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RheumNow Podcast – Tricked Up Lupus Criteria (8.9.19)

Aug 09, 2019 3:00 am

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including new SLE criteria, ULT in gout and MSU reductions, IVIG in ANCA vasculitis and non-TNF biologics outperform the TNF inhibitors. 

  1. Internet based study by Choi et al - looked at 517 gout patients and examined if gout flares were associated with vaccination. They found a twofold higher odds of gout flare (adjusted OR 1.99; 95% CI 1.01 to 3.89 in those who were vaccinated (any vaccine). https://buff.ly/2ZOhVO4
  2. Patients with pain, fatigue & myalgias should be FM; but rarely could be Macrophagic myofasciitis – a rare myopathy manifest as "algias", weakness, fatigue, fever, & muscle tenderness. Dx by biopsy of vaccinated muscle shows PAS+ macrophages w/ aluminum deposits https://t.co/9Ll4pE3wXJ
  3.  IL-16 studied in Scleroderma: finds increased perivascular IL-16 lymphocyte expression with  more IL-16+ cells in dcSSc vs lcSSc (44% vs 29%, Phttps://buff.ly/2YPsMtQ
  4. Prospective study of 83 gout patients; 77 on urate lowering therapy; 6 discontinued Rx. The D/C group had no change in MSU deposits or SUA levels, In the ULT group MSU burden significantly decreased (MSU volume: p=0.007) and sUA dropped from 7.2 to 5.8 mg/dl. https://t.co/YfXjTKz1va
  5. Metanalysis of 9 studies shows that use of IVIG in ANCA-Associated vasculitis is associated with significant and rapid improvement in BVAS (SMD –1.7), ANCA (SMD –0.72) and CRP (SMD –0.92) within 2-24 weeks. https://t.co/aw3VjBWCcf
  6. Claims analysis of 88,463 #RA pts (2006-2015) finds no greater risk of cardiovascular events with tocilizumab (11.8/1000 PY) compared to TNF inhibitors (15/1000PY) or abatacept; suggesting no net increase in CVD w/ occ hyperlipidemia seen w/ TCZ https://t.co/6L8aKlLGta
  7. Claims analysis of 45,208 TNFi +MTX initiators and 1,387 triple DMARD (MSH) initiators showed no significant difference in the risk of serious infections (2.46 TNFi+MTX vs 2.03 triple DMARD/100PY) (HR 1.23; 0.87‐1.74) https://t.co/pe52p8Xtrv
  8. Oral candidiasis (OC) is a significant predictor of severe infections during immunosuppressive Rx in ANCA-associated vasculitis. 71 AAV patient cohort study; Predictors of severe infection: low albumin, pulse methylprednisolone (adj HR = 5.44), & OC (adjHR  5.31) https://t.co/BSZzWxDU4k
  9. Periodontal Disease and P. gingivalis Increased in CCP+ Pre-Clinical RA
  10. Are Non-TNF Biologics Superior to TNF inhibitors? 
  11. New EULAR/ACR Classification Criteria for SLE 

 

 

Disclosures
The author has no conflicts of interest to disclose related to this subject

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