An Ounce of Prevention (2.4.2022) Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  He discusses the GI side effects of IL-17 inhibitors, downstream revenues from rheumatology care and dietary prevention of gout. 

1. Retrospective study of 84 pts with Erosive Hand OsteoArthritis (EHOA)- 89% females DIPs erosions scores were higher than PIP’s. Comorbid dz = crystal arthritis (8%), RA (5%) & PsA (1%), Pain usually >5/10 w/ 1/3 responding to NSAIDs. Big Unmet need! https://bit.ly/3J3dOUg
2. Treatment of Complex regional pain syndrome type-I (CRPS-I) in adults is difficult! A Systematic review shows that only parenteral bisphosphonates (and maybe ketamine) lowered VAS/NRS pain scales vs placebo. https://bit.ly/3on52ZB
3. Poncet’s disease: a reactive arthritis secondary to pulmonary M. tuberculosis https://bit.ly/3gnVNny
4. Persons living with diagnosed HIV (PLWDH) have more hospitalizations and death from COVID-19 than those not HIV+. In 100K PLWDH, 63%) were fully vaccinated, 4% partly Vax & 32% no Vax. VAX in PLWDH was lower than gen population (63% vs 75%)  https://t.co/oegf5WjmNF
5. In the USA, the prevalence of Vitiligo in adults is between 0.76% (1.9 million cases in 2020) and 1.11% (2.8 million cases in 2020). Approximately 40% of adult vitiligo in the US may be undiagnosed.  https://t.co/rsyoIbHmS8
6. Radiographic progression in AxSpA studied in 101 Spanish Pts - pts w/ sustained low ASDAS had less XRay progression than those with active Dz (2.33 vs 1.76, p=0.027). Long term TNFi use didnt influence progression until the 3rd Yr  https://t.co/KHCdzbqhzr
7. FDA has expanded its approval of REMDESIVIR for use in non-hospitalized adults and pediatric patients for the treatment of mild-to-moderate COVID-19 disease. Previously, Veklury was limited to hospitalized COVID-19 pts. https://t.co/dHbomchfB5
8. Finnish Parkinson’s disease (FINPARK) cohort (22,189) looked at the assoc w/ #RA. RA pts using only chloroquine/hydroxychloroquine was associated with a lower risk of developing PD (adjusted OR 0.74); not with other DMARDs  https://t.co/yZhgVT0xLh
9. Systematic review of GI Safety of IL-17 inhibitors included 106 RCTs and 40,053 patients. Inflammatory bowel disease occurred in 0.4%; Most freq Sxs - diarrhea (2.5%), nausea or vomiting (0.7%), and gastroenteritis (0.2%). https://t.co/tv3QXHU1Hg
10. Study of Academic Clinicians showed that for every $1 generated though office visits (E&M coding) by 5 practicing academic rheums, $12.14 were generated through downstream revenue (mostly infusions).  https://t.co/YQ1RL5JF9u
11. Article in JAMA estimates that there are 110,000 LESS deaths per year when US adults aged 40-85 years or older had a modest increase in their modest increases in moderate-to-vigorous physical activity intensity per day (ie, 10 minutes per day) https://t.co/n1ictmjnqi
12. 2021 approved Efgartigimod (Vyvgart) for myasthenia gravis: (binds neonatal Fc receptor, stops Ig recirculation): pts w/ AChR Abs respond best (68% vs 30%). Common AEs include URI, UTI, HA; other AE: eyelid swelling, rash, and SOB. https://t.co/wQKZuAlXoR
13. Pediatric Rheumatology Workforce Shortages
14. Healthy Diets Prevent Gout in Women
15. ACR/EULAR 2022 Classification Criteria for Granulomatosis with Polyangiitis
16. RheumNow.Live 2022 - Invigorate, Instigate and Debate Rheumatology at RNL 2022
17. ASK CUSH ANYTHING  Dr. Jan Granieri - AS patient with paradoxical granulomas from a TNF inhibitor?