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RheumNow Podcast – Believe in Vitamin D or Rituximab? (9.20.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
Read ArticleFEAR: A Perception of Fact In Spite of the Fiction
Pregnancy for patients with lupus has long been considered high risk and associated with both medical and obstetric complications, but outcomes have improved over the last 2 decades and continue to improve.
Read ArticleACR Survey Shows Half of Patients Cannot Afford Treatments
Americans living with rheumatic disease face significant healthcare challenges, according to a national patient survey released this week by the American College of Rheumatology. More than 1,500 U.S. adults living with rheumatic disease responded to the survey, which asked a range of questions related to healthcare access, affordability and lifestyle. Key findings include that even though 90 percent of respondents reported having health insurance coverage, nearly 60 percent said they had difficulty affording their medications or treatments in the past year.
Read ArticleNeed for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement
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.
Read ArticleModifiable Risk Factors for Hyperuricemia
Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia.
Read ArticleRheumNow Podcast - I Wanna New Drug (8-30-19)
Dr. Jack Cush vents on choosing new therapies in rheumatoid arthritis.
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War on RA – Part 4: Desperado – Time to Open the Gate
Do you know what the best-selling album of all time is? Could it be Bing Crosby? U2? Fleetwood Mac? AC/DC? I know, it’s Michael Jackson’s “Thriller” right?
Actually it’s the Eagles Greatest Hits – it surpassed Jackson’s Thriller in August 2019 as the best-selling with a total of 36 million copies sold since it was released in 1976. Wait! Are we not Rheumatologists? Aren’t we supposed to be discussing rheumatoid arthritis?
New EULAR/ACR Classification Criteria for SLE
The European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) have jointly developed new classification criteria for systemic lupus erythematosus (SLE); prompted by the need for criteria that were both highly sensitive and specific. The net result is improved sensitivity and specificity, but the use of positive ANA requirement along with a longer list of weighted criteria ensures its utility in SLE research (including early or latent SLE), but not clinical practice.
Read ArticleWar on RA - Part 3: Useless Drugs
We have options that are endless – we have 28 biologics in rheumatology; 19 approved for RA in the last 20 years, but 15 of these are me-too copies or biosimilars. We currently have 2 JAK inhibitors and may have 3 or 4 by year end. But what we really need is the right drug, at the right time, in the right patient – but how will we know.
Read ArticleWar on RA - Part 2: It's All About You
Part II of this series is a direct message to rheumatologists. If we’re doing such a great job in RA, then why do we need a war on RA? Why is this conflict being laid at the feet of good soldier rheumatologists, those who toil daily at winning therapeutic battles one patient at a time? The reasons are blunt and true.
Read ArticleWar on RA - Part 1: Walk on the Moon
It’s a great time to be a rheumatologist and to manage RA. But, if you keep doing what you’re doing, you’re going to keep getting what you’ve got.
Read ArticleRecommendations for Exercise in Ankylosing Spondylitis
Australian researchers have assessed the problem of exercise in ankylosing spondylitis (AS). After posing 10 questions to 11 experts they have provided evidence and consensus-based ecommendations on exercise in AS.
Read ArticleThe Cost of Physician Burnout
An article in the Annals of Internal Medicine has analyzed the cost-consequences of physician burnout, including costs related to physician turnover and reduced clinical hours.
Read ArticleSleep Myths Debunked
A panel of 10 sleep experts studied 20 common sleep myths and found little or no evidence in support of these beliefs.
Sleep issues are highly prevalent among US adults, but few admit to it or do anything to manage it.
Read ArticlePolypharmacy Blunts Responses and Ups the Safety Risks
A study from the British Society for Rheumatology Biologics Register (BSRBR-RA) demonstrates that polypharmacy is a predictor of lower treatment responses and more serious adverse events (SAEs) in rheumatoid arthritis (RA) patients.
Read ArticleDr. Harold E. Paulus (1929-2019)
Dr. Harold “Hal” Paulus lives in the annals of Rheumatology as a major contributor, mentor, researcher and clinical trialist. He passed away last week, one day after his 89th birthday. I met Dr. Paulus as a fellow in 1985, when he easily included me in his discussions and research on rheumatoid arthritis. I admired his easy demeanor, wry humor and every man character. Most remark on his calm recessive and kind personality that was complemented by a body of work that was large, impactful and usually at the cutting edge.
Many of Dr. Paulus’ colleagues and friends have contributed their testimonies and fond memories of this great man.
Dietary Supplements Fail to Reduce Mortality Risks
An NIH funded prospective study has shown that the use of daily dietary supplements was not associated with a subsequent lowering of mortality risk.
Read ArticleAn Autoimmune Diagnosis Alters Perceptions of Pregnancy and Lactation
A study from UT Southwestern and the Baylor Research Institute examined the preceptions and practices of women with autoimmune or inflammatory rheumatic diseases (AIRD) noting that an AIRD diagnosis changed most womens future hopes and plans regarding pregnancy and lactation.
Read ArticleACR Position Statements on Drug Pricing and Step Therapy
The American College of Rheumatology Committee on Rheumatologic Care has released new drug pricing and step therapy position statements that they hope legislators will consider as they continue to explore policy and regulatory options to make drugs more affordable and accessible.
Read Article2018 Swedish Guidelines for Giant Cell Arteritis Treatment
The Swedish Society of Rheumatology has developed evidence-based guidelines for the management of giant cell arteritis (GCA) with a focus on the appropriate use of corticosteroids and tocilizumab.
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