Higher Medical Costs with Corticosteroid Use Rheumatoid arthritis (RA) health insurance claims database study from Japan shows that RA patients initially treated with glucocorticoids (GCs) and disease-modifying antirheumatic drugs (DMARDs) experienced greater medical costs and https://t.co/ETWX9yH11w

This week’s Grand Rounds featured Dr. John Cush, Executive Editor @RheumNow, with an outstanding talk on “Seronegative vs Seropositive RA,” spotlighting differences in disease course, alternative etiologies & treatment response.

Turkish study of Childhood-onset arthritis (n 1713; age 6.8 yrs). Most Dx: JIA 50% (most oligo), FMF 16% (recurrent oligo), vasculitis 14% (most IgA vasculitis; 94% oligo), reactive arthritis 9% (monarthritis) & acute rheumatic fever 5% (polyarticular& migratory), SLE 5% (oligo https://t.co/HkiPT0hsr7

EULAR & European Respiratory Society have published clinical practice guidelines for ILD assoc w/ connective tissue diseases (SSc, RA, SjD, IIM, SLE, MCTD). 2 publications included Dz specific ILD management algorithms; use of Hi Res CT over Lung Bx; ILD risk factors

Long term outcomes of secukinumab in Children & Adolescents w/ Psoriasis (n=84). 80% completed 4 yrs of Rx w/ either low dose [N 31] & high dose [N 36]) with sustained PASI 75/90/100 results at week 208 [SEC LD: 96%/89%/52%; SEC HD: 88%/82%/73%]. No deaths; No dose-dependent https://t.co/y059SJTxP1

A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA

• Interleukin-17 Inhibitors and Major Adverse Cardiovascular Events

Prospective study of 171 suspected Sjogrens (130 dx w/ SjD) pts compared Dx accuracy - Labial gland Bx best Dx efficacy (AUC 0.90), followed Ro/SSA (AUC 0.79), Omeract score (AUC 0.78). Salv gland US grade 3 strongly predicted +Bx (AUC 0.77) & correlated w/ salivary flow ~-0.5

6 yr study of Dutch #SLE pts (n 221) - unemployment was high (54%) & increased over time. Employ ed assoc w/ supervisor support, regular working hrs, skill discretion, decision authority. Unemployment most from SLE Sxs (63%) & assoc w/ older, less education, Dz Dur, organ

EHR analysis of Alaska Tribal Health System finds the prevalence of Sjögren's disease at 199 per 100K adults (primary SjD 129; secondary 70 (RA,SLE)). The age-adjusted incidence 16.6 per 100K Pt-Yrs. Only 5% had salivary gland Bx & 3% met 2016 ACR/EULAR or 2012 ACR criteria https://t.co/4tMdWIGTEi

Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/F231nz57NY

• Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease | RheumNow

SMART study from India finally published. RCT compare split-dose to single-dose oral MTX, in 253 RA pts. Split dose was superior w/ significantly higher EULAR good response at 16 weeks; & reduced need for 2nd DMARD, but had more intolerance and transaminitis. https://t.co/4jBxP2GPZM

LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn