RheumNow Week in Review – Vitamin D Falls Again (10.4.18) Save

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

1. Medical marijuana use is up 83% (46K users) in Illinois -with sales of ~$12million/month. Use lead by PTSD (4000) which surpassed fibromyalgia (3400) and cancer (2500) https://t.co/NxizLBoJeC   
2. Gabapentin (GABA) is 10th most Prescribed drug in USA; 22% of opioid abusers abuse GABA (also high in EU); off label use is pervasive; GABA assoc w/ overdose deaths in Tenn (4%), https://t.co/DHYeBfjgi1 (15%), NC (20%), KY (41%). Should it be Schedule V https://t.co/UVOB9Kif6S 
3. ILAR/PRINTO Again wants to again redefine JIA - as 4 groups: a) systemic JIA; b) RF+ JIA; c) enthesitis/SpA-related JIA; d) early-onset ANA+ JIA. Hopefully subsets will differ in MOA, outcomes, Treatments and NOT all be reported together in the future.https://t.co/qjEuvsC873   
4. Medicare claims data analysis compared 4,551 ESRD/Hemodialysis and 45,510 controls and showed that PPI and H2 blocker use was associated with a 25% and 23% increased risk of Hip fracture. https://t.co/h4lKO506yH 
5. Twitter Poll: Often Not discussed but do you combine Otezla with a biologic (TNFi or IL-17 inhibitor) in your difficult PsA patients? Rheumatolgists poll – 81 respondents: 36% No/Never; 26% can’t get approval; 26% yes +benefits; 12% Yes but no benefit.   
6. RCT Extended vs flexed knee positioning for arthrocentesis in 55 knees (20 vs 35) - Extended knee was 2X better in Syn fluid yield (16.9 vs 5.9 ml) and more succcessful at dx fluid aspiration (99% vs 77%). Mechanical compression equaled out these results. https://t.co/JfAjTDRBhG 
7. ASPECT trial in 1250 Belgians shows a 20 and 30% increased risk of developing IBD & acute anterior uveitis, respectively after 10 yrs of axial SpA; IBD and AAU risk (not psoriasis) related to Dz duration and inflammation, https://t.co/BnMFCAKSSB 
8. TCZ doesn’t meet primary end point in ph3 trial for AOSD but helps⬇️ steroid dose: ACR50 at wk 4 61.5% vs 30.8% PBO but p=0.24. Steroid dose ⬇️ by 46.2% in the TCZ vs 21.0% in PBO group (p=0.017). ACR 20/50/70 84.6%/84.6%/61.5% at wk52 https://t.co/Q9vrNsGb9F @RheumNow 
9. JAMA study of 59 FDA approved drugs (138 pivotal RCTs) in 2015-2016 shows the median cost per trial to be $19 million (range, $5 million for uncontrolled 3 orphan drugs to $347 million for noninferiority trial). Noninferiority trials most expensive! https://t.co/F0X5V5I0RD   
10. Vitamin D Fails to Improve Bone Health  
11. Zolendronic Acid Benefits Elder Women with Osteopenia 
12. Predictive Risk Factors for Uveitis in JIA