RheumNow Podcast – Take it Back Jack! (4.26.19) Save

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

1. This Saturday is National Prescription Drug Take-Back Day where you can dispose of old, unused, unwanted (Potentially harmful) prescription medicines. These are run by your local police or DPS. Use this link to find out where in your town https://t.co/eae3l6OtqC
2. Results from Nationwide Inpatient Sample Database (2003–11) finds 31,439 obstetric hospitalizations in RA women who had a higher maternal age (30.5 yrs) & significantly more HTN, premature membr. rupture, antepartum hemorrhage, preterm delivery, IUGR & C sections https://t.co/pz5uQH5rrx 
3. Animal data suggests targeting of neutrophils in APS may mitigate thrombotic disease. Adenosine recept agonists suppresses aPL Ab-mediated NETosis & reduces IVC thrombosis. Same shown for dipyridamole (incr. adenosine & cAMP breakdown).  https://buff.ly/2Uv7onr
4. Swedish population study compared 8109 RA pts and 11562 full siblings to the general population, finding the risk of acute coronary syndrome to be increased in RA (HR 1.46; 1.28 -1.67) and RA Sibs (HR 1.22; 1.09 - 1.38) w/ risks confined to seropositives https://t.co/oYUP3jgY60
5. Danish study of 92 355 adults compared Fx rates between new users of denosumab (DEN) or alendronate - finds no advantage for DEN for hip Fx (aHR 1.08; 0.92-1.28) or any Fx (aHR 0.92; 0.83-1.02). Data doesnt support preference for DEN in high risk pts. https://t.co/dpyRF9VxH6     
6. UK study shows that statin (atorvastatin) use in RA is safe and effective - resulting in significant reduction in Cardiac\MACE events (HR 0.60), LDL (HR 0.77) and CRP and confers a risk reduction similar to that seen in other populations https:\t.co\Zl2KaK12P5 
7. Metanalysis shows NSAIDS increase rates of delayed union or nonunion (OR 2.07; 1.19 to 3.61) in adults with fracture, osteotomy, fusion surgery; but not in pediatrics (OR 0.58) or with low dose/short duration NSAID exposure (OR 1.68). https://t.co/0tM8OFLhzt   
8. UK NHS study shows RA patients have a 1 in 5 lifetime risk of knee and hip replacement. 13 961 RA pts fins a 22% (TKR) and 17% (THR) risk following a RA Dx (for an avg 64 yr F, nonsmoker, BMI27). Risk is even higher in younger patients. https://t.co/asOVrRUZLx 
9. Do you use PJP prophylaxis w/ Bactrim in RA pts? 2640 RA pts found only 19 cases of pneumocystis pneumonia. Risk factors were high dose MTX (OR 4.5), >65 yrs (OR 3.7), ≥2 ISPs (3.7), prednisolone ≥5 (OR 12.4) - a combo of these has a 2.3-5.8% riskof PJP. https://t.co/5Pf2FskE30   
10. Should you check hydroxychloroquine levels in your #SLE patients? I do not but probably should in patients who are not in remission as nonadherence to HCQ may be as high as 50%. This is routinely available. https://t.co/UkxjMh3lQz
11. What is your best therapy when treating calcinosis cutis? (or write in your Rx)  https://twitter.com/RheumNow/status/1120005751769128960   
12. CORRONA study of 880 RA pts w/ hx of Solid cancer shows many on biologics following Dx. 42% were on biologics/tsDMARDs in the 12 mo before cancer. Post CA 31% were on same Rx, 5% switched biologics &10% started a biologic, the majority starting TNFi (54%). https://t.co/PjjQvFVnsI 
13. Skyrizi (risankizumab) FDA Approved for Psoriasis  http://rheumnow.com/content/skyrizi-risankizumab-fda-approved-psoriasis
14. Ustekinumab Effective in Behcet's Disease    
15. Higher Comorbidities in Hidradenitis Suppurativa RheumNow.Live