Night Splinting for Carpal Tunnel (3.24.2023) Save

Dr. Jack Cush reviews the news and journal articles from the past 2 weeks on RheumNow.com.  This week reviews clinical associations with SS-A, a new biomarker for SSc-ILD and cancer screening for myositis patients.

1. 29 pts w/ PsA Sine Psoriasis: 16F/13M, mean age 45 yrs w/ PsA ~6.2 yrs. 54% had 1st-degree relatives with PsA. 66% had DIP arthritis, 39% polyarticular, 36% oligoarticular, 25% were axial. Nail findings seen in 89%, enthesitis 59%, dactylitis 62% https://t.co/FPAqosYr9C

2. Retrospective study of Apremilast survival in 281 #psoriasis pts(22% w/ PsA) showed 1 yr drug survival=54%, less at 2 yrs (41%), 3 yrs (32%), and 4 yrs (30%). Half 1+ adverse events; D/C mostly for lack of efficacy (27%), adverse events (12%) https://t.co/F2YtzzWMdT

3. 28 biomarkers studied in 259 SSc-ILD, 179 SSc-NO ILD, 172 IPF & 30 healthy controls. Composite biomarker index (w/ SP-D [surfactant prot. D], Ca15-3 [MUC1], & ICAM-1) strongly correlated w/ SSc-ILD (adj OR 12.7); independent of age, sex, smoking, PFTs https://t.co/F0iKFqcZoY

4. Open-label trial of Guselkumab (IL-23 inhib) in 20 moderate-to-severe hidradenitis suppurativa (HS) pts saw 65% with HiSCR response at wk 16. Yet phase IIB NOVA PBO-RCT showed GUS HiSCR response 45–51% (vs 39% PBO). GUS may only benefit subgroup of HS https://t.co/OxtFfyRMFk

5. Carpal Tunnel - Steroid injection vs. Night Splinting A randomized trial conducted by the UK National Health Service, studied interventions in patients with CTS and found no advantage to either CTS CSIor NS as the initial treatment of CTS. https://t.co/05AADf55uB

6. Retrospective insurance claims study of PMR & GCA pts. No cases PJP (pneumocystis) found in 547 Pt-Yrs F/U in 1168 GCA pts and 1 case found during 7,446 Pt-Yrs F/U in 15,575 PMR pts (incident 0.07 cases per 1,000 Pt-YRs). NO NEED FOR PJP prophylaxis! https://t.co/UFlKtm88Dj

7. Long-Term Survival of Idiopathic Inflammatory Myopathies A single center cohort study analyzed the outcome and survival of IIM patients and showed good 5 and 10 year survival but showed significant declined 15-25 years post-diagnosis. https://t.co/EmxRcDCIVn

8. Cancer detection study in idiopathic inflammatory myositis: found w/in 3 yrs of onset 9/1011 (0.9%) CT chest & 12/657(1.8%) CT Dx cancer. Yield best w/ DM, TIF1γ pos. Yield very low age<40 yrs; high false(+) w/ antisynthetase synd & necrotizing myositis https://t.co/FCBwEYW1eT

9. Metanalysis of adverse PREG outcomes in 1675 women (1920 pregs) w/ anti-SSA/RO Abs - 4% preg termination, 5% spontaneous Ab, 26% preterm labor, 50% C-sect, 4% perinatal death, 3% IUGR, 7-12% heart block recurrence, 19% cut. neonatal LE https://t.co/pD2JkMsyVX

10. In studies were glucocorticoids(GC) are used as initial bridging Rx, the odds of continuing GC 1 mo beyond expected end of GC bridging was 18% (decreasing to 7% from 6-18 mos). Initial higher doses & longer GC bridging assoc w/ higher cumulative GC doses https://t.co/6iyNVzxt1K.

11. 10 yr study of 390 RA pts, of whom 160 (41%) had MTX-related gastrointestinal intolerance (GIS); meaning they D/C MTX and had EGD - H. pylori was significantly higher in MTX GIS pts; such pts had 3 fold higher odds of Rx w/ biologics or JAKi's https://t.co/RvrUErHyWe

12. Tofacitinib May Reduce Interstitial Lung Disease Risk in RA 

13. A Pilot Trial of Anifrolumab in Discoid Lupus A research report in JAMA Dermatology describes the use of the type 1 interferon receptor inhibitor anifrolumab in patients with chronic discoid lupus erythematosus (DLE). https://t.co/T7dWQWc1gX

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