Hard Decisions in RA (9.1.2023) Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow, and introduces our September campaign - "Hard Decisions in RA".

1. ACR Position Paper: Cost Impact of Rheumatologic Care

2. FDA Approves Canakinumab for Gout Flares

3. SGLT2 Inhibitors as Gout Treatment

4. Lupus study from N. Zealand (2005–2021) shows #SLE pts had 4x worse survival compared to gen. population. From 2,802 pts 25% died, w/ 30% being SLE deaths. SMR=0.29/100K in women (0.05 men). Younger more likely to die from SLE; 2X worse in Māori https://t.co/6fhoehLu71

5. Posthoc analysis 2 phase III RCTs of ABAtacept x 2 yrs in 409 poly JIA pts; ABA monoRx vs ABA+MTX Rx pts were compared & there were NO between group differences in efficacy (JIA-ACR & JADAS27-CRP), bio-naive vs bio-experience responses, safety & PK studies https://t.co/lBJrPzm5S1

6. Comparison of 158 adults and 58 juvenile-onset Systemic sclerosis showed differences: - Time to Dx: 5 vs 2 yrs - ILD: 51% vs 30% - HTN 18% vs 0 - More limited cutaneous Dz in aSSC (74%) - More diffuse cutaneous Dz in jSSc (77%) - Higher mortality aSSC https://t.co/pMQiydwEE2

7. Systemic sclerosis (SSc) pts w/ HRCT proven ILD compared pts Rx w/ tofacitinib (n=9) >6mos vs 35 matched SSc-ILD Rx conventional meds. TOFA pts had improved Skin (mRSS), DLCO, HRCT fibrosis scores vs controls https://t.co/xGVzf7L0IP

8. Retrospective study of 41 pts w/ refractory inflammatory myositis treated with tofacitinib; (23 DM, 12 CADM & 6 PM). In ALL pts - no improvement in strength observed, but Skin did improve! 54% discontinued TOFA for lack of benefit or death. https://t.co/NPgdeOuw8C

9. Vasculitis is a risk factor for Pneumocystis pneumonia (PJP). Among 600 ICU pts, 115 (19%) had PJP. Risk factors included AIDS (OR 3.31), NHL (OR 3.71), vasculitis (OR 5.95), metastatic tumor (OR 4.31), CT ground glass (2.19), Lymphopenia https://t.co/8mOryhJqcb

10. Hip Replacement Surgery After Age 90

11. Gut Microbiome Differences Antedate JIA Development Researchers have shown that gut microbiome differences may be associated with later development of JIA, and that such differences are present years before the disease is diagnosed. https://t.co/MlzkzvlNoS

12. Tuesday Nite Rheumatology - Oral Surveillance Revisited - Tuesday Sept 5th (featuring Drs. Pope, Fleischmann,Curtis, and Giles)