RheumNow Podcast – Bill of Rights (12.15.2023) Save

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Two major reports on fatigue and fibromyalgia misfired, and "ankylosing spondylitis" is sent to the Rheumatology dead word cemetery. 

1. Korean ULTRA registry studied 117 Gout pts starting ULT; compared T2T achievers (SUA< 6) vs non-achievers. @6 mos, 71% reached target SUA (w/ better adherence (98% vs. 76%) than non-achievers. T2T achievers assoc w/ good adherence, +FamHx, & HTN meds https://go.nature.com/4aoBeC0

2. Clinical Practice Res Database studied 51K gout pts before ULT therapy, 36% had  ≥ 1 recurrent flares, 17% flared w/in 12 mos of Dx. Flares risk: Male, blacks, obese, CHF, CKD, CVD, diuretics, Hi SUA (HR 4.6). Only 28% Given ULT w/in 12 mos of Dx https://bit.ly/4723MOK

3. Specialty clinic eval 1395 Lyme pts & saw marked differences between blacks & whites. Black patients had 5 fold (OR 4.93) higher risk of disseminated LD & delay in Abx Rx. Dissem Dz also more likely in men (OR, 1.6) EM Rash harder to spot https://bit.ly/4aldKxG

4. Programmed-cell-death 1 (PD-1) expression on T-cells is assoc w/ activation & exhaustion. The exhausted phenotype of PD-1+CD8+ T cells add to the pathogenesis of active idiopathic inflammatory myositis. https://t.co/TRgtYCbnf2

5. Metanalysis shows the prevalence of self-reported sleep problems in #PsA ranged 30% to 85%. 6 studies showed poor sleep quality in 73% (statistically higher than controls 27%). Sleep ranked in the top 4 health-related quality of life domains by PsA pts. https://bit.ly/41qsKqc

6. PsA undergoing lumbar degenerative disease (LDD) surgery have 2 fold higher risk of VTE. National Inpatient study 471,283 LDD surgeries showed PsA had higher overall morbidity (9 % v 7 %), VTE (1.4 % v 0.7 %), unfavorable D/C(21% v. 17 %). https://t.co/C0eimmwEmm

7. Expert consensus(ASAS) prefers SpondyloArthritis(axSpA) as preferred over "ankylosing spondylitis" (historic but no longer appropriate based on MRI research showing this is more than SI disease). AS radiographic axSpA(r-axSpA) can be used interchangeably https://t.co/jvT3lQFaPq

8. RA pts more likely to get autoimmune thyroid Dz (AITD), but after dx, AITD risk signif. drops (HR 0.81), suggesting RA Rx lowers AITD risk; greater drop in biologic Rx RA (HR 0.54).Swiss registry compared 13,731 new-onset RA pts to 63,201 matched controls https://t.co/n0n2EfUyqR

9. Danish study compared 106K adults w/ major osteoporotic fracture (hip, vertebrae, wrist, humerus) vs 1+ mill controls & found Mortality highest 30d following 1st index hip Fx (HR 10.98 women; & HR 16.40 men). Pneumonia most common cause of mortality https://t.co/0D7ynN4f5L

10. CDC: Chronic Fatigue Syndrome 2021-2022

11. EULAR 2023 Recommendations on Fatigue 

12. Gender Gap Confirmed for TNF Inhibitor Response in Axial SpA  

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