Dr Jack Cush reviews the news, journal articles and takes a few Back Talk questions this week:

Pisetsky and Lipsky have reviewed the evolving literature on the utility of antinuclear antibodies (ANA). ANAs generated as part of an autoimmune disorder may form immune complexes that mediate pathogenesis by tissue deposition or cytokine induction.

Extraintestinal manifestations (EIMs) frequently accompany inflammatory bowel disease, often augmenting morbidity and mortality are associated with disease activity and may increase the need for surgery or treatment escalation.  A recent review in GUT details the treatment options for patients with EIM.

Since patients with SLE have longer life expectancies in the modern era, they may be at elevated risk for HCQ adverse events, including maculopathy and cardiomyopathy. Therefore, Peter M. Izmirly, MD, of New York University School of Medicine in New York City, and colleagues assessed whether older SLE patients could safely discontinue HCQ.

ARD has published a report showing that patients with early rheumatoid arthritis have cardiovascular disease that is modifiable with conventional and aggressive therapy and that it did not matter if first line DMARD therapy was with a tumour necrosis factor-inhibitor or methotrexate.

Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy.