1/600 Falls May Die (4.5.2024) Save

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

1. Among 3.2 million people who starting opioids, there were 506 573 serious fall, esp w/ increasing age; Opioid use associated with increased risk of serious falls, esp. if >85 yrs (adj IRR 6.35) and within the first 28 days of commencing opioid use https://buff.ly/3VMThNj
2. H2H study of secukinumab vs adalimumab biosimilar in axial-SpA pts saw no difference & little change in Xray progression for both Rxs. 859 pts showed no signif diff w/ NO Xray progr (66%, 67%, 66%) or mSASSS (0.54, 0.55, 0.72) change https://buff.ly/49oyqTF
3. RCT 302 Dupuytren contracture pts Rx w/ Surgery (n 101), needle fasciotomy (101), or collagenase injx (100). 292 & 284 completed; Success (>50% improved) @3 mos was same: 71%, 73% & 73%. @ 2 yrs, surgery was superior (78% vs. 50% or 65%) https://t.co/K74p1xpnZx
4. CDC surveillance data 2019–2021 identified cases: - 59,655 coccidioidomycosis - 3,595 histoplasmosis - 719 blastomycosis (unusually high fatality rate in 2021 of 17%; typically 8%–10%) https://t.co/cDC0nuZLsb
5. 337 PMR pts studied by FDG PET, followed 6 mos - 9% (31) had subclinical vasculitis (GCA) - 21 had isolated LG vessel - 3 isolated cranial vasculitis - 7 both cranial & LG vessel vasculitis. Steroid use higher w/ subclinical vasculitis, but not relapse https://t.co/QyRFwY45eU
6. Cohort of 158 active #RA pts (DAS28 3.6-5.6 & pain 4-7/10) found that Pain was explained by: - 27% - Inflammation (+PDUS), no FM - 27% - w/ FM - 19% - w/ both FM and inflamm - 27% (No FM, no PD) - peripheral nociceptive pain https://t.co/uM6Gw8D8D8
7. Oral Surveillance study revisited: the risk of Venous thromboembolism & Pulmonary emboli were higher with tofacitinib (10>5 mg BID) versus TNFi and were generally consistent over time. VTE & PE risk incr by age, BMI, and VTE Hx https://buff.ly/3vvQLR7
8. Korean claims study of #RA & pregnancy (& adverse preg outcomes (APO), shows MTX or LEF use w/in 3 mos of conception assoc w/ incr. in APOs (aOR 2.14-.68). In 5728 preg: 1152 APOs, HCQ most commonly used, DMARD use decreased during preg. https://t.co/7UBsNdpRgx
9. Soluble Fms‐like tyrosine kinase‐1 (sFlt-1)/placental growth factor (PlGF) ratio, biomarkers of placental function and adverse pregnancy outcomes. Study of 158 RA pts, 1/2 on TNFi during Preg. TNFi assoc w/ incr birthweight; no effx on sFlt‐1 & PlGF https://t.co/JFvDxrTAfr
10. 13 Risk Factors for RA-associated Interstitial Lung Disease
11. Mortality in Psoriatic Arthritis 
12. Ask Cush Anything - 70 yr old with chronic LE rash - Dr. P. Sepulvado
13. Tuesday Nite Rheumatology - 4/9/24