Depends on Where You’re Looking (8.9.2024)

Jack Cush, MD

Aug 09, 2024 7:00 am

Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week.

N Zealand Rheum Assn audit of 355 new seropositive pts referred, saw 65% starting DMARDs w/in 6 wks. DMARD starts were linked rurality & the # of rheumatologists. If there was 1 Rheum FTE/100,000 population, 80% were on DMARDs <=6wks https://t.co/8OvniRQt1I
Exploratory study of 22 RA pts w/ mod/severe periodontitis and RA. After periodontal Tx, only pts w/ severe (not moderate) periodontitis had significant reduction in DAS28 and CCP2 levels. Use periodontal Tx in RA management & T2T strategy? https://buff.ly/3WGu7ia
Review of Inflammatory vs non-inflammatory pain in RA - Pain may be more than inflammation - Residual plain is a problem - Consider damage vs FM - Central vs. Neuogenic pain https://buff.ly/3WTYKCh
Retrospective study from Univ of Tokyo on 194 Behcets dz (BD) pts, found 25% who developed intestinal BD (meanF/U 12 yrs). Use of #PPI significantly incr risk of intestinal BD (adj HR 2.48; vs non-PPI), w/ a confirmed duration/dose-dependent relationship. https://t.co/e5TSsfYtxE
Calif Cohort of 19340 rheumatic pts, finds Cardiovascular events (CVE) in 1.4% & antiphospholipid syndr in 5.5%. CVE increased risk of adverse pregnancy outcomes (>50%), including Sm for Gestational age (aRRs 1.2-1.5), Premature birth (aRR 1.6) https://t.co/9lxzrOVEks
Prospective Vasculitis Study of Takayasu’s Arteritis - 236 pts, 92% women, mean age 36 yrs, Dz duration 2.6yrs. Damage present in >80% at baseline (75% vascular, 40+% cardiac), even with recent Dx and >40% pts accrue new, mainly disease-specific damage https://buff.ly/3WxMfLg
EU study of 1052 systemic sclerosis pts failed to show early immunosuppressive use (vs late) lowered ILD risk. Early Rx (Dz Dur < 3yrs) group (n=547, 52%) more male, diffuse Dz, 60% Rx w/ MTX (1.7% biologics); ILD in 47% after3.6yrs (HR 1.13;0.93–1.38) https://buff.ly/4cz3phL
Systematic review: RX of macrophage activation syndr (MAS), included 57 reports, 1148 MAS pts (889 sJIA, 137 SLE). Most effective was high-dose GCs, IL-1 (83%) & IFNγ (93%) inhibitors, especially in sJIA-MAS. Also Ciclosporin, etoposide, Ruxolitinib https://t.co/4EnMOnlcYl
Gout Forecast: 70% Increase by 2050 The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) of 2021 has forecasted prevalence of gout to increase by 70% by 2050. https://t.co/7OSQXSBtUc
UK Biobank 11+ yr study of 5728 incident gout pts - light alcohol decreased in gout incidence among females (HR 0.78). Light red wine also reduced gout risk, whereas beer or cider, champagne or white wine, and spirits increased the gout risk at any dose. https://t.co/nP8vObFsOH
Study of 136 referred LBP pts (71 w/ DDD, 38 DISH, 27 axSpA) found significant overlap of imaging features in all 3. SpA-like spine CR features were found in 1/4 of patients with DISH, and MRI BM edema found in 1/3 of those patients. https://t.co/dKIcuE3IGZ
Finding Spondylitis Among Psoriasis, Uveitis and Colitis Patients