Higher Cancer Rates (8.16.2024) Save

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

1. 355 PsA (n=279) & psoriasis (76) pts studied. PsA pts had more comorbidity vs PsO (43% v 26%). >70% low exercise level. Exercise signif improved DAPSA, TJC/SJC, ESR, PASI. Hi Mediterranean diet decr ESR, PASI, but signif only for enthesitis (p 0.015) https://t.co/mdruLj9h5a
2. Anti-Inflammatory Diet yields a lower risk of Dementia. UK Biobank study shows patients w/ type 2 diabetes, heart disease, or stroke who were on an anti-inflammatory diet had a 31% lower risk for dementia vs. a pro-inflammatory diet https://t.co/2ttdBIfgx6
3. Breast CA (BC) & TNFi - study of 2 cohorts (Optum commercial * SEER/Medicare) found that 17% & 16% of BC pts received TNFi. 1 yr overall survival was no different +/- TNFi (HR= 0.77 & 0.84); but BC survival better on TNFi (HR 0.28; 0.08–0.98) vs csDMARDs. https://t.co/cGqT80rGTR
4. Should scleroderma (SSc) be screened for cancer? 1,588 SSc pts from CPRD database - 206 developed cancer following SSc Dx (116 prevalent, 90 incident). Common were mucocutaneous (4.5%), lung (2%), breast (2%). Signif incr adj HR 1.41 & 1.32 https://t.co/wOenGi4nge
5. Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/iPlPk9fOEe
6. Mass General Brigham Study 172 RA-ILD pts w/ 6.5 yrs F/U (age 62 yrs): noted (4%) lung transplants & 44 (26%) ILD-related deaths. FVC rapidly declining pts (14%) had aOR 19x lung transplant & aOR 2.8 ILD-related death. Slow decline in 54%, no decline 32% https://t.co/fKDnJIu9a7
7. Lit review of ILD in anti-synthetase syndrome finds no conclusive evidence of effective treatment. 10 studies, 514 pts (68% female); Hi Res CT positive in 87% w/ 49% having NSIP pattern. 48% Jo-1+, 28% Ro52+. Low improvements w/ RTX (12%), CYC (17%). https://t.co/B7R0xQrUyw
8. Anti-Ku + myositis: an acquired inflammatory protein-aggregate myopathy. 92% female, median age 56yrs w/ very hi CK levels, 31% have overlap w/ scleroderma (half of these have ILD). Path shows by myofiber necrosis, MHC-class I/II+, endomysial inflammation https://t.co/7HDUEPmbdi
9. Favorable results from Vasculitis Pregnancy Registry; enrolled 147 women, 149 pregnancies; data on 78 pregs. 36% had active vasculitis during Preg, 14 hospitalized (4 w/ vasculitis. 74% Rx vasculitis meds during preg & 97% live births, 21% preterm https://t.co/rq2Y4ij0OW
10. EMR study looked at NIDDM & 4 indicators of #Obesity (waist circumference, waist/hip ratio, BMI, & visceral fat area -- 600 gout pts vs 9,935 controls shows all obesity measures signif incr odds of #Gout (OR 1.775, 1.691, 1.858, & 1.578, respectively) https://t.co/JJn5txgxiN
11. 3+ million persons died in USA in 2023. Overall age-adjusted death rate in 2023 was 6.1% lower than 2022. Overall death rate highest among non-Hispanic Blacks or African Americans. The number of COVID-19 deaths was 68.9% lower than in 2022 https://t.co/Oqgxcs4yUz https://t.co/lDn1PuEQ5Z
12. Less Mortality with GLP-1 Agonists in Rheumatic Patients
13. ASLeap: Higher Dose Secukinumab in Ankylosing Spondylitis