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13 October 2017 The RheumNow Week in Review

Oct 13, 2017 5:30 pm

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from In this week's report, Dr. Jack Cush discusses a novel antiviral drug or the use of stem cell therapy for scleroderma, rituximab in HSP, when to withdraw NSAIDS in RA, and congrats to PAs and NPs!

  1. Antifibrotic effects of antiviral HIV drug Nelfinavir shown to decrease TGF-β1-mediated pulm fibrosis & myofibroblast differentiation in and animal model of Systemic sclerosis
  2. Rare Antimalarial cardiomyopathy - 47 cases seen in RA & SLE patients, with a 45% mortality rate; presents as CHF, syncope or AV Block.
  3. 1491 RA patients in the Frenc REGATE study - 1st SIE rate 4.9/100PY. Increased SIE risk in those taking  LEF, with a high DAS28, ACPA negativity, ANC >5000.
  4. Prospective 16wk study of NSAID Withdrawal in RA patients who are in LDAS with a DAS<3.2.  Overall an 85% success without a signficant change in DAS28 or PRO, especially in those with SJC=0 at baseline.
  5. Uveitis may occur in adults (@26yrs) after a JIA onset (9 yrs). 19pts reviewed; 79% Rx topicals; 89% on systemic Rx
  6. In 11 studies & 938 gout pts, the diagnostic accuracy of Ultrasound in Gout = sensitivity 65% and specificity of 89%
  7. Multicenter study ofv135 JIA pts who stopped biologic - 76% flared; more if W/D tried before 2 years of remission.
  8. Metanalysis of 38 studies of Stem Cell Transplant. in PSS had high heterogeneity but shows improved skin & lung FVC
  9. 31465 on ULT, allopurinol assoc w/ 39% lower risk renal dz (HR 0.61 vs febuxostat). Higher doses = more protection
  10. 21 patients with Henoch-Schonlein Purpura Rx with RTX: 20/21 achieved remission, resulting in improved Proteinuria, BVAS, CRP levels; overall  35% relapsed  
  11. Jan 1st CIGNA will stop covering Oxycontin - is this improved safety or another way to max $$$ &reduce company risk?
  12. Congratulations and thanks to all PHYSICIAN ASSISTANTS in rheum - this is national PA week! We need more PA's!
  13. The Big Need - NPs and PAs 
  14. Zilretta - a New Drug FDA Approved for Osteoarthritis of the Knee


The author has received compensation as an advisor or consultant on this subject

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