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The RheumNow Week in Review - 22 December 2017

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

  1. FDA approves Xeljanz (tofacitinib) for use in adults with psoriatic arthritis, alone or in combo w/ MTX/DMARDs. But warns agains combining with biologics, cyclosporine or azathioprine as these have not been studied. https://t.co/ffsAfiaU70
  2. SPIRIT-P1 study of Taltz (IXE) in PsA shows that after initial 24 blind, PBO & ADA pts rerandomized to IXE q2 or q4 wks==ACR20/50/70 of 69%/55%/39% for q2wk and 69%/53%/40% for q4wk at 1 yr. https://t.co/IPg1Hf7VoT
  3. Metanalysis of 7 RCTs on IL-17 inhibitors in PsA shows a 2 fold greater ACR20 response, with no increased risk of infection, AE, TB, candida or SAE https://t.co/rrBD3Wokqt
  4. Swedish analysis of 38,702 AS/SpA/PsA pts (vs 200,417 gen population) shows Biological-naïve AS/PsA /SpA have no incr risk of TB risk (OR 1.2; 0.5 to 2.7); but biologic use incr risk of TB (OR 7.5) https://t.co/zqPpxLZk5q
  5. 320 kids with juvenile PsA from CARRA shows 1 in 5 w/ JPsA are obese and > one-third were overweight. https://t.co/MoMW3Hpvqu
  6. FDA has studyied the safety of Gadolinium-based Contrast Agents (GBCAs)since 7/15 & now rewarns HCPs to limit GBCA to circumstances where a contrast agent is necessary & limit use of repetitive MRI w/ GBCAs https://t.co/ckEuDsJEUD
  7. Life expectancy at birth in the U.S. fell slightly in 2016 (for 2nd consecutive yr)-- to 78.6 years from 78.7 years in 2015, according to the CDC's National Center for Health Statistics. https://t.co/dAcIflYMxs
  8. The problem of nonadherence to meds, not filling Prescriptions is a big one. NYT reviews it stating that the only promising solution is cheaper meds https://t.co/tSEbH54Dt3
  9. 21.4 million Americans (9.6%) have tinnitus; 1/4 have for more than 15 years; 36% its constant & in 7.2% its a big problem. Assoc w/ loud noises at work (OR 3.3) or during recreation time (OR 2.6); AAO-HNSF has guidelines https://t.co/1TacoiRyHu
  10. Rain May Not Cause Achy Joints - Analysis of 11.6 milion medicare outpatient visits shows no association between rainy (or # rainy) days & visits for back pain, arthritis https://t.co/X56rWSBAf2
  11. Claims data shows kids with SLE have high health care utilization in the year preceding pedi-SLE Dx (seen for CP, VTE, thrombocytopenia, AKI) suggests a substantial failure to dx pSLE early https://t.co/YGuUogFJey
  12. Incidence of giant cell arteritis in Western Norway 1972–2012:16.7 per 100,000 over age 50, Women 2-3 fold higher risk; peak 70-79 yrs (34.5/100k) https://t.co/DFQkERdMd5
  13. Olmstead Co (Mayo) study shows rising incidence of gout (67-->137/100000) from 1989 to 2010 is associated w/ rising rates of comorbidity (HTN 54->69%; DM 6-25%; CKD 11-28%; morbid obesity 10-29%) https://t.co/LsVYIa1rH5
  14. Allopurinol Dose Escalation is Safe with Severe CKD  
  15. Risk of Gout Onset and Flare Linked to Urate Levels  
  16. Frequency of Rheumatoid Knee Replacements Down in the Biologic Era  
  17. Baseline Risk Score Predicts Serious Infection Risk in TNF-Treated RA Patients  

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