RheumNow Podcast – Don’t Take My Advice (7.19.19) Save

Dr. Jack Cush reports the news and new journal articles from the past week on RheumNow.com.

1. There was no increased risk of cancer in 767 patients with giant cell arteritis in western Norway was compared to matched controls https://buff.ly/30Ip2ro 
2. anti-MDA5+ amyopathic dermatomyositis (ADM) with ILD is severe and refractory. NEJM letter reports on 18 ADM Rx w/ tofacitinibs who showed better 6 mo survival (100% vs 78%) (P=0.04) and improved ferritin, FVC, DLCO, & CT Chest over time. https://t.co/lsVGPxChoO
3. Can Febuxostat be given to Allopurinol Hypersensitivity? Such pts not included in registrations trials; yet many literature reports of no toxicity & rare cross-Rxn; PI says ULORIC indicated w/ intolerant to allopurinol, or when allopurinol Tx not advisable https://t.co/KG36Ls6VsI
4. A review of 376 FDA advisory panels between 2008-15, finds that 22% of FDA’s final actions were discordant with an advisory panels recommendations (moreso w/ safety panels). Of these, 3/4 lead to more restrictive actions and 1/4 less restrictive decisions https://t.co/AK7KbwN2l5
5. Analysis of 149 OA and 203 RA pts from Rush Univ Rheum Clinic showed the same disease burden (by RAPID3) betw OA & A at initial visits, but after 6 mos. RAPID3 was more improved in RA patients than OA patients (P < 0.001). https://t.co/fNQ2ncJScI
6. ER study from 2015-17 shows that among 456 #gout patients, 28.3%) received opioid at discharge; 80% of these were new. Average dose was 38mg morphine equivalent for a median of 8 days - more likely w/ polyarticular gout, hx diabetes & hx prior opioids https://t.co/xf2jD1i4hg
7. Do biologics work in relapsing polychondritis? French cohort of 41 pts use 105 biologics (TNFi=60; TCZ 17; anakinra 15; RTX 7; ABA6). While 63% resp in 1st 6 mos (on pred!), a complete response rate was 19.0%. Steroid sparing variable, high infx rates. https://t.co/Ff9KULlKVD
8. Intraarticular Capsaicin in Knee Osteoarthritis  
9. Increased Risk of Cardiovascular Death in Hip and Knee Osteoarthritis   
10. Upadacitinib Superior to Adalimumab in Methotrexate Refractory RA