The National Institute for Heath and Care Excellence has turned down Otezla for coverage under the U.K. healthcare system for psoriatic arthritis. It cited concerns about cost-effectiveness, claiming it is less cost-effective with fewer quality-adjusted life-years than its competing tumor necrosis factor-alpha (TNF-a) inhibitors.

An incident cohort study from Denmark showed that 84 SLE pregnancies resulted in 62 live births.  Lupus disease activity strongly influenced maternal complications seen in half and fetal complications were observed in one-third of cases. SLE flares developed in 46.4%, pre-eclampsia in 8.3%, and the HELLP syndrome in 4.8% of cases.

A randomized controlled trial of compared the outcomes of  surgical decompression or physical therapy in 169 lumbar spinal stenosis patients.  After two years, intention-to-treat analyses revealed no difference between groups. Sensitivity analyses using causal-effects methods to account for the high proportion of crossovers from PT to surgery (57%) showed no significant differences in physical function between groups.

Estimates on the prevalence of psoriatic arthritis among psoriasis patients has varied widely, ranging from 5-40%.  A systematic review of the literature shows that prevalence of undiagnosed PsA was 15.5% when all studies were considered and 10.1% when only epidemiological studies were considered (souce citation: http://buff.ly/1IGm7kE).

Cardiovascular (CV) risk and adverse cardiac outcomes are common in rheumatoid arthritis (RA). It has been presumed that chronic systemic inflammation has a deleterious effect on the myocardium and vasculature, thereby leading to higher rates of MI, CHF and CV death.

Using ultrasound guided intraarticular injection of the hip, 98 OA of the hip patients were randomized to receive IA ketorolac or triamcinolone. At, 1, 3, and 6 mos pain scale and Harris hip scores were improved equally in both groups with no statistical differences.

A large Swedish cohort study of hypertensive men and women presented at the 25th Scientific Meeting of the European Society of Hypertension, identitied a protective effect on osteoporotic fractures among current users of thiazide diuretic drugs independent of blood pressure level.  This retrospective cohort study analysed data on 60,893 hypertensive patients between 2001 and 2008.

Idiopathic pulmonary fibrosis carries a high mortality rate and can be a management challenge. Moreover, exacerbations of IPF may be fatal. A multicenter uncontrolled study examined the utility of targeting autoantibody production with revealed surprising results. Eleven patients were treated with therapeutic plasma exchanges and rituximab, followed by intravenous immunoglobulin.

There are no detailed recommendations agreed upon by SLE experts on what treatment to use after first and second (and often third) line treatment has failed.

A Canadian registry shows that in community-based infusion clinics, infusion reactions to IFX are uncommon and mild to moderate in nature. Antihistamines, intravenous steroids, and acetaminophen are widely used as preventative premedication, although this study showed an absence of benefit with their use.

A systematic review of the benefits and harms of arthroscopic knee surgery involving partial meniscectomy for middle-aged and older adults with knee pain and degenerative knee disease was recenttly published in BMJ. They found inconsequential benefits 3-6 months after surgery, but no long-term benefits or improvement in physical function.

This review details nine of the most common compliance missteps physicians are making regarding protected health information (PHI). These errors may result in legal trouble, but are avoidable. These include: 1. Texting unencrypted PHI could raise serious HIPAA problems. 2. E-mailing unencrypted PHI - use applications that protect such information.

Biologic Use Curtails Sepsis Events. An analysis of the German biologics register, RABBIT, examined the effect of current biologic therapy on future risk of sepsis (#OP0161). In their very large database of DMARD and TNFi treated RA patients they sought to see if a serious infectious event (SIE) was followed by subsequent sepsis (within 30 days) or death after SI without sepsis (within 90 days) or no complication at all.

The FDA has issued public warnings that 4 over-the-counter products promoted for pain relief contain potentially harmful, undeclared dexamethasone. The supplements are Asihuri Plus Forte, Ginseng She Lian Wan, Jianbu Huqian Wan, and Saurean Fong Sep Lin. The manufacturers have been warned and no adverse events have been reported as yet. 

When gastroenterologists responded to a nationwide survey regarding their management of GERD and contipation, half of the 830 gastroenterology respondents (23% response rate) prescribed for their patients OTC proton-pump inhibitors (PPI), 13% recommended an OTC histamine-2 receptor antagonists, and only 33% recommended a prescription PPI.