Rheum Manpower Needs - More Programs! (12.2.2022) Save

Jack Cush, MD

Dec 02, 2022 5:00 am

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

NRMP Results for rheumatology 2022 : - Adult Rheum: 97.8% of 272 fellow positions filled (41% US grads) (371 applied) - Pediatric Rheum: 69.2% of 39 positions filled (54% US grads) (29 applied) WE NEED MORE ADULT PROGRAMS AND MORE INTEREST IN PEDI RHEUM https://t.co/YpMhTPnDM4
Low Dose IL-2 Therapy in Sjögren’s There is a large, unmet need in treating Sjögren’s syndrome, yet a new randomized clinical trial has shown that lLD-IL-2 was effective and well tolerated in patients with pSS, with evidence of restored immune balance. https://t.co/0obaV0wnGX
1602 pemphigus pts Rx w/ rituximab vs azathioprine or MMF. RTX pts had lower risk of MI (RR 0.45; P = .01), CVA (RR, 0.42; P < .001), PVD (0.47), HTN (0.48), hyperlipidemia (0.45), NIDDM (0.63), obesity (0.49). Mortality equal betw groups https://t.co/uvDDU5z8gp
Estimated worldwide market for DMARDs in 2022 was $20.7 billion USD and is expected to rise at a 3.5% annual growth rate to $ 272 billion USD by 2030 https://t.co/futp7249rF
Estimated Global SLE market size was $1.46 billion in 2020, with a global (7 Major countries) prevalence of 651,965 in 2020; and a USA prevalence of 351,176 SLE cases. https://t.co/f4Tghup5PC
Study of 1207 joints in 55 RA pts shows that Xray progression over 2 yrs is significantly assoc w/ US Power Doppler (OR 2.92), erosions (OR 4.74), but also with Joint tenderness w/o swelling (OR 1.85) ! (Less signif w/ PsA) https://t.co/gue5jt6Xdx
Mayo LUMEN study looked at SLE nephritis incidence betw 1976 -2018, & showed that LN increased over past 4 decades. LN patients have poor outcomes w/ higer rates of ESRD & mortality rates (SMR 6.33); @10 yr survival =70% & 13% ESRD https://t.co/QDDTORSgyZ
Study of 294 SLE pts on HCQ (2005-2021): 37 (13%) developed CHF w/ low EF (HFrEF), arrhythmia or cardiac death. After adjustments, wt-based dosing of HCQ not assoc w/ cardiac events(sHR 0.62; 0.41,0.92) & may decrease risk in non-smokers https://t.co/ufYcnuMI2r
RCT data on BTK inhibitor evobrutinib shows it to be well tolerated. Ph 2 RCT data on 1083 pts (RA, MS, SLE) Rx w/ evobrutinib(861) or placebo(271) for ~ 6 mos. No diff in TEAEs or EAIR , 2 deaths (SLE), SIE 2-3/100PY https://t.co/4HOTKuCAUi
JAMA - Update/Review of Hemochromatosis Dx and Rx. - 5 gene defects in hepcidin. 95% HFE & the C282Y variant - 90%are asymptomatic - Suspicion w/ arthralgias, LFTs, hepatomegaly, cardiomyopathy, 1st degr relative - Untreated, 9% risk of cirrhosis https://t.co/nuq8Ioralk
1st quarter of 2022, only 29% of Medicaid and Medicare users had at least one telehealth visit - down from 46% in all of 2021. (Data from Centers for Medicare & Medicaid Services) https://t.co/RCYjlJOPS3
FDA is investigating risk of severe hypocalcemia in dialysis patients taking Prolia (denosumab). After an interim safety data review reports of hypocalcemia w/ advanced CKD. Monitor Ca, use Ca & vit D supplements. Await further FDA information https://t.co/6pMwBPFJJr
Do oral JAKs in atopic dermatitis cause VTE? Meta-analysis (15 RCTs, 466 993 pts) does NOT show increased risk of VTE associated with AD & JAK inhibitors (HR 0.95) w/ low VTE incidence (0.05%) w/ JAKi and (0.03%) placebo. https://t.co/vcvW8N11cm
RheumNow Rheumatology Roundup Dr. Jack Cush and Dr. Arthur Kavanaugh discuss, dissect and deliberate the sessions and data presented at the #ACR22 meeting in Philadelphia. https://t.co/ppe5I5upvj
Recent CDC/MMWR report shows Paxlovid x 5days (including those w/ prior COVID or vaccination), had a 51% lower hospitalization rate within 30 days after diagnosis than those not prescribed Paxlovid. Use it irrespective of vaccination status https://bit.ly/3AWu0VV
A great read from Dr. Anthony Fauci as he steps down from leading the NIH NIAID research for nearly 40 years. He writes on pundits, need for specialty growth, evolution of vaccines and "it aint over till its over" is now "its never over" https://t.co/z0noGckIvx
TIME Mag - "Why Masks Still Matter". 1) COVID is still out there; 2) Influenza on the rise. Authors write "With limited yet mixed data, we would be wise to ...err on the side of masking in high risk, indoor crowded public settings..." https://t.co/l8jiTwAdZz