Lead with Lupus (8.2.2024) Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com - leading with lupus because everyone wants to know about lupus!

1. Lg prospective (2013-2020) multinational, cohort of 3449 #SLE pts (F/U 2.8 yrs)- LLDAS (lupus low Dz activity achieved >= once in 73%. Sustained LLDAS >3mos assoc w/ signif less damage (HR 0·60), remission: (0·66) & flare (0·56). https://t.co/AFyOBWcIZf
2. TRUST: 10 Yr Japanese study of tacrolimus in 1355 SLE nephritis pts; half on TAC x 10yrs. TAC use assoc w/ signif reduction corticosteroid use (~16 mg/d @4wks to 7.2 mg/d @ 1Yr(P < 0.001). 9.7% w/ serious AEs. https://t.co/PsfCVZF4tk
3. US Childrens Hosp Admission database finds 8588 kids w/ SLE & ≥ 1 hospitalization; 13% for infections, w/ Bacterial pneumonia most common. cSLE In-hospital mortality in 0.4%, but 2% for infection. Highest mortality w/ PJP (21%), fungal infx (21%) https://t.co/fmyRXagCcD
4. Calcinosis cutis affects 40% of SSc pts w/ significant morbidity. Assoc w/ Long Dz duration, vascular dysfunction, & osteoporosis. Dx by radiography. Surgical treatment is most effective therapy, but no medical therapies have proven efficacy in RCTs https://buff.ly/46u2cXo
5. Cohorts of 100 compared PsO/PsA pts to controls. Psoriatic pts had significantly more cases of polyneuropathy than controls (RR ~20), but the significance was lost when corrected for frequent comorbidities that cause neuropathy https://t.co/ujPlgmISUc
6. Elder adult Cohort study of 2413 women & 792 men w/ hip BMD-defined osteoporosis based on CT scans, shows 30% of women & 34% of men had hip Fx. Rx w/ alendronate (34%F; 24% M) signif lowered Fx rates (aOR 0.26 and 0.21, respectively) = no sex difference https://t.co/briuZAYVKx
7. Medical literature review of suggests low vitamin D status is common in Rheumatic pts. & low vit D levels linked to loss of muscle strength, MSK pain, sarcopenia & falls (esp in IIM, PMR, SLE, RA, SSc) (BUT DOES REPLACING VITAMIN D FIX THESE PROBLEMS???) https://t.co/QVVxH5pEua
8. In the UK, estimated cost of hardardous NSAID use is £31.43million (pounds) (£9.28m to £67.11m) over 10 yrs. High risk = Elderly >65y without gastroprotection, pts on anticoagulants; & Pts w/ heart failure, chronic kidney Dz , or Hx of peptic ulcer. https://t.co/bPXnQbQnNV
9. NSAID use despite contraindications: https://rheumnow.com/news/nsaids-used-despite-contraindications
10. Polypharmacy Doubled in 20 Years. Polypharmacy (5+ Rx last month) went from 24% in 2000 to > 40% in 2020 https://t.co/2czI4DxlVm
11. FIRST registry of 1424 #RA pts found 732 achieving HAQ-DI <0.5 & 454 w/ pain VAS <4/10. Achieviing LDA in 1st 6mos predicted by seropositivity & JAKi use. Less likely were: older, failing ≥ 2 b/tsDMARDs, hi baseline HAQ & steroid use (not comorbidities) https://t.co/7y0uMV414j
12. Frequency and Features of CPPD  
13. Review of Calcium Pyrophosphate Deposition Disease  
14. Pain Reduction with Methotrexate in Knee Osteoarthritis