Skip to main content

RheumNow Podcast – Gout Guidelines (7.3.20)

Jul 03, 2020 3:35 pm

Dr Jack Cush reviews the journal reports and news from RheumNow this past week. Highlights include:

  1. If you treat #SLE patients, Do you get a renal biopsy before starting therapy for Lupus nephritis?   [Twitter Poll]
  2. Claims data study of nearly 3 million receiving influenza vaccination shows an increased risk of subsequent subdeltoid bursitis, but incredibly low with an attributable risk was 7.78 additional bursitis per 1 million vaccinated.
  3. Pneumonia vaccination of 21461 RA pts in UK Clinical Practice Research Datalink (2000-18) finds 38.2% vaccinated; 44.3% ≥65 years, 66.4% female; 36.5% vaccinated prior to starting csDMARDs, moreso in elderly. VAX increased over time (esp 2003 to 2007)
  4. A federal appeals court on Wednesday upheld two patents for Enbrel (Amgen), rejecting Novartis AG’s effort to void the patents and clear the way for their etanercept biosimilar Erelzi
  5. National Inpatient study of 61,615 systemic sclerosis pts (1998–2016) finds most common serious infections were pneumonia 45%, sepsis 32%, SSTI 19%; by 2015–2016, sepsis 1.8X more common than pneumonia. Hosp STAYS AND SIE mortality decr over time (10% to 8%)
  6. A Genetic Probability tool used to calculate risk of rheum Dz in 3 pt cohorts (1211 eMERGE, 245 Partners & 243 early inflam arthritis. Dx AUc: 0.69, 0.81 & 0.84. Likely dx made in 64% & r/o in 45%. ?Could be used to improve Dx accuracy in clinical practice?
  7. Rituximab (RTX)-associated autoimmune disease flare is rare and only seen in 7/185 pts (3.4%); all w/ type II mixed cryoglobulinemia vasculitis. Flare occurred a median 8 days post RTX, as acute kidney insuf, purpura with myocarditis or GI involvement
  8. Schulz-Koops reports 2 #RA patients Rx with RTX who died from COVID pneumonia and ARDS. Both were older, had comorbidities (COPD, HTN, OP) and had received last RTX either 2 wks and 6 mos before COVID infection onset; both had nl IgG levels
  9. 66 critically ill & 13 non‐critically ill COVID‐19 were tested for multiple anti‐phospholipid (aPL)Abs. APL common (47%) in critically ill, may be transient (35‐39d post onset). Multiple medium/high levels aPLs may identify at risk for CVA or APS 
  10. Series of 11 severe COVID-19 pts Rx w/ Anakinra. 7/11 recv anakinra w/in 36 hrs - none required ventilation. 4 got anakinra after 4days of Resp Sx & required ventilation; 1 died. Pts were SARS‐CoV‐2+, w/ fever, ferritin >1,000 ng/mL & acute resp failure.
  11. Tocilizumab May Benefit COVID-19 Pneumonia 
  12. COVID's Multisystem Inflammatory Syndrome in Children (MIS-C)
  13. Coexistent Gout and Rheumatoid Arthritis 
  14. 2020 ACR Gout Management Guideline 
The author has received compensation as an advisor or consultant on this subject

Add new comment

If you are a health practitioner, you may to comment.

Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.