The RheumNow Week in Review - 16 March 2018 Save

Dr. Jack Cush reviews the highlights from the news, journals and major meetings.  Bigtime rheumatologic lessons with tales from intestinal crypts, the friendly skies & the hips of hockey players. Also the microbiome and lupus, benefits of ENT findings with GPA and rare risk of opportunistic infections with biologics.

1. Metanalysis of checkpoint inhibitor (nivolumab, pembrolizumab or atezolizumab) shows high rates of hypothyroidism (OR 7.6), pneumonitis (5.4), colitis (2.9), hypophysitis (3.4), rash (2.4), fatigue (32%), diarrhea (19%) and  a >20% frequency of arthraligia or back pain. https://t.co/1WMuRRCWZN
2. Science Translocation of a gut microbe, Enterococcus gallinarum to tissues triggers autoimmunity in mice with a genetic predispositon to lupus. Vancomycin prevented mortality by suppressing E. gallinarum and eliminating pathogenic autoantibodies and T cells. https://t.co/02vZstzQ86
3. An Italian 89 pt GPA study finds ENT involvement in 72%; they tend to be younger with less renal disease. Sinonasal symptoms were seen in 58% and otitis media/otomastoiditis in 35%. ENT involvement predicted better outcomes and milder GPA with risk of lower renal disease and mortality rate. https://t.co/UWjzzloxm9
4. Comparing patients who travel by air vs. those by land to/from hospital after TKR, THR, finds 3 fold higher rates of venous thromboembolic events (VTE) (1.64% vs 0.58%) https://t.co/n5cu9eeqz6
5. Opportunistic Infections in RA Rare with Biologics   
6. Bone Marrow Edema Found in SI Joint of Athletes  
7. Plaquenil During Lupus Pregnancy Lessens Flares 
8. CARES Study- More CV Deaths with Febuxostat 

“A goal without a plan is just a wish.” ― Antoine de Saint-Exupéry (goals specific, measureable, attainable, realistic & timely - Christine Bundy)