Approximately 90% of patients with rheumatoid arthritis (RA) have foot problems. A multidisciplinary panel (including 2 patients, 22 professionals (rheumatologists, rehabilitation physicians, orthopaedic surgeons, specialized nurses, podiatrists, orthopaedic shoe technicians, pedicurists, researchers) in the Netherlands set out to develop recommendations for those who treat RA foot problems. 

The Annals of Internal Medicine has published a cohort study of lupus nephritis patients with end-stage renal disease showing that renal transplantation is associated with improved survival benefit, and a reduction in death from cardiovascular disease and infection.

Dr Jack Cush reviews the news from the past week at RheumNow.com.

Obese patients with psoriatic arthritis (PsA) who followed a short-term, very low-energy diet showed improvements in multiple aspects of disease activity, a prospective study found.Over a period of 6 months, patients on the restrictive diet (640 kcal/day) lost a median of 18.7 kg (41.2 lbs), which represented 18.6% of their weight, according to Eva Klingberg, MD, PhD, of the University of Gothenburg in Sweden, and colleagues.

A subanalysis of the early rheumatoid arthritis (RA) "IMPROVED" study has shown that changes in RA-autoantibody levels are not associated with disease activity or or long-term drug response, but instead reflect intensity of immunosuppression. Thus while autoantibody levels may be modifiable by our best therapies, modifying CCP or RF levels appears to have limited clinical relevance.

Despite striking improvements in survival among patients with systemic lupus erythematosus (SLE) in recent decades -- from 1-year survival of less than 50% before the introduction of prednisone to 90% today in most specialized treatment centers -- many challenges remain in this perplexing, multisystem disease.

In 2019 there have been numerous reports of higher drug pricing for many drugs.  Yesterday it was reported that the price of insulin drugs have more than doubled from 2012 to 2016. Reuters reports that in the United States, the pricing on more than 250 prescription drugs have gone up.

It’s hard work wearing a crown. The dermatologists have been dethroned as Medscape’s happiest specialty after years at the top. While studies only detail that we are the most satisfied outside of work, I argue we are the happiest working, too. With an N of 1, here are my 10 observations.

Alcohol, smoking and obesity have all been shown to influence the risk and activity of rheumatoid arthritis (RA) and may also influence response to therapy. This study assesssed whether smoking would influence response to rituximab (RTX) in RA. 

Using data from 5,467 adults in the US in the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2016, researchers found that the prevalence of gout and hyperuricemia has remained at 3.9%, having doubled from the 1960s to the 1990s, corresponding to an estimated 9.2 million adults with gout in 2015-2016.

58-year-old woman with a history of hypothyroidism presents with a 2-week history of joint pain and swelling in her right knee, which became migratory and later affected the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of her fingers; this followed a series of others being sick in the household.

Dr. Jack Cush reviews the news, articles and FDA Panel discussions from the past week.

There seems to be both hope and uncertainty regarding the use of weekly methotrexate (MTX) in giant cell arteritis (GCA) patients whom need to limit their glucocorticoid use. While well done clinical trials have shown no certain efficacy, data suggesting MTX benefits comes from small trials, anecdotes and clinical experience. 

The US Food and Drug Administration’s advisory committee on Bone, Reproductive and Urologic Drugs voted Wednesday in favor of approving Amgen’s osteoporosis anti-sclerostin drug, romosozumab (Evenity) for use women with postmenopausal osteoporosis.  Reuters reports that the panel voted 16-1 in favor of the monthly injection developed jointly by UCB.

A retrospective analysis of hospitalized patients who also had a gout and pseudogout attack shows that injections of anakinra (interleukin-1 receptor antagonist) were highly effective and safe in nearly three-quarters of patients.   Through a medical records search they found 100 patients and 115 episodes between 2014-2017 who were treated with anakinra for crystal arthritis.