A 10-year study of more than half a million Danish children found no evidence that vaccines increased the risk of autism. The study comes at a time when anti-vaccine suspicion is on the rise again. https://t.co/ZhZaW1kUQl

• https://nyti.ms/2TEtHKU

Complacency - not knowing whether you’re in a groove or rut - Lisa Bodell

“Innovation is the pirate ship that sails into the yacht club”. - Lisa Bodell

Shoulder replacement surgery - low risk of revision in older women (2.7%), highest (23%) in men 55-59 yrs; Revision highest in the 1st 5 yrs. SAE risk <90d was <4.8%; highest in men >85 yrs (21%). Pulm embolism risk Rel Risk = 61fold in women 50-64. https://t.co/NVSzfgZvwS

• https://buff.ly/2U15dIK

Systematic review of Paternal DMARD exposure prior to pregnancy shows no firm evidence of harm with TNFi, ABA, RTX, azathioprine, cyclosporine, HCQ, leflunomide, MTX or mycophenolate mofetil. Data from 84 papers, 611 male exposures, 5986 pregnancies https://t.co/yfIYoMqaRs

• https://buff.ly/2SLifsw

Study of 6529 Afib pts on warfarin, 37.5% were also on aspirin. Adding aspirin to warfarin yielded significantly more bleeding (26 vs 20%), major bleeding (5.7 vs 3.3%), ER visits (13.3 vs 9.8%) but similar thrombosis rates (2.3 vs 2.7%) at 1 yr. https://t.co/m5XDBEN6jh

• https://buff.ly/2TAQmHZ

Claims analysis from Natl Taiwan Health Database, compared 262 JIA pts w/ controls & showed JIA pts have 30 fold higher risk of an adult autoimmune dz- Hazard Ratio=129.5 for RA; aHR-10.1 SLE, 49.62 AS & 8.2 PsA. Highest risk (46x) for JIA onset 11-15 yrs https://t.co/oL3stNLYvc

• https://buff.ly/2SKBgvd

Risk of pancreatitis with azathioprine in adults estimated to be 3-7%, but unknown in kids. 3374 pairs of pediatric IBD pts compared pts on AZA vs not. AZA use was associated with a 5.82 events/100PY risk of pancreatitis (AZA 49·1 vs NOT 8·4 events/100PY) https://t.co/arap2ShTPN

• https://buff.ly/2HkIlAm

Rule of thumb on VTE risks: Normal population 0-.4/100PYs; RA patients are increased at 0.3-0.7/100 PY. If a new RA drug were to cause VTE (venous thromboembolic events; DVT/PE) it would have to have a rate consistently higher than 0.5 and probably higher than 0.7/100PY

The PARA study shows among 249 pregnancies (2002-2008), breastfeading was less in RA - at 4-6, 12 & 26 wks postpartum 43%, 26% and 9% of the RA breastfed (vs 63%, 46% & 41% in controls). Many patients D/C breastfeeding so they could start medication. https://t.co/ONf1jgFJYL

• https://buff.ly/2IUIFYW