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ACR Clinical Guidelines Flawed by Low Evidence

JAMA Internal Medicine has reported that recommendations and clinical practice guidelines (CPGs) from the American College of Rheumatology (ACR) are often based on expert opinion, but lack rigorous (grade A) evidence to support many of their recommendations.

Creaky Joints Nails New Patient Pregnancy and Family Planning Guidelines

Patients and physicians are riddled with misconceptions when pregnancy is concerned.

The RheumNow Week in Review - 17 November 2017

Dr. Jack Cush reviews the news and highlights from the past week on RheumNow.com. This week he covers FDA warnings on gout drugs, steroid use in Australia, biosimilars lost savings and methotrexate hepatotoxicity in psoriatic arthritis (PsA).

ACR 2017 Highlights: RA, SpA, PsA, OA, Lupus and More

Another year and another great ACR meeting. San Diego proved to be a an amazing host with the perfect combination of a convenient convention center with great lodging at walking distances from the conference, amazing food and superb weather. 

Podcast of ACR17 - Day 4

Check out this compilation of our ACR17 Day 4 broadcasts, merged into a single one hour podcast !

The ACR17 RheumNow Week in Review - 10 November 2017

This special edition of the RheumNow Week in Review covers highlights of selected sessions from the 2017 ACR annual meeting in San Diego. Dr.

Practice Patterns of PJP Prophylaxis Among ID Physicians

While the incidence of pneumocystis pneumonia (PJP) is low is patients with rheumatologic diseases the mortality is quite high compared to PJP in patients with HIV and infection can be prevented with appropriate prophylaxis.

SLE Clinical Trial Design and Outcome Measures

Clinical trials remain a challenge in SLE and a number of outcome measures have been used with varying success.

Two abstracts in this session sought to address novel ways to assess responses in SLE trials.

Gut-derived TNF: Connection Between Crohn’s and SpA and Sacroiliitis

The pathogenesis between microscopic gut inflammation leading to the development of Crohn’s disease and sacroiliitis has been poorly understood. Dr. Debusschere, et al sought to understand this important link between IBD and axial SpA.

Co-morbid Fibromyalgia

Rheumatoid Arthritis and SLE can be quite challenging to manage in clinical practice, but our arsenal of medications to tone down inflammation is becoming quite broad.

Social

Whom with GCA should receive tocilizumab? What happens when it is stopped? Optimal dose for maintenance weekly or Q2 weekly? GiACTA gives only some answers. Need RWE #EULAR2020 @eular_org @RheumNow @CRASCRRheum @earlyarthritis #vasculitis https://t.co/aNvR14vfEV
5 years 3 months ago
Hand OA Rx strikes out. HCQ Rx neg and colchicine Trial negative. I wouldn’t put hand OA as same category of no Rx as for SSc and Sjogrens but agree though nuts to crack @eular_org @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/QRe3UpKpbz
5 years 3 months ago
#EULAR2020 OP0333: Could SLE itself be a risk factor for retinopathy (not just because of HCQ)? @Janetbirdope study of >600 pts noted retinopathy risk factors: 1. longer duration of antimalarials 2. any use of chloroquine 3. SLE (OR 16.1 CI 2.1-125) @RheumNow https://t.co/seAR42K1SU
5 years 3 months ago
#EULAR2020 Dr. V Ritschl:EULAR Task Force on Patient Adherance: 30-80% of pts do not adhere to Rx. resulting in ⬆️dz severity, pain, fatigue, depression, decreased in function, physical activity. HCPs should discuss adherance reg. & explore factors affecting adherance. @RheumNow
5 years 3 months ago
ENbrel works in long term for the few people left on the drug at 10 yrs with SpA. Enormous dropout. If you are still on Rx for a decade you are in the minority. Drop out of TNFi in SpA mirrors RA & PsA @RheumNow @eular_org @CRASCRRheum @earlyarthritis #EULAR2020 https://t.co/dLS2fw5uRP
5 years 3 months ago
Can you classify SLE by labs only but should you? Serology is part of criteria but why dx with only +ANA, +antiDNA and no other CTD characteristics. Would need cytopenias & RBC casts to think of lab dx of SLE OP0094 @LupusCanada @RheumNow @eular_org #EULAR2020 @CRASCRRheum https://t.co/Jr6SRr3HR1
5 years 3 months ago
Avacopan is as effective as steroids in ANCA Assoc Vasculitis – 330 pt RCT AAV Rx w/ RTX or CTX but randomized to prednisone or avacopan (C5aR antagonist). Avacopan=prednisone remission rates same (72% vs 70%) wk 26 & wk 52 (66% vs 55%). #EULAR2020 #OP0011 https://t.co/WIXJCYkxSb

Dr. John Cush @RheumNow ( View Tweet )

5 years 3 months ago
#EULAR2020 OP0096 Dr. L Chatzis study on Sjogren: 1. 2nd most common autoimm dz in women 2. women:men ratio 20:1 (not 9:1) 3. 2 types Ro-Ab: nuc. Ro60 (assc w/La)and cytopls. Ro52 (assc w/ILD/myositis) 4. Seroneg. Sjogren's (neg Ro/La/RF) good prognosis:⬇️lymphoma @RheumNow https://t.co/fV3ltQqnkf
5 years 3 months ago
MTX in GCA (+/- TCZ): can GiACTA data provide insights? MTX didn't add anything from data provided, but channelling bias a definite issue (note PNL numerically higher in non-MTX). MTX as adjunct/cover post-TCZ? We'll need to test for it properly FRI0220 #EULAR2020 @RheumNow https://t.co/BCsEKqqaMh
David Liew @drdavidliew ( View Tweet )
5 years 3 months ago
I've heard people say FDG uptake on PET/CT in PMR/GCA is just a correlate of systemic inflamm. Look at the uptake intensity (SUVmax) vs inflamm markers in n=65 PET/CT in GCA. There's no pattern whatsoever. Not just an expensive ESR! @FreemanHospital SAT0272 #EULAR2020 @RheumNow https://t.co/D4xAZC7KmO
David Liew @drdavidliew ( View Tweet )
5 years 3 months ago
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