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Does Fibromyalgia Need B12? (9.9.2022)

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from

  1. Study of 130 patients with ITP (w/ 10 later Dx SLE (30 mos F/U). Risk factors for ITP developing SLE included young age (< 40yrs; OR 6.3), organ bleeding (OR 13.7), and ANA (≥ 1:160; OR 6.6)
  2. Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%)
  3. Multicentre matched control study looked at primary Sjogrens that developed lymphoma or NOT. Parotid swelling (PSW) is an early major predictor of non-Hodgkin lymphoma in pSS; esp if present before or dx, & w/ a longer duration of PSW
  4. Study of 100 Korean systemic sclerosis pts, shows that while many had SSc finger involvement, fingerprints is SSc pts did not change significantly, but may be inadequate/ difficult with finger deformity, acroosteolysis or digital ulcers
  5. ACR RISE Registry, 9,560 gout pts- ONLY 56% of patients had > = one Serum Urate recorded during the year; amongst those w/ 1 SU recorded, 74% achieved the SU target. ONLY HALF? GETTING SUAs? Are we not Rheums?
  6. Systematic review of Telemedicine in Rheumatology - 36 reports: 27 observational studies, 7 RCTs , 2 controlled trials - most on general rheum. Most show TM as good as usual / in-person care (Dzactivity, pt satisfaction, costs, & feasibility). TM Works
  7. JAKi inhibit Vaccine responses some - study of 113 RA fully vaccinated pts assess 6wks post 2nd jab - 51 on JAKi and 62 not on JAKi. Pts not on JAK 77.4% had humoral response; 29% less (54.9%) in thos on JAK inhibitors; even more if on MTX + JAKi
  8. Hypertension Associated with RA and OA Analysis of NHANES data suggests that both rheumatoid arthritis (RA) and osteoarthritis (OA) are strongly associated with hypertension (HTN).
  9. Genetic Testing for Autoinflammatory Disease 
  10. Nintedinib has been studied in 39 children (6–17 yrs) with fibrosing ILD demonstrating pharmacokinetics (wt based dosing) and safety. Adjusted mean changes in FVC % at week 24 were 0.3 with nintedanib and −0.9 with placebo
  11. B12 or Placebo effect? Open label study of B12 (1000mcg/d) in 29 fibromyalgia pts showed after 50d, significant reductions in FM Impact Quest. (FIQR; 49.8 to 40.00; p< 0.01), Function, Sxs, anxiety scores all signif improved.
  12. Does Dendritic Cell Targeted Therapy Work in SLE? 
  13. Ask Cush Anything (ACA) - Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. 



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