. 

Diet During Pregnancy May Influence Future Allergic or Autoimmune Disease

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A systematic review of the literature on the relationship between diet during pregnancy, lactation, or the first year of life suggests that maternal ingestion of probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.