Cannabis therapy is legal in 30 states in the US, and soon to be legal in Canada and Great Britian, but the US Veterans Administration continues to reject medical marijuana as a therapeutic option - even in states where it is approved.

  Palindromic rheumatism (PR) is an intermittent inflammatory arthropathy with episodes of arthritis and/or periarticular inflammation that wax and wane over time. It is thought that up to one-third of such patients may go on to develop rheumatoid arthritis (RA).

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

The Annals of Rheumatic Disease have published the recently developed Latin American clinical practice guidelines for systemic lupus erythematosus (SLE) addressing the best pharmacologic interventions for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, hematological manifestations and the antiphospholipid syndrome.

The majority of patients with psoriatic arthritis (PsA) who achieved a state of minimal disease activity (MDA) after 6 months of treatment with adalimumab (Humira) maintained that response through 24 months, a large observational study found.

By recognizing the limitations of memory and patient recall, I tend to focus historic elements that have high predictive value and avoid time consuming worm-holes in history-taking that have low predictive value. This leaves me with more time to listen to the patient.

Gout, the ancient disease of kings is usually treated with the ancient (and costly) drug colchicine, often without consideration of nonsteroidal antiinflammatory drugs (NSAID) or corticosteroids. A recent metanalysis compared the NSAIDS and steroids and showed that both were equipotent in managing the pain of acute gout, but corticosteroids appear had a more favorable safety profile. 

A consensus panel was convened to develop consensus-based clinical and therapeutic recommendations for the use of methotrexate (MTX) in the management of Juvenile Idiopathic Arthritis (JIA) patients.  

The Journal of Rheumatology reports a population-based study demonstrating that gout is associated with an increased risk of developing erectile dysfunction (ED) suggesting that hyperuricemia and inflammation may be independent risk factors for ED.

Positive tests results for antinuclear antibodies (ANAs) are frequently referred to rheumatology despite their poor predictive value, even in individuals who are ‘At Risk’ for autoimmune connective tissue diseases (AI-CTDs). A new study shows that combining ANA positive with interferon-stimulated gene expression increased the liklihood of progression to AI-CTD.

Dan Wallace and colleagues report in Lancet the results of a phase II study of the selective baricitinib, an oral selective Janus kinase (JAK1 and JAK2) inhibitor, in patients with systemic lupus erythematosus, demonstrating the efficacy and safety of JAK1/2 inhibition with baricitinib as a new potential oral therapy for SLE.

Dr. Jack Cush reviews highlights from the news and social media on RheumNow.com in the past week. 

Based on clinical trial data, patients starting tumour necrosis factor-alpha inhibitors (TNFi) have roughly a two-thirds chance of achieiving a good clinical response. French investigators have studied a series of potential biomarkers and surmised that the combination of baseline prealbumin, platelet factor 4 and S100A12 can predict a 78% response to TNFi in rheumatoid arthritis (RA) patients.