ANA+ consult (10.18.2024) Save

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.

1. AI-powered chatbot (Bing) was asked 10 questions each on 50 common drugs. Of 500 AI generated answers overall had low readability and a high but still not sufficient quality, repeatedly lacking infor or w/ inaccuracies possibly threatening patient & medication safety.… https://t.co/r1wwKPAtrK
2. FDA has approved a 4th biosimilar to Stelara - the new agent, ustekinumab-srlf (Imuldosa), is indicated for Rx of plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis. Originator Stelara sales in 2023 were nearly $10.86 USD billion globally… https://t.co/MoNBj2UaVH
3. Cardiovascular health (CVH) is critical in arthritis care. NHANES study 5919 arthritis pts finds 10-point incr, in CVH score yielded significantly lower all-cause mortality risk (adj HR 0.72; 0.67–0.79); best results with OA/DJD, more than inflammatory arthritis.… https://t.co/etBbH7bH1D
4. Eu Heart J - Cardiometabolic risk factors in RA Pregancy rose in last 15 yrs. RA-Preg at higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, venous thromboembolism during hospitalizations. https://t.co/7SnjWFluCf
5. GWAS study of 2.6 million people (120,295 w/ prevalent gout) detected 377 loci & 410 independent genes (149 prev unreported), includes genes of inflammation, epigenetic remodeling, cell osmolarity, NLRP3 activity, & clonal hematopoiesis (CHIP) https://t.co/GmXWtTlJkO
6. Biologic (bio-originators) & biosimilar serious Infx rates are low & similar. Retro Study w/ 2+ yrs F/U shows hosp. Infx to be 7% infliximab & 2% etanercept. Similar SIE w/ ETA IR = 11.8 (7.9, 16.8) vs 8.4 (6.9, 10.1) & INFLX SIE IR= 33.4 (27.2, 40.1) vs 29.3 (26.6,… https://t.co/3VI47MjVb2
7. Metanalysis of 40 papers, 486,465 RA pts & 3,928 incident ILD outcomes shows no signif risk of ILD w/ DMARD use; no ILD risk w/ TOFA or TNFi (Oral Surveillance n=2,911; OR 0.94). MTX use yielded a Lower ILD risk (OR 0.49; 0.32 to 0.76) vs no MTX use. https://t.co/JGf0U3RS9w
8. ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/53bmkQ0qj0
9. Comparison of 2 criteria for "difficult to Rx PsA" - 378 pts - 19.8% met Perrotta criteria, & 15.3% met Kumthekar D2T criteria. Sensitivity 30-38%, but specificity 82- 86%, w/ good agreement betw 2 sets. D2T-PsA research is needed! https://t.co/MUWPsargrU
10. Cytokines/biomarkers from IL-23/IL-17 pathways are Increased in psoriasis. Subanalysis of phase 2 254 pt PsO trial revealed that 12 wks of deucravacitinib assoc w/ reduction in IL-17A, IL-17C, beta-defensin, PI3 - decreases correlated w/ PASI changes https://t.co/Ii381B2mZx
11. GI Abnormalities in Scleroderma A prospective Scleroderma Cohort Study found that gastrointestinal tract (GIT) involvement was common and negatively impacted quality of life, physical function, and employment, but had no effect on mortality. https://t.co/9z1ycWkCQt
12. Inadequate Zoster Vaccination in Immunocompromised Patients 
13. Run-Walk Exercise May Help Lower Back Pain    
14. Efficacy of Acupuncture for Sciatica  
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