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RheumNow Podcast – LTF – Listen to Fauci (7.17.20)

Jul 17, 2020 8:10 am

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

  1. Retrospective study of 603 myositis (IIM), 4047 RA and 4061 controls shows IIM has higher risk of CV events (HR 1.38) and MI [HR 1.61] but not CVA [HR 0.92]. The CV risk in IIM was equal to that in RA [HR 1.01]. IIM CV risk only present 1st 5 years
  2. Systematic review of DYSPHAGIA in inflammatory myositis finds it may be an initial or sole symptom. Prevalence in IIM was 36% and higher 56% inclusion body myositis, cancer or NXP2 -associated myositis. Dysphagia may be complicated by aspiration pneumonia
  3. Ghent Univ experience and literature review shows that diffuse and localized scleroderma occurs in 2.4 to 7.4% often with Raynauds (6/8), scleroderma pattern on nailfold videocapillaroscopy and SSc-specific autoantibodies
  4. ARD Italian report of 2 cases (1 w/ stable RA;1 without prior arthritis) who developed polyarthritis after hospitalization for COVID pneumonia. Synovial Bx showed synovial proliferation - 1 w/ crystals and both w/ CD3+ and CD138+ cells
  5. NEW #COVID19—"Symmetric peripheral polyarthritis developed during #SARSCoV2 infection" Comment by Rosario Talarico and colleagues
  6. JAMA Internal Medicine reports that the number of hydroxychloroquine prescriptions increased from 367,346 to 683,999 (86.2%) from February to March 2020, and chloroquine prescriptions increased 158.6%, rising from 2,346 to 6,066 prescriptions.
  7. Rheumatology reports a UK study of Clinical Practice Research Datalink and 17 760 incident RA pts; 42% who recv steroids; The HTN rate was 64.1 per 1000 PY & GC use assoc w/ 17% increased risk HTN (hazard ratio 1.17), esp at doses > 7.5 mg/d
  8. Canadian 1484 incident early #RA pts (enrolled 2007–2017). SC MTX monotherapy had fewer Rx changes(45% SC vs 79% PO) with longer treatment duration. Similarly taking biologics or triple therapy had a longer time without treatment change.
  9. FDA has approved guselkumab (Tremfya) for active psoriatic arthritis, making it the 1st IL-23 inhibitor approved for PsA. Approval is based on DISCOVER-1 & DISCOVER-2 RCTs. Dosing: 100 mg SC q8 wks after loading dose at 0, 4 wks.
  10. EMR analysis of 453 gout pts D/C from ED or hospital, shows that 28.3% received opioids at discharge (~80% new pts). Average dose 38mg morphine equivalent for a median duration of 8 days - more common with polyarticular gout, DM, prior opioid use
  11. MMWR reports 2019 survey data showing 6.6% of women used opioid during pregnancy. 21% admitted misuse, 27% wanted to stop/reduce narcotic use and 32% did not receive MD counseling about how opioid use could affect an infant.
  12. PRIME Cells Predicting Rheumatoid Arthritis Flares
  13. NEJM letter Reminders on Masking: 1. Everyone should wear masks; most who are infected dont know they are infx (asymptomatic); 2. Risk of transmission is directly correlated with the duration and intensity of contact - especially in closed quarters; less so if outside
  14. #LFT


The author has received compensation as an advisor or consultant on this subject

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