The Inflammation Reflex (5.20.2022) Save
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week, neuroimmunology leading to therapy, the cold shoulder approach and Regulatory updates from the FDA.
Ontario population study shows that musculoskeletal disorders account for 12.3% of all adult emergency dept. visits and 28.5% outpatient physician visits https://bit.ly/3G2psib
From 4 Nordic Registries, 24083 RA patients starting 41K courses of bDMARDs shows RA patients had an 80% higher risk of acute coronary syndromes than in the general population. ACS risk on bDMARDs did not improve at 3yrs or 5 yrs https://bit.ly/3NqN3eQ
Local cryotherapy in adjuvant-induced arthritis in rats given bid resulted in lower arthritis scores, structural damages, less vascular inflammation/endothelial activation (less mRNA CXCL-1, IL-6, IL-1β, leukocyte infiltration, lower IL-17A and OPG https://t.co/b4cAa9E4PJ
RCT (WBC) whole body cryotherapy (-130C x 3 min; 6 WBC in 14 d) in 56 RA pts. Pain at 2 wks was signif better in WBC than controls (-2 vs -0.88 ; p=0.003) & remained lower x 12 weeks (w less pain meds); Dz activity & Function improved but not signif @wk 12 https://t.co/K7a7CQ7rGj
Israel study of 171 kids w/ MIS-C (med age 8 (5-12): Dx#s - 59 during Alpha , 79 Delta , & 33 Omicron waves. All Rx w/ IVIG + steroids. 6-15% prev recv COVID VAX, none ICU admitted. Worse Dz & higher incidence during alpha wave (54.5/100K) https://bit.ly/3sLjo8b
SARS-CoV-2-infected alveoli (specifically N protein-coding plasmid alone) induces IL-6 production. Also, COVID-19 Sera also induced IL-6, moreso in those w/ severe disease. anti-N Ab promotes IL-6 production & may lead to cytokine storm https://t.co/FwIs11i2qc
FDA has approved baricitinib (Olumiant) for the Treatment of Certain Hospitalized Patients with COVID-19 who require supplemental O2, mechanical ventilation, ECMO. Rec dose: 4-mg once daily for 14 days or until hospital discharge https://t.co/RiEp01tc0v
24 week, Phase II RCT of baricitinib in 314 active #SLE patients showed significant reductions in levels of dsDNA, IgG, Sm & ACL Abs; but had no effect on C3/C4, RNP, SSA, SSB. Changes in dsDNA did not correlate with SRI-4 responses though. https://bit.ly/3FSWXmF
Differential diagnosis of dysphagia - when due to autoimmune dz is called Autoimmune neurogenic dysphagia - causes include inflammatory myopathies, inclusion body myositis, myasthenia gravis, Guillain–Barre, MS, NMO, paraneoplastic neuropathies https://t.co/58MyQwmxhL
Large Granular Lymphocyte Leukemia rarely assoc w/ #RA. LGL accounts for 2-5% of lymphoprolif. disorders; often assoc w/ Autoimmune Dz (mostly RA). RA w/ LGL presents with leukopenia, anemia, splenomegaly, onset after mean 6 yrs of RA https://t.co/AIz2edHDXp
Multimorbidity Burden in Rheumatoid Arthritis Crowson and colleagues at the Mayo Clinic have shown that rheumatoid arthritis (RA) patients have a higher prevalence of multimorbidity with as many as 44 different morbidities of interest in RA. https://t.co/vgC1dCA7kZ
RNL22: STEP talk by Dr. Uma Mahadevan - How Stopping Drugs in Pregnancy Leads to Greater Harm
ASK CUSH ANYTHING – NP and PA’s – record your question or case
TNR 5/24 RA Best Management – Register for the webinar or watch our live stream (Youtube, Twitter or LinkedIn) – lectures from Drs. Janet Pope, Elena Myasoedova and Karen Costenbader
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.