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Consults in Cars
In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?
Dr. Jack Cush reviews this past week's journal articles and news features on RheumNow.com. Colchicine, vaccine rollout, risk of RA in endometriosis patients, tREACH trial, lupus nephritis news, rheumatology burnout and more.
Predictive modeling of data derived from the DANBIO registry (of treated IMID patients) revealed a 4 fold increased risk of serious infection (SIE) in those starting biologic DMARD (bDMARD) treatment. From this large dataset, researchers developed a simple prediction model to estimate future infection risk that may inform shared decision-making in individual patients.
A systematic review by Urowitz and colleagues examined placebo responses in randomized controlled trials of non-renal, non-neuropsychiatric SLE patients showing unexpectedly high placebo responses; with more than one-third of the placebo-treated SLE patients responding by validated outcome measures.
Kidney International reports on a series of systemic lupus erythematosus (SLE) patients, who despite inactive urinary sediment and low level proteinuria, had a high rate of glomerulonephritis (GN) proven by renal biopsy; moreover, the LN was not predicted by laboratory abnormalities. A single center retrospective study included 87 SLE patients with proteinuria <1000 mg/24-hour proteinuria who also had their first kidney biopsy.
Pfizer announced results Wednesday from its FDA-mandated postmarketing safety study of tofacitinib (Xeljanz), and they don't bode well for the drug and possibly others in its class.
Acute gout has its well defined protocols, and most state that urate lowering therapy (ULT) should be continued; but does ULT affect outcomes in an acute gout attack?
The 2021 Medscape Survey on Physician burnout ranks rheumatology second, just behind Critical Care medicine. The survey included over 12,000 physcians from 20 specialties. While 42% of MDs claimed to be burnt-out, Rheumatologists claimed this 50% of the time. The top 3 this year were Critical care (51%), Rheumatology (50%) and infectious disease (49%).
A press release from Montreal Heart Institute announced that the COLCORONA clinical trial provided evidence of the protective effect of colchicine; demonstrating a 21% reduced risk of death or hospitalizations in patients with COVID-19 compared to placebo. COLCORONA trial was a contact-less, randomized, double-blind, placebo-controlled study of 4,488 non-hospitalized patients from Canada, the U.S., Europe, South America and
On January 22nd, the FDA approved voclosporin (Lupkynis) for use in adults with active lupus nephritis; voclosporin is a calcineurin-inhibitor immunosuppressant indicated for use in combination with a background immunosuppressive therapy. FDA approval was based on data from the pivotal AURORA Phase 3 study and the AURA-LV Phase 2 study, which demonstrated the ability of voclosporin to significantly improve LN outcomes after 52 weeks of
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com, with more than a dozen items to discuss on this week's podcast.
NEJM has published the interim analysis of the REGN-COV2 trial, wherein an antibody cocktail reduced viral loads with less clinical consequences. 
JAMA has published the BLAZE-1 study, showing significant SARS-CoV-2 viral load reduction at day 11 and less COVID-19 progression when combination anti-spike monoclonal antibody therapy (bamlanivimab and etesevimab) was given to mild to moderate, non-hospitalized COVID-19 patients.
JAMA Dermatology has reported on a longitudinal cohort study of 12,319 secukinumab (SEC) treated patients (psoriasis, psoriatic arthritis, or ankylosing spondylitis); no new cases of active tuberculosis (TB) and very few cases of latent tuberculosis infection (LTBI) were found. 
A Medicare claims analysis of rheumatoid arthritis (RA) patients showed that RA-associated interstitial lung disease (RA-ILD) was seen in nearly 5% of patients and was found to increase mortality risks, including respiratory and cancer mortality not explained by other factors.
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