PMR & Popeye's Spinach (10.6.2023)

Jack Cush, MD

Oct 06, 2023 7:00 am

Dr. Jack Cush reviews the big PMR reports from this week along with other journal reports from RheumNow.com.

Best quote from last nights Tues Night Rheumatology on #PMR , comes from Dr. Stephen Paget (#HSS) who said, "steroids to a new PMR patient are like spinach to Popeye" https://t.co/r7L1cUTJeT
SAPHYR Trial: Sarilumab Wins in Relapsing Polymyalgia Rheumatica
Absence of prolonged AM stiffness (AMS >45 min) at the time of Dx may indicate a cancer Dx. 143 #PMR pts (age 71yrs) & 35 (24%) without prolonged AMS. Cancer found in 20% w AMS<45" and 2.7% if AMS>45". Of 10 Cancer pts in 1st 6 mos, 7 had AMS<45" https://t.co/pS3vu3NbZa
GCA pts w/ prior #PMR Dx had 2 fold more Lg vessel dz & signif more vasculitic stenoses. Study of 311 GCA pts, 16% had prior PMR ~ 31 mos before. prior PMR had more LVV (51 vs 25%) & stenosis(18 vs 3%). Prior PMR incr LVV (OR 7.65) https://t.co/1kqtkPnPaz
X-sectional case-cntrl study w/ UK Biobank looked @ comorbidity w #PMR (n=1036) & GCA (102) pts (98% W; age 63 yrs) - pts rated their health as poor. Comorbid Dx included-more hypothyroidism (OR 1.34), HRT use (1.26), HTN (1.21-1.86) & cataract (1.51-3.84) https://t.co/GxpzN5NWug
FDA Approves the first Actemra biosimilar (from Biogen) - called tocilizumab-bavi (Tofidence) or BIIB800 (during development). This IV FORMULATION is approved for use in active RA, polyarticular JIA and systemic JIA. https://t.co/DxZOJyPNQP
Retrospective EHR study of 7,970 gout pts from Singapore finds ~28% are poorly controlled, with only 46% prescribed allopurinol (13% @doses ≥300). Poor control assoc w/ male gender (adj OR 1.66), Malay ethnicity (aOR 1.27), CHF (aOR, 1.64) https://t.co/M8dJFIbZEV
Metanalysis of 17 studies (n=862849 pts) looked at fall risk w/ #OA. OA Hip (OR 1.50 & knee (OR 1.55) assoc w/ signif incr risk recurrent falls, but not FX. Xray knee OA w/ incr risk of falls (OR 1.28); Xray hip OA decr risk recurrent falls (OR 0.70) https://t.co/7iD8CDA1L7
The frequency of demyelinating Dz (DD) studied in 2260 #SpA pts, finging 18 DD events (IR 31 per 100K PYs) DD at 20 yrs was higher in axSpA than PsA (1.30 vs 0.13%, p= 0.01). DD risk w/ smoking (HR 2.9), axSpA (8.8) & IBD (5.7) -- NOT TNFi! https://bit.ly/46zsfv9
Pneumothorax in an RA patient is likely from rheumatoid nodules eroding into air spaces in advanced seropositive RA patients. https://t.co/Rcg5OEqrmQ
Tuesday Night Rheumatology - Steroids and PMR
REgister for next weeks TNR - 10/10/23 Steroids and PMR