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Recommendations – Good & Bad (5.27.2022)

May 27, 2022 9:53 am

Dr. Jack Cush reviews the news, regulatory updates and journal reports from the past week on This week gout worries, mortality risks, measuring anti-drug antibodies and a better way in lupus?

  1. May 2022 EMA meeting the CHMP recommended new indications for Cosentyx (juvenile PsA, Enthesitis-related arthritis), Olumiant (alopecia areata), Rinvoq (ulcerative colitis) and Xeljanz (ankylosing spondylitis). EMA approval pending

  2. Study of 100 pts w/ gouty arthritis, 51% had hypertension, nearly half insufficiently controlled. Undiagnosed HTN was seen in 18%. Gouty pts w/ HTN frequently (92%) had serum uric acid levels above the target

  3. 1049 non-diabetic hospitalized gout pts (2014 -2020); saw an inverse relationship betw CKD & NAFLD, & increaseing negative associations w/ NAFLD severity (mild OR 0.392; Mod: 0.379; Severe 0.148). NAFLD negatively assoc w/ CKD risk in gout

  4. NEJM : 40 yoM 2 wk hx scaly foot rash, joint swelling & LBP. 1 wk ago had diarrhea & urethral discharge. Feet show keratoderma blenorrhagicum; PSO on scalp, trunk, hands, nail changes, +swollen joints, CRP 59/L, UA sterile pyuria, B27+

  5. 86 #SLE pts w/ pulmonary embolism (age 38 yrs; avg lupus duration 46.5 mos) found 20% died; 1 yr (83.4%) & 3-year survival (79.4%). Mortality Predictors = Thrombocytopenia & lymphocytopenia. HCQ & anticoagulation were protective

  6. NSAID use is not associated with increased COVID-19 severity, all-cause mortality, invasive ventilation, AKI, or ECMO in COVID-19 inpatients. 38-center retrospective cohort propensity matched of EHR data from the National COVID Cohort Collaborative.

  7. Study of 282 inflammatory arthritis (IA) pts Rx with TNFi, 11 (3.9%) had neutralizing anti-drug Abs (nADAb). nADAb+ was more likely in smokers; such had significantly worse Dz activity, physical function, & inflammatory markers

  8. VA and Marketscan data analysis ~345k RA pts shows multimorbidity increased in RA; over-represented are cardiopulmonary, cardiometabolic, and mental health and chronic pain disorders (OR 1.17 - 2.96).

  9. Amitriptyline and FDA Treatments for Fibromyalgia  

  10. Can SGLT2 Inhibitors Be Protective in Lupus and Vasculitis?   

  11. To TDM or Not in Rheumatology?        

  12. Cardiovascular Risk in Calcium Pyrophosphate Deposition Disease  

  13. Follow our EULAR 2022 Coverage June 1 - 4 for key opinion leader perspectives, clinical trial highlights and more, as we cover #EULAR2022.

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