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RheumNow Podcast- Best Biologics (2.7.20)

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

  1. Analysis of  30 synovial fluid samples (12 MSU, 18 CPPD); Gout crystals were ID at room temp (92%) & refrigerated (100%) for 7 days;  CPPD crystals were less durable at room temperature (67%) after 7d; w/ less reduction when refrigerated in heparin tubes. http://bit.ly/2Sk3v5J   
  2. Study of 75 adult Stills pts looked at flare biomarkers (25 not on TCZ; 6 on TCZ). AOSD flares , ESR/CRP/Ferritin were significantly elevated on TCZ+; but less so in TCZ- pts. WBC & LDH rose regardless of TCZ Rx. Best Biomarkers: WBC, CRP, LDH, Ferritin http://bit.ly/2ttmBxE   
  3. Canadian study of 643 pts triaged for a positive ANA; 41% were seen by a rheumatologist.  1) 24% of ANA+ ps had an ANA assoc rheumatic dz (AARD); 2) 26%no evidence of any disease;  3) 39% other rheum Dx4) 11%  failed to met AARD criteria. http://bit.ly/2vUFP07   
  4. Claims cohort study looked at serious infection in RA pts Rx w/ tofacitinib vs 7 biologics. Overall risk was 3.12/100PYs. Signif higher SIE in TOFA vs ETN (aHR 1·41), lower vs INFLX (0.81), similar to ABA, GOL, TCZ, ADA. TOFA 2X higher risk of Shingles https://t.co/7EZwqCE9qY
  5. Tacrolimus as an option in RA? Metanalysis of 5 studies shows odds of achieving ACR20 was 1.71 (95% CI 1.20-2.42) for 1-2 mg/day and 2.30 (1.79-2.96) for 3 mg/day. Odds of creatinine elevation was 1.95 for 1-2 mg/day and 3.81 for 3mg/day.  https://t.co/xyamI3O8Ui
  6. Head drop - as a Sx of myopathy? 107 pts reviewed; 53% w/ specific Dx: Inflammatory myositis(n = 16), myopathy w/ rimmed vacuoles (10), radiation(8), nemaline ( 7), myofibrillar (4), facioscapulohumeral ( 3), 2 ea w/ incl. body,mitochondrial, PSS https://t.co/Rjrpv0nsIu
  7. Danish Registry study of 12,185 Chronic Urticaria patients shows an overrepresentation mastocytosis and anaphylaxis, as well as atopic dermatitis, rheumatoid arthritis, SLE, thyroiditis and vitiligo https://t.co/N3nvNSBzjN
  8. MRA vs FDG-PET in newly Dx GCA and Takayasus shows a differences in Sxs & imaging. Carotidynia & arm claudication more common in TAK with evidence of vascular inflammation (PET). GCA lesions by MRA showed more damage than inflammation https://t.co/Xh4osfKepe
  9. Which Biologics are Best in Psoriasis           
  10. Bariatric Weight Loss Fails to Alter RA Risk  

 

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The author has received compensation as an advisor or consultant on this subject