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RheumNow Podcast – Myth Busters (5.21.2021)

May 21, 2021 2:09 pm

Dr Jack Cush reviews the news and journal reports from the past week on

  1. Metanalysis (11 RCTs, 19 registries) of Pulm arterial HTN assoc. w/ CTD (w/ 1,267 & 4,008 CTD-PAH pts), showed Investigational Rxs reduced morbidity/mortality by 36%. CTD-PAH survival was lower (62 vs 72%) @3yrs, but improved after 2010 (73 vs 65%)

  2. Textbooks say fever is common in lupus ("36%–86%") BUT IT IS NOT! Lupus is cause of FUO in 5%; Fever is seen in a minority of SLE onsets; Fever occurs w/ SLE complications - vasculitis, pneumonitis/serositis/alveolar hem, CNS, & INFECTION!

  3. "Arthritis Mutilans" - worse outcome to chronic inflammatory arthritis is due to 5 disorders: 1) RA 2) Psoriatic arthritis 3) Tophaceous gout 4) polyarticular JIA 5) Multicentric reticulohistiocytosis (Ive never seen this!!)

  4. Checkpoint Inhibitor Safety in Melanoma Patients with AID A study from the DMT shows that the use of checkpoint inhibitors for advanced melanoma in AID patients didn't increase the risk of irAEs, except for those with preexisting IBD.

  5. Rituximab Tops Mycophenolate Mofetil for Pemphigus Vulgaris. One year study of 135 moderate-to-severe pemphigus patients saw complete remission in 40% of RTX vs 10% of MMF patients.

  6. JAK inhibitor helping vitiligo? Results from phase 3 TRuE-V trial ruxolitinib cream in adolescent/adult vitiligo pts - showed significantly more RUX pts with 75% improvement in facial vitiligo area scoring index (F-VASI75) compared to control at Week 24

  7. Cohort study of 4.4 million adolescents w/ 7.6 million fluoroquinolone Rxs found a 90 day LOW risk of tendon ruptures (0.47/1000 Pt yrs) or tendinitis (9.34 per 1000 person-years). These events were rare in kids and appear to be more common in adults.

  8. Genomic study of 1190 vasculitis pts & 11302 controls identfied a genetic variant, rs3743841, located in an intron of the NAGPA gene, reached genome-wide significance for Kawasaki (p= 8.06x10−10) and IgA vasculitis.(p= 1.25x10−7; OR 1.47)

  9. Another reason to be vaccinated: 2020-21, with mask wearing & distancing, influenza #s dropped by 98% to record lows In the USA; Flu test positives dropped from 19.34% to 0.33%. PLEASE NOTE; COVID VACCINATION IS WAY WAY MORE EFFECTIVE THAN MASK WEARING!

  10. Factors Associated with COVID-19 Deaths in Rheumatic Patients

  11. Tocilizumab Risk of Diverticulitis and GI Perforation

  12. Check out TNR Spondyloarthritis session highlights from RNL2021

  13. Register for the CCF Biologic Therapies Summit IX  May 21-23

The author has received compensation as an advisor or consultant on this subject

Rheumatologists’ Comments

rudy greene

| May 21, 2021 7:05 pm

I have seen 5-6 RA and Lupus patients who have had major flare of their disease after covid vaccines lasting 2-3 weeks. Anybody else reporting this?

Fred Anton Pages

| Jun 27, 2021 5:28 am

Hi, great mythbusting, what's your opinion on arthritis mutilans secondary to neuropathic arthritis, in terms of frequency and DDx.

Greetings from Spain!

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