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Prelude to a Meeting (ACR22) (11.11.2022)

Nov 11, 2022 12:51 am

Dr Jack Cush reviews the news and journal reports from the past week on and looks forward to highlight sessions in the next few days at ACR Convergence 2022.

  1. Study of 78 824 adults shows Prevalence of Cannabis use was significantly higher during the pandemic vs before the pandemic in states where it is legalized (but not increase in nonlegal states) esp in adults 18 to 29 and 30 to 54 years

  2. Chronic Pain increased from 2010-2919. A cross-sectional study of 46 420 respondents, shows nonpharmacologic Rx increased [aOR 2.72] & was greater than opioids for chronic, but not surgical pain. Govt policy & practice guidelines have helped.

  3. Sleep Habits study from NHANES - 9004 adults >20 yrs (2017-2020) finds mean sleep duration 7.6 hrs on workdays & 8.2 hrs on free days; 23% slept <7 hrs & 25% went to bed > midnight. Nearly 30% had trouble sleeping (daytime sleepiness 27%)

  4. Plaquenil (HCQ) reduces #SLE mortality. Metanalysis (21 studies, 26,037 pts). Pooled findings - HCQ significantly reduced SLE mortality (HR 0.46); HCQ also reduced mortality in SLE pts w/ renal (HR=0.43), & cardiopulmonary dz (HR=0.37)

  5. Cluster analysis of 112 SLE pts looked at Erosive arthritis. Arthritis seen in 73%, arthralgia in 27%, erosive arthritis in 26%. Cluster that included erosive Dz also seen w/ CNS EL, serositis, Pos tests for ACPA, Carp, Sm, RNP, Dkk1

  6. NY Times reports preprint article showing that taking Paxlovid w/in 5 days of COVID Test+ lowers risk of Long COVID Sxs by 26%. EMR study of 56,340 COVID pts w/ >= risk factor for severe infx; 9,217 Rx w/ Paxlovid had lesss post-Covid Sxs > 90D

  7. FDA issues an Emergency Use Authorization (EUA) for anakinra (Kineret) to treat Hospitalized COVID-19+ Patients with pneumonia requiring supplemental O2 & ! risk for respiratory failure or increased suPAR levels

  8. 12 pts w/ new onset IgA vasculitis (IgAV) post COVID- 19 vaccination (5F; age 52 yrs) - 10 had mRNA & 2 viral vector Vax. Time from Vax to Sxs=11.5 d; 8/12 had vasculitis w/ 1st dose; all skin (7 Jts, 4GI, 2 renal). All Rx w/ steroids

  9. The spike protein of SARS-CoV-2 drives NLRP3 inflammasome activation (one of several reasons that patient may flare or activate after COVID-19 infection or vaccination?)

  10. National Swedish Hip & Knee OA registry compared outcomes if pts seen in-person (F2F) or digitally (online) in 6946 pts - both groups improved at 3 mos; but digital pts had larger improvement at 3 mos (pain & Function) -- unknown if clinically meaningful

  11. New 2022 EULAR Recommendations for the Management of Rheumatoid Arthritis


The author has no conflicts of interest to disclose related to this subject

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