RheumNow Podcast – Richer or Poorer (5.17.19) Save

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

1. Public health study from Norway compares the top 1% richest and bottom 1% poorest found significant difference in life expectancy -14 years for men and 8 years for women. Similar USA study finds roughly the same as in Norway. https://t.co/h1QFZmgXaJ 
2. Large study from OTIS on PsA and AS shows an increased risk for adverse pregnancy outcomes - including preterm delivery (RR 1.81, 3.82) & Cesarean delivery (RR 1.63, 5.82). Active disease & steroid use may also increase these risks. https://buff.ly/30lTKqI 
3. Literature review - 23 studies on Natural dietary supplement (NDS) use finds that worldwide 47% of RA pts use NDS, did not differ by geographic region, 47% found NDS to be effective, 13% had adverse side effects, & 30% informed their physicians. https://t.co/N2O16NxuxU 
4. Reactivation of latent CMV infection is rare in Rheum Pts. 14 pts described w/ febrile illness, on steroids (13), with coinfections (8), 4 died during hospitalization, tend to have longer hospitalizations (47 vs. 7 days), more coinfections (67% vs. 17%) https://t.co/pijtFv55Uq   
5. Overall prevalence of low back pain among US workers is 26.4%, with 5.6% having severe LBP, according to May 14th Annals of Internal Medicine. https://t.co/5sfYFQWHyh   
6. PCSK9 inhibitors (ie, Repatha) can safetly be used in Statin-induced HMGCR+ myopathy pts . 8 pts given PCSK9 inhib for hyperlipidemia, showed no Sx worsening, CK levels dropped (956±1137 IU/L to 419±393 IU/L) & HMGCR Ab titers decreased; 2/8 improved https://t.co/iSuPz6ptBY 
7. Studies argue about MTX efficacy in GCA; many calling for new RCTs at higher doses. A new real world study compared 83 GCA pts on MTX (13.5mg/wk) vs 83 controls showing signif. lower relapse rates with MTX (0.32; 0.24–0.41), but no change in steroid use https://t.co/aCrL4PILUM
8. DECT is most accurate in diagnosing established gout - review of 10 studies shows a pooled (95% CI) sensitivity of 0.81 (0.77, 0.86) and specificity of 0.91 (0.85, 0.95), respectively. W/ short disease duration (⩽6 wks), sensitivity 0.55 and spec 0.89  https://buff.ly/2Ecw1Qg 
9. Medicare analysis shows Gout patients are twice as likely to have chronic pain (HR 2.02; 95% CI 1.98-2.05) and use of allopurinol or febuxostat was associated with a lower risk of chronic pain (HR 0.72-0.79) https://t.co/xW5rVPyC69 
10. Coexistent Gout Increases Risk in Rheumatoid Arthritis  
11. Methotrexate Use Not Linked to Interstitial Lung Disease in RA  
12. Generic Price Fixing Alleged by State Prosecutors