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The RheumNow Week in Review – Vitamin D Snark Report (4.20.18)

Apr 20, 2018 3:00 am

Dr. Jack Cush reviews the news and journal reports from the past week on  A second life for Syk kinase, Vitamin D talk, VTE, regulatory hearings and the Lupus clinic edge.

  1. Fostamatinib, a spleen tyrosine kinase (Syk)inhibitor, that failed in #RA, has been FDA approved for use in adult with chronic immune thrombocytopenia (ITP) who have had an insufficient response to a previous treatment. The drug will be called Tavalisse.
  2. ACTIVExtend study shows that 9mos of abaloparatide followed by 2 yrs of alendronate is better for BMD and Fx rates than abaloparatide or alendronate alone.
  3. Medscapes annual report on MD salararies shows a pay increased of 9% to $257,000 (the range in change was +16% to a -9% for general surgeons).
  4. IGRA are specific for M.Tbc but there are few NTM (nontuberculous mycobacteria) that can give a +QFT; M. Bovis, M. Africans, M. kansasii, M.Szulgai, M. marinum, M.gordonae. These have ESAT & CFP Ags.
  5. 2996 HIV+ patients on HRT finds 113 w/ Rheumatic disease, lead by AVN 39 (1.3%), psoriasis 28 (1%), RA 7, PsA 6, & SLE 6pts. HIV Males 1.7 times more likely to have a rheum Dz. Hep C incr the risk of RD. RD Risk in HIV+ appears same as gen population.
  6. Lupus care provided by a Lupus specialty vs General Rheumatology (GRC) shows LC w/ better quality measures [86% vs 70%] w/ better APL testing, DXA, steroid sparing , ACE inhibitor use Moderate correlation between the MDs #SLE patients and QM performance
  7. Study of 1181 Systemic Sclerosis pts finds 3.4% w/ hx of VTE events= VTE incidence of 2.7 per 1000 pt-yrs (equal to general population). Risk factors for VTE were PAH, peripheral arterial disease, Scl-70+, anticardiolipin Abs (OR 2.45-5.7)
  8. What drives VTE risk in Rheumatology Clinic? Surgery, inflammation, obesiy, smoking, drugs or Cancer? RHEUMS ONLY vote here-->
  9. EMA will have a hearing on June 13th on the safety of quinolones. 
  10. OMI! Low Vitamin D is ALSO associated with an increase risk of noninfectious uveitis, primarily in blacks - if only giving vitamin D could fix the disease its associated with !
  11. UNBELIEVABLE. NEWS FLASH.. Vitamin D again linked to something, this time a greater risk of diabetes. Take the vitamin D and a few marshmallows.
  12. USPSTF Recommendations on Vitamin D, Calcium Supplementation to Prevent Fractures  
  13. Kineret Approved for Still's Disease in EU 
  14. Shared Epitope - Smoking Pathogenic Link Clarified  


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

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