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Lupus Worries (3-25-22)

Mar 25, 2022 3:01 pm

Dr. Jack Cush Reviews the news and journal reports from the past week in

  1. French study of "Pre-Hab" before Total Knee replacement (prospective, OL, randomized trial) in 262 Knee OA pts >50yrs; saw no benefit of PreHab before TKR. 4 d post surgery, functional independence was same in PreHab (34%) & control (27%)
  2. Effect of Intraarticular Steroid Shots on Knee OA Outcomes In patients with osteoarthritis of the knee, intra-articular injections of steroids did not increase rates of either disease progression or subsequent knee replacement surgery, researchers said.
  3. TENS does not work! Multi-centre, trial in 220 active Knee OA pts pitted TENS vs placebo TENS for 3 Wks. Using WOMAC pain scores there was no difference between TENS and placebo TENS (mean diff -0.06; P=0.74). No diff in AE or 2ndary outcomes
  4. Having the MUC5B promoter variant increases odds of RA-ILD w/ earlier onset in RA, esp w/ older age of RA onset. Mass Gen Biobank study of 1,005 RA pts; MUC5B found in 15% w/ incr risk of RA-ILD (OR 3.34) & RA onset after 55 yrs (OR 1.52)
  5. Swedish study found 1774 systemic sclerosis (SSc) pts in 2015 w/ median age 65 yrs (84% women) = prevalence=22.7 per 100,000 . Incidence (2004-2015) was 11.9 per 1,000,000 PYs - incidence remained stable; Females were 5x more common than Males.
  6. 10 yr Spanish study evaluated PET/CT in newly dx inflammatory myositis (except IBM); /77131 IIM pts had PET/CT screening for occult cancer with AUC ROC of 0.87; those not evaluated for OC did not develop cancer after median 3.3 years
  7. Lit review of MDA5 antibody-positive clinically amyopathic dermatomyositis w/ ILD - shows limited data from 15 studies, 388 pts, 1 RCT: ? best survival with high-dose steroids + immunosuppressive (CTX or CyA/tacrolimus). Refractory dz Rx w/PLEX, Tofa, RTX
  8. Adalimumab Addition vs. Methotrexate Escalation in Psoriatic Arthritis
  9. Montreal General Hosp SLE cohort study of 489 SLE pts - 35% have Raynauds phenomena; RP in SLE assoc. w/ Female (OR 2.43), White (OR 1.85), CNS disease (OR 1.98), RNP Abs (OR 3.0); negatively assoc w/ hemolytic anemia & cellular casts
  10. SLE Higher Risk of Postoperative Cardiac Events
  11. Poor Outcomes in Lupus Patients Not at Target 
  12. Ask Cush Anything - Questions: 
    • Dr. Elnadi - Raynauds, pulmonary hypertension and anticentromere Abs.
    • Dr. Elasir - Best vaccine for lowest rheumatic disease flare risk


The author has received compensation as an advisor or consultant on this subject

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