Turkey Tryptophan (11.28.2025) Save

Dr. Jack Cush reviews the news and reports from this past week on RheumNow.com, including reports on FDA resurrections, FM seasonal worsening, and do you fight switch or swap biologics in PsA TNFi nonresponders?

1. 2023 National Health Interview Survey studied arthritis-attributable work limitations (AAWL) in US adults (18-64 yrs) - it was 38.8% (unchanged from 2019). AAWL was higher in Hispanics (50%), American Indian/Alaska Natives (56%), & disabled (62%), & veterans (52%) https://t.co/sE3En74zfq
2. Zantac is Back! Ranitidine has been off the market for 5yrs, withdrawn over concerns about N-nitrosodimethylamine (NDMA) impurity affecting shelf-life. The FDA has approved reformulated ranitidine tablets - the drug has the same prior efficacy and safety label. https://t.co/j655eiCvgf
3. Tryptophan is Back since 2005 (removed in 1989 for contamination and EMS)
4. Subclinical Cardiac Dysfunction in Gout. ECHO study of 202 hyperuricemic (100 gout vs 102 asympt [asymSUA]) pts. VS. asymSUA, Gout pts had signific more LV Diastolic Dysfunc (31% vs 11%), lower LV ejection Fx (60 vs 65); questioning need for tailored CV monitoring in ^SUA pts https://t.co/gCOKKk7H05
5. Colchicine prevents total joint arthroplasty (TJA). Study of 31,478 colchicine initiators, followed 4.5 yrs. W/ an overall 12% lower risk of TJA (HR 0.88 95% CI 0.81 to 0.96), and a 23% lower risk of TJA in those with knee/hip OA (HR 0.77) https://t.co/1JsZd8K0sI
6. Study of 2280 dermatomyositis (DM) & polymyositis (PM) pts looked at short term (ST: <3 mos) vs long term (LT) steroid (GC) use. Vs ST, LT GC use assoc w/ higher risks of heart failure (adj OR 1.8), osteoporosis (1.9), all-cause & PM/DM-related admission (3.8) & higher costs https://t.co/Q9xt06yzew
7. Retrospective study of 39 pts w/ MDA5 + DM-ILD Rx w baricitinib. 31 (79.5%) had improvement in Gottron’s, heliotrope, dyspnea, HRCT score, ferritin, LDH, steroid dose & 6 mo survival (87% vs. 70%, p = 0.047). https://t.co/RCTbBsCkeV
8. Retrospective analysis of 2614 FM pts in the Italian Fibromyalgia Registry underscores the seasonal changes in FM pain, w/ signif. differences in FM assessment tools WPI p=0.042 & FASmod p=0.037); Worsening seen in AUTUMN, only in female patients, not males https://t.co/LqXnTgGIMB
9. BASDAI scores elevated in Fibromyalgia - 58 FM pts were surveyed wtih FIQ, SSS, BASDAI. BASDAI was ≥ 4 points in 91.4% of FM (vs 13% controls (p < 0.001). BASDAI correlated w/ the FIQ (pain, fatigue, stiffness) & SSS scores (r = 0.88, p < 0.00). Could BASDAI be used in FM? https://t.co/VF94ru0o3Q
10. Betw 1990 to 2021 the global psoriasis burden had a slight increase w/ little difference betw men & women, roughly 57-61 100 000 (10% increase). Risk highest in N.America & W.Europe. PSO risk highest with higher incomes.  Peaks ages 40-70. https://t.co/raruHn5Txx
11. Obesity-inflammation axis in PsO & PsA: obesity is assoc w/ less remission& poorer drug responses; possibly from adipokines, biomechanical stress, gut dysbiosis, etc. Notably, weight loss can improve both psoriatic disease course and response to therapy. https://t.co/cZbeu0zfmR
12. Study of 452 #PsA pts who failed 1st line TNFi Rx (LOE) - 275 Cycled to another TNFi vs 177 Swapped to an IL-17i. Higher Retention in Swap (78%) vs cycled (68%) PsA pts (p < 0.001) @12 mos (60 v 40%@3yrs). Tx failure predicted by cycling, Dz Activity, Rx year, axial & mixed involvement (p <=0.001). https://buff.ly/aL3MLzA
13. In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/lIX4gDLjqd
14. Managing Perioperative DMARDs with Arthroplasty 
15. RheumNow Live 2026 is coming February 7th and 8th to Dallas, Texas - and registration is now open! This year’s program covers vasculitis, autoimmune disease, PsA, RA outcomes, spondyloarthritis, and much more. View the program and register today at  https://t.co/7FNhcvEE45
16. RNL 25 Replay: Spondyloarthritis Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit https://t.co/o78Pc8LPsQ