Gouty Tomatoes, Alveolar Hemorrhage and Famous RA Faces: August 2015 Top Social Media News Save

In August, RheumNow published 76 tweets covering novel news, research and teaching points gleaned from the medical literature, regulatory reports and internet sources. We had a reach (impressions) of 60,800, with 45 mentions, and 2049 visits to RheumNow.com. Our social media feed is just one of several ways we deliver information to over 2000 rheumatologists and over 2000 followers on Twitter about the wide world of rheumatology. The following depicts our top tweets from August 2015 according to analytics from Twitter and Buffer.com.

• New Zealand population survey showed tomatoes are the 4th most common trigger for Gout. This new information is supported by few studies showing tomatoes increase uric acid levels (http://buff.ly/1OjEsZY). This tweet had an estimated reach of over 46,600. On the same day this was published (8/25), we also posted data from the National Hospitalization Database showing there is a seasonal association for gout as acute gout attacks peak in November; overall attacks are highest in the autumn and lowest in the spring. (http://buff.ly/1Lr8A1X)
• The Clinical Practice Research Datalink study shows that UK treatment guidelines for RA were associated with an increase in DMARD use from 43% in 1995 to 78% in 2010 (http://buff.ly/1ISHHEm). This shows the potential impact of treatment guidelines. While many rheumatologists have concerns or objections to guidelines, they are assuming greater importance both in practice and in the marketplace. The new ACR Guidelines on RA are forthcoming--will they have the same impact? This tweet had an estimated reach of 37,600 (Posted 8/7/15).
• Clinical pearls on drug management with pregnancy in RA patients (http://buff.ly/1JiUfSe). Drs. Kavanaugh and Cush review the misconceptions, current practice trends, and when to start and stop DMARDs or TNF inhibitors in RA patients who are pregnant or planning for pregnancy. Rheumatologists have more to offer their pregnant patients than well wishes or episodic prednisone. This tweet refers to a blog on RheumNow (11 Pearls for Pregnancy Management in RA) that reached 20,700. (Posted 8/26/15)
• Drs. Werth and Actman from the University of Pennsylvania published a superb review of the pathogenesis of cutaneous lupus (http://buff.ly/1WgFaJP). Cutaneous lupus has its many forms (acute, chronic/discoid, subacute) and variants (profundus, bullous, etc.) and is a challenge to clinicians and researchers alike. This well done review meets the needs of many as this tweet had an estimated reach over 18,400. (Posted 8/12/15)
• ICD-10 To-Do lisT by Dr. Martin Bergman: Is there a code difference for being bitten by duck (W61.61XA) or hit with a duck (W61.62XA)? (http://buff.ly/1f4pXJU)  Last month’s info piece will be this month’s worry and next month’s anguish as ICD-10 approaches on 10/1/15. This popular tweet had an estimated reach of 14,400 on Twitter and an even larger reach in the internet news world as Dr. Bergman’s preparatory article was syndicated by MedPage today. (Posted 8/10/15)
• Diffuse alveolar hemorrhage in SLE is associated with a 67% survival when treated with Steroids and Cyclophosphamide, but no effect with Apheresis (http://buff.ly/1JeQ3S2). This systematic review of this rare but grave manifestation of lupus covers presentation and the success of therapies. They report SLE patients survived 61% of 174 DAH episodes occurring 140 patients. Clearly, very aggressive and early intervention is needed to avoid the mortal risks associated with alveolar hemorrhage. This post was seen by 8,800. (Posted 8/27/15)
• Anakinra in Adult Stills disease is associated with high remission rates, reduced steroid requirements and marked reductions in tender and swollen joints, and normalization of the CRP and ESR (http://buff.ly/1OjF69S). This review underscores the dominant effect of IL-1 inhibition in AOSD; not only on systemic manifestations and acute phase reactants, but also on the articular features as well. This tweet had anestimated reach of 8,500. (Posted 8/17/15)
• There is no long-term benefit to CT-guided sacroiliac joint injections with corticosteroids (http://buff.ly/1QmS1p2). While it hardly seems necessary to take this approach given today’s available therapies for inflammatory sacroiliitis, there have been many uncontrolled reports suggesting the benefits of SI steroid injections – at least in the short-term. This retrospective study of 61 patients followed 2-3 years rebukes this approach showing the lack of sustained meaningful benefits. This tweet had an estimated reach over 6,900. (Posted 8/6/15)
• JAMA Quiz: 30 yr. old woman with polyarthralgia, fatigue, no swelling or morning stiffness is found with a +ANA 1:80. Is this RA, lupus, nothing or an ANA from thyroid disease (http://buff.ly/1Fl49X5)? The popularity of this lab lesson ANA (anestimated reach of 6,800) underscores the frequency of this finding, the misdiagnosis and the misuse of the ANA test. (Posted 8/27/15)
• FDA reports 33 cases of joint pain due to the diabetes drugs Januvia (most cases) and fewer reports with Onglyza or Tradjenta (http://buff.ly/1FS1aQN). The good news is this appears to be a rare adverse event that does improve with drug discontinuation. The bad news is the ensuing parade of lawyers and class action suits asking rheumatologists to adjudicate their claims. This tweet had anestimated reach over 6,800. (Posted 8/31/15)
• A Chinese study shows Leflunomide has a long 2 week half-life and once weekly doses (50 or 100 mg) is equal in efficacy and safety as daily doses (10 or 20 mg) (http://buff.ly/1QmSCaj). In addition to the ease of dosing, such information takes on importance when leflunomide 10 or 20 mg pills are in short supply. Whether dosed with 100 mg pills or five 20 mg pills once a week, intermittent pulse leflunomide is effective maintenance for many who achieve a response with daily dosing. This tweet had anestimated reach of 6100. (Posted 8/14/15)
• In CKD patients allopurinol adjustments may not be needed; but Colchicine is a high toxicity risk if the dose is not adjusted in CKD patients (http://buff.ly/1IY7oTQ). Renal disease and renal insufficiency are common in gout patients and may complicate or limit drug use. This is a good reference that clarifies the effects of GFR on allopurinol and colchicine use. This tweet had an estimated reach 5,800. (Posted 8/12/15)
• Here are 13 famous faces Diagnosed with Rheumatoid Arthritis; from Venus to Renoir to Sandy Koufax. They all achieved greatness and infamy in an era of little or no treatment options (http://buff.ly/1LCEV3j). Lucille Ball, Dr Chrisian Barnard, Kathleen Turner, Camryn Manheim, Aida Tuturo, James Coburn, Edith Piaf, Boticelli's Venus round out this list. This tweet resonated with 4,700 people. (Posted 8/31/15)