I suspect that everyone in rheumatology has a special place in their hearts for lupus patients. Their disease is so cruel, and we have so little to offer them, but the young women (and some men) that I treat keep battling on. The longer I have cared for them, the more I wanted to do for them. Managing their illness alone did not seem like enough. 

JAMA Internal Medicine reports that in the USA, those who smoke cigar, pipe, or cigarette have a significant overall  mortality risk, and a much highers cancer mortality risk compared to nonsmokers. The National Longitudinal Mortality Study collected baseline survey data from 1985 through 2011 and included 357,420 participants reporting on their use of cigar, pipes, or cigarettes.

Proceedings of the National Academy of Sciences (PNAS) has published new research on the mechanistic link between the rheumatoid arthritis (RA) "shared epitope" (SE) risk alleles and environmental triggers such as cigarette smoke that leads to joint inflammation and bony destruction. 

A systematic review in the Journal of the American Dental Association evaluated the safety and efficacy of analgesics and foundp opioids less effective than nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen when treating dental pain.

Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub!  This is their light-hearted, gender biased debate on the best patients: Men vs. Women.

The U.S. Preventive Services Task Force (USPSTF) concludes current scientific evidence is insufficient regarding the use of vitamin D and calcium, alone or in combination, to prevent fractures in men and premenopausal women. The USPSTF recommends against daily supplementation with 400 IU or less of vitamin D and 1,000 mg or less of calcium to prevent fractures in postmenopausal women. Current scientific evidence is insufficient regarding the use

SOBI has announced that Kineret (anakinra) has been approved by the European Commission (EC) for the treatment of Still’s disease (Systemic Juvenile Idiopathic Arthritis [SJIA] and Adult-Onset Still’s Disease [AOSD]), in all 28 European Union (EU) member states. Still's disease is a rare systemic multi-organ disorder of auto-inflammatory nature that affects approximately 25,000 children and adults in the EU.

A recent meeting (April 9-12) of the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) considered the problem of dosing errors with methotrexate (MTX), citing "continued reports of overdose." 

MMWR reports that eight states, including Colorado, have legalized recreational marijuana for use by adults and that a study of use in Colorado has shown that nearly 15% of Colorado adult workers have used marijuana in the past 30 days. Use was highest among young adults, especially men, working in the Accommodation/Food Services and Food Preparation/Serving industries.

CreakyJoints and Pfizer have selected the Mayo Clinic and the University of Alabama at Birmingham (UAB) to each receive a $500K research award (funded by Pfizer Independent Grants) for Learning & Change. Grants submitted from both centers haved focused on shared decision making between rheumatoid arthritis (RA) and health care providers.

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Highlights includes manpower shortfalls, comorbidities in AA Lupus, certolizumab pregnancy safety, which Shingles vaccine is best and the power of combination biologics in severe refractory  SLE.

The current issue of the NEJM reviews the Food and Drug Administration (FDA) “breakthrough therapy” designation that was introduced in 2012 to expedite testing and approval of medications that were intended to treat serious or life-threatening conditions.  This status is granted when preliminary evidence with a new drug suggests substantial benefits over existing therapies for these unfortunate conditions.

One of the driving pathogenic mechanisms in systemic lupus erythematosus (SLE) is the generation of immune complexes capable of inducing netosis (NET formation) and NET-derived DNA that may be an amplifying autoantigen and give rise to anti-nuclear autoantibodies (ANAs).