Lee and a group of Korean investigators have analyzed the comparative safety of allopurinol and febuxostat in a small cohort of gout patients with fatty liver disease (FLD) and found febuxostat had a lower risk for hepatotoxicity (defined as AST or ALT at least 3× the upper limit of normal) compared to allopurinol.
A multicenter study of early systemic lupus erythematosus (SLE) patients examined manifestations at disease onset and found that certain clinical features can help to distinguish early SLE from other SLE‐mimicking conditions.
Dr. John Cush RheumNow
7 years 10 months ago
Musculoskeletal/Rheumatic diseases (arthralgias, myalgias, arthritis, PMR, myositis, Sjogrens, SLE) are uncommon side effects of immune checkpoint inhibitors, so-called irAE (immune related adverse events). Good review here. https://t.co/R52SW0HUjv
Dr. John Cush RheumNow
7 years 10 months ago
Despite many excellent therapies, most patients with gout are not adequately managed, and patients and providers have many misconceptions about gout. Great review by Ted Fields, MD https://t.co/Njpo1225XP
Dr. John Cush RheumNow
7 years 10 months ago
Bisphosphonate safety review - risk of Atypical Femoral Fracture is 1/1000 and risk of osteonecrosis of the jaw is 1/10,000. One-third of IV zolendronic acid pts will have arthralgia/myalgias or flu like sxs. https://t.co/80xBkZlKgn
Dr. John Cush RheumNow
7 years 10 months ago
TB Testing 2
- Note: <10% of pts initially PPD/IGRA neg may be positive later (either they were anergic or have a new TB infx). I Recommend repeat TB testing 3 mos after starting or changing from 1st to 2nd biologic
- Repeat testing indicated if newly EXPOSED or when Risk Changes
Dr. John Cush RheumNow
7 years 10 months ago
TB Testing
- Do PPD or IGRA before TNFi or biologic
- If negative, start therapy
- If Positive, Eval for active TB (Sxs, CXR, C/S); if neg --> LTBI Rx BEFORE biologic
- If "Indeterminate", repeat or change test. If same or neg--> start biologic
- Do not do annual TST or IGRA
Patients with systemic lupus erythematosus (SLE) remain at risk for accelerated atherosclerosis, and important questions have yet to be answered, British investigators reported.
Dr. John Cush RheumNow
7 years 11 months ago
Metanalysis shows DMARDs (6 studies) and biologics (5 studies) offer NO clinically significant benefit compared with placebo in Osteoarthritis. https://t.co/fNGVzuNQNo
The CMAJ (Canadian Medical Association Journal) has reported that trazadone use in the elderly may be associated with a risk of falls and major fractures. Using claims data from ICES, researchers compared 6588 seniors given trazadone to 2875 receiving another atypical antipsychotic.
Dr. John Cush RheumNow
7 years 11 months ago
Vasculopathy (inflammatory, occlusive, necrotizing) distguishes juvenile dermatomyositis from adult myositis - also w/ high risk of severe extra-muscular dz (GI, Lung, cardiac, skin). Good review article here https://t.co/yH8xwKl6S8
Dr. John Cush RheumNow
7 years 11 months ago
Could routine use of hydroxychloroquine reduce the rate of serious infections in immunosuppressed patients? A modest to moderate risk reduction noted in two large SLE cohort studies. https://t.co/pssLrteRRq
Dr. John Cush RheumNow
7 years 11 months ago
2018 NRMP report shows Rheumatology as one of the most competitive fellowships with 313 applicants for 221 positions - 147 filled by US grads and 69 by FMGs. https://t.co/xRmMyA2yCy
Dr. John Cush RheumNow
7 years 11 months ago
Clinical Trials Benchmark for Biosimilar Development is one of several educational videos available in the "Therapeutic Update: Biosimilars in Rheumatology" video series, sponsored by Sandoz, Inc. and now available on RheumNow. https://t.co/1vmnEJqOSi
Dr. John Cush RheumNow
7 years 11 months ago
J Rheum (Ward et al) reports that the minimal clinically important improvement (MCII) of RAPID-3 was –3.8. https://t.co/UxCOeMl52g
