The George Institute for Global Health has performed a systematic review of drugs used to treat back pain. Their findings, published in the Annals of the Rheumatic Diseases, shows that only one in six improve their pain with NSAID therapy.
Their previous studies have shown that acetaminophen is ineffective and opioids provide minimal benefit over placebo.
Up to 30% of patients with rheumatoid arthritis (RA) will eventually undergo joint reconstructive surgery, yet we have limited data to guide the perioperative management of DMARDs and biologics.This decision is often surgeon-dependent. Historically, RA patients have worse outcomes after joint replacement, but this was largely due to poor disease control prior to surgery.
Doubt remains regarding the appropriateness, efficacy and safety of methotrexate in the treatment of moderate to severe cutaneous psoriasis. Moreover, high dose, subcutaneous MTX has not been studied in a well-designed trial.
Dr. Jack Cush reviews this week's highlights from RheumNow.
Kevzara (sarilumab), an interleukin-6 (IL-6) receptor monoclonal antibody, was approved by Health Canada for use in rheumatoid arthritis (RA).
Gout should be one of the easiest and best managed of rheumatic disorders. However, numerous deficits exist with regard to the treatment and long-term care of gout.
Swedish investigators have assessed the likelihood of gout patients that would receive and persist with urate lowering therapy.
Prior to the biologic era, nonsteroidal antiinflammatory drugs (NSAIDs) were the mainstay of drug therapy in thos with spondyloarthritis (SpA) and ankylosing spondylitis (AS). Their role in the modern era has changed and the claims for efficacy have varied. Baraliakos and colleagues have studied the utility of NSAIDs are first-line therapy in axial SpA (axSpA) and non-radiographic axSpA (nr-axSpA) patients.
There are several trials that test the efficacy and safety of combination tumor necrosis factor inhibitor (TNFi) plus methotrexate against triple therapy (methotrexate plus hydroxychloroquine plus sulfasalazine) in patients with rheumatoid arthritis.
Most patients who present with gout to rheumatology clinics are at very high risk of cardiovascular (CV) disease, Spanish researchers found.
Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines.
Infection is a major cause of morbidity and mortality in RA patients and thus vaccinating against preventable infections is a top priority for rheumatologists. Numerous studies have looked at efficacy and immunogenicity of various vaccines in this population and it is known that RA treatments may reduce efficacy.
Dr. Cush reviews highlights from the past week on RheumNow.com.
CHMP sends a positive recommendation for tofacitinib to the EMA. This would be for the 5 mg bid dose mod-severe RA https://t.co/O2XfkDF6XB (NOTE: video error says tocilizumab, when tofacitinib (Xeljanz) was intended!)
A JAMA article presents the US Public Health Task Force review of OSA testing. The task force points out that “the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults (based on lack or poor quality evidence) and that screening for OSA in asymptomatic patients is likely to lead to unnecessary diagnostic testing and higher health care costs without evidence of benefit.
Neuropsychiatric lupus (NPSLE) is a diagnostic challenge as its clinical manifestations are protean and the pathophysiology is poorly understood.
A study published in the current issue of Rheumatology uses unique methodology to compare brain histopathology and ex vivo imaging in lupus patients with and without NPSLE and controls.
RheumNow will periodically report safety issues as Drug Safety Bulletins. These will update you with safety issues, label changes and reports of new, ongoing and resolved drug shortages that affect rheumatology. If you have suggestions or information about specific drug shortages or drug safety issues, please email us at info@rheumnow.com.
