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Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the perioperative management of DMARDs and found inconsistencies and low quality evidence, with great reliance on conditional (expert opinion) recommendations.
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Manifestations and Treatment in Relapsing Polychondritis
A large multicenter cohort study of Relapsing Polychondritis (RP) describes the clinical manifestations and treatment approaches to this rare, heterogeneous, multisystem disease.
Osteoporosis treatment benefits people older than 80
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EurekAlert!
People who are older than 80 should be considered for osteoporosis treatment after a fracture to avoid further risk, according to a study being presented Saturday at ENDO 2025, the Endocrine Society’s annual meeting in San Francisco, Calif.
Interstitial Lung Disease and Lung Cancer Risk
A large prospective cohort study found that interstitial lung disease (ILD) is associated with an increased risk of lung cancer.
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Biologic survival study of British Assoc. of Dermatologists Biologics Register (11/07-6/23) looked at 19,034 Rx courses (median F/U 2.3 yrs), of TNFi, IL-12/23i, IL-17i, & IL-23i. IL-23i (GUS & RIS) had best survival (~1.93yrs) for efficacy & safety (broadalumab the least) https://t.co/aAULb0e3o9
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Systemic sclerosis have more adverse pregnancy outcomes. Swedish Medical Birth Register study pre- & post SSc Dx (94 vs 978) finds incr risk post SSc for preeclampsia (RR 3.8), preterm birth (3.3), & caesarean (2.5). No incr of maternal or neonatal death, nor stillbirth https://t.co/9PWREN62r0
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Martinque, Afro-Caribbean population (n 354 800) study(2004-2022) of 33 AOSD pts (71%F; 79% systemic; 21% chr articular); 91% met Yamaguchi criteria; features as expected but more Pulmonary Dz(51%; 94% w/ a systemic pattern). Half Dx < age 35 yrs. Prevalence 7.6 /100 000 mean https://t.co/QWyfNuvhkl
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NHANES study (1999–2018) of 38,272 participants looked at the neutrophil-to-albumin ratio (NPAR), & elevated NPAR significantly assoc w/ an increased risk of RA (ORtertile3vs1 = 1.27), esp if NPAR > 13.6. NPAR superior to SI), SIRI, PLR, MLR, & NLR. https://t.co/asLc6ghz7w https://t.co/2dAhIvekGA
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NHANES study (2007 to 2020) of 19,904 participants (≥ 20 years), including 1,477 RA pts. Prevalence of kidney stones was higher in RA (17% vs. 8%, p < 0.001) (OR = 1.77) https://t.co/0NZKQdQWR8 https://t.co/BRZ1RTNh5W
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RA study shows rapid remission (DAS28-CRP < 2.6 <12 wks) occurred in 28% of 865 pts & assoc. w/ better respsonses at week 26. Also rapid remission had signif. 5 yr benefits (SJC, TJC, Fatigue, HAQ, pain, & most PRO outcomes. https://t.co/2tvxS8oXP2 https://t.co/YAFGAri3Uj
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10-20% of IBD pts have IBD-assoc. spondyloarthritis, as either peripheral arthritis or axial Dz, subclinical gut inflammation w/ IL-23–IL-17–TNFα playing central roles. TNFi & JAKi Rx is effective, but IL-17i may exacerbate IBD (vedolizumab??) Review here>> https://t.co/kNIAi55Y7z
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HHS secretary Abruptly Cancels USPSTF Meeting on July 10 - to discuss diet, physical activity, and weight loss to prevent cardiovascular disease in adults. An HHS spokesperson did not give a reason. https://t.co/IqNOUWeVA4 https://t.co/0AmxQ1ZAcQ
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CMS to Test Prior Authorization Model in Traditional Medicare
The Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some politicians and experts https://t.co/o8iV9Bb6Ir
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No Increased Malignancy Risk with Ixekizumab
A pooled analysis of 25 randomized clinical trials affirms the safety of ixekizumab (IXE) when used to treat patients with psoriasis (PsO), psoriatic arthritis (PsA), or axial spondyloarthritis (axSpA). The observed incidences of https://t.co/7dAoQyeq5x
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Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
https://t.co/ZjuOO08sKx https://t.co/rNVBFxgjZY
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Study of 74 systemic sclerosis pts shows nailfold videocapillaroscopy (capillary disorganization, late pattern changes) predicts ILD progression, worsening PFTs & mRSS in SSc over 2 yrs. KL-6 correlates w/ NVC findings & PFT decline. ILD incr from 38 to 51% in 2yrs https://t.co/A3LiG6Nn0m
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Is the term polymyositis obsolete?.. now being replaced by dermatomyositis, necrotizing myopathy, inclusion body myositis, antisynthetase syndrome & overlap myositis. Full read overview of inflammatory myositis & new treatments from Joint Bone & Spine https://t.co/X46sptp1Ax https://t.co/smqCd8Rm2o
Links:
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MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/PXkEC3LO6n
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Don't Stop the DMARDS!!
Retrospective study of 91 JIA pts (all types; 36% oligo, 27%poly) all Rx w/ cycles of DMARD therapy. Consistently two-thirds relapsed and flared. Only one-third of JIA patients were able to remain off DMARDs. https://t.co/ifqnMKfhAe https://t.co/8JAbpO1IVe
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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/wC2dPvVR7x https://t.co/HCFSXBfVGM
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