Leaving Academia (2.2.24) Save

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week we discuss hipsters undergoing hip replacement, pregnancy outcomes in RA and the future of academic clinicians.

1. Celebrities/famous folk who've had hip replacement: Steve Carrell Arnold Schwarzenegger, Michael Douglas, Billy Joel, Jane Fonda, Ray Charles, Eddie Van Halen, Bob Hope, Steve Perry, Lionel Richie, Alec Baldwin & soon Paulina Porizkova https://t.co/z3v39gxAZa

2. 240 consecutive estab. RA pts underwent cervical spine X-rays looking for ant. atlantoaxial subluxation (aAAS >3 mm); aAAS found in 25 (10.4%) mean interval =4.2mm. One-third had no neck pain. aAAS predicted by lower BMI, CCP, erosions & joint prostheses https://t.co/OXNbJ6aiCG

3. Dupilumab (IL-4/13 Inhib) may cause MSK Sxs. Study of 470 Atopic Dermatitis pts on dupilumab; 36 referred to rheum consult, 26 pts (14M/12F) had US/MRI proven enthesitis, arthritis, or tenosynovitis (16 mild, 4 severe). All responded to NSAID or DUP D/C https://t.co/S3ACOC4xUZ

4. Metabolic Syndrome increases RA risk. UK Biobank (369,065) study saw 4901 incident RA (12 yrs F/U). Signif hi RA risk with MetS (HR 1.22), waist circumf (1.21), incr TG (1.12), decr HDL (1.31) & hyperglycemia (1.15) - all additive. https://t.co/jN15axxTmu

5. Greek study finds 251/1264 #RA pts (20%) had difficult to treat RA (D2T). D2T Predictors were Younger age, fibromyalgia, OA, no change in DAS28-ESR in 1st 6mos b/ts-DMARD Rx. Mental-/pain-/metabolic-Dz contributed to LT worsening https://t.co/QIsu6yIJHO

6. Study of 235 newly Dx #RA patients (157 females) found that 11 pts (5%) had carpal tunnel syndrome (CTS) at the time of initial RA diagnosis. Such pts were more likey to be older, female, CCP negative and have a longer Sx duration. https://t.co/Jb3hynyqGx

7. Biden administration will re-negotiate top 10 Medicare costly drugs - this includes two of interest to rheumatologists 1. Stelara (ustekinumab) - avg Part D Rx cost = $119,951 2. Enbrel (etanercept) - avg Pt D Rx cost = $58,148 https://t.co/HuXmFodZfd

8. Meta-analysis of 35 RCTs (>20K pts) with inflammatory skin disorders shows that w/ short-term (<5 mos) use JAK inhibitors do not significantly increase risk of all-cause mortality (OR, 0.83; 0.44-1.57), MACE, or VTE (OR, 0.52; 0.26-1.04)

9. 11-yr French study of #RA Pregnancies: more adverse Preg outcomes in RA, esp w/ active Dz. 11.8K RA vs 10.4 million non-RA Pregs. 75% live births in RA. RA had more preterm(aOR 1.84), low birth wt (1.65), C-Sect (1.46), hospz (1.30), & prematurity (2.02) https://rmdopen.bmj.com/content/10/1/e003762.long

10. One-Third of Physicians Intend to Leave Academia

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    Half of Subclinical Synovitis Patients May Remit