Alveolar Hemorrhage and Mortality in Lupus

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Metanalysis of patients with diffuse alveolar hemorrhage (DAH), show this to be a rare and life-threatening complication of systemic lupus erythematosus (SLE), that is more apt to affect older, severe lupus patients with active infection.

Checkpoint Inhibitor Use with Pre-existing Autoimmune Disease

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Annals of Internal Medicine reports treating advanced melanoma with immune checkpoint inhibitors (ICI) in patients with pre-existing autoimmune disease (AID) was as effective and safe in those with AID compared to those without AID, although severe colitis occurred more frequently among pati

RWCS Highlights - Day 4

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As another year at RWCS in Maui wrapped up, I’m so thankful I had the opportunity to participate remotely. Here are my day 4 #RWCS2021 pearls from the Novel Therapies Year in Review (RA, SLE, OA); novel concepts in pediatric rheumatology; and post-COVID telerheumatology sessions.

ACR and Three Societies Agree on HCQ Eye Safety

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Four major medical societies issued a joint statement of principles on safe use of hydroxychloroquine from the perspective of ocular toxicity.

MIRROR Study: Pegloticase With Methotrexate in Uncontrolled Gout

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Botson et al has reported that the combination of methotrexate (MTX) and IV pegloticase is safe and effective in patients with uncontrolled gout. This exploratory, open-label clinical trial screened 17 patients and treated 14 patients (all men, 49.3 ± 8.7 years) with IV pegloticase with MTX (15 mg/week) and folic acid (1 mg/day) 4 weeks prior to and throughout pegloticase treatment.

RWCS Highlights - Day 3

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Day 3 report from the 2021 RWCS meeting in Maui (and virtually) includes pearls from the PsA 2020 Year in Review; fact vs. fiction on evidence based medicine: diet and rheumatic diseases; hot topics in allergy/immunology; and pediatric rheumatology highlights.

RWCS Highlights - Day 2

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As I attend RWCS virtually, I am always amazed by the amount of thought that goes into preparing great talks geared toward busy clinicians. Today, I am highlighting a few more pearls that you may find interesting as well.

Weekly Semaglutide for Weight Loss in Adults

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NEJM has reported the results of a trial showing semaglutide once weekly plus lifestyle intervention was associated with sustained, weight loss in overweight or obese adults; such that nearly one-third lost over 20% of their body weight.

RWCS Highlights - Day 1

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The 2021 Rheumatology Winter Clinical Symposium launched yesterday as a hybrid meeting. As always, this conference lends itself to data for the practical clinician. Here are my pearls about new developments in RA, checkpoint inhibitors and IV IgG taken from several sessions presented on Day 1.

ACR Promotes New COVID-19 Vaccine Clinical Guidance for Rheumatic Patients

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The American College of Rheumatology has published a draft guidance on the use of COVID-19 vaccination in rheumatic disease and musculoskeletal disease patients, based on the efforts of the North American Task force. The document provides guidance to rheumatology providers on the use of the COVID-19 vaccine and the associated management of RMD patients around the time of vaccination. Here is a summary of the recommendations.

Synovial Tissue Signature Guiding Targeted IL-6 Therapy in RA

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RNA sequencing and classification of RA subsets has proven useful. RNA sequencing-based stratification of RA synovial tissue showed stronger associations with clinical responses compared with histopathological classification. Additionally, for patients with low or absent B-cell lineage expression signature in synovial tissue, tocilizumab is more effective than rituximab.

Comorbidity and Drugs Drive COVID-19 Severity and Survival in Rheumatic Disease

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While comorbidities are associated with severe COVID-19 infection, it appears they also influence severity and survival in rheumatic disease (RMD), according to a a French cohort study,

IVIg in MIS-C

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Among children with multisystem inflammatory syndrome (MIS-C), treatment with IVIG and methylprednisolone vs IVIG alone was associated with a more favorable fever course. MIS-C is a rare but serious pediatric condition associated with COVID-19 where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.

NSAIDs in Osteoarthritis: Study Suggests Need for New Look

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Knee osteoarthritis (OA) patients using nonsteroidal anti-inflammatory drugs (NSAIDs) showed greater loss of medial minimum joint space width than did others taking other drugs, registry data indicated.

Abrupt Cessation of Long-Term Opioid Prescribing Common

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Medicare beneficiaries were increasingly likely to have long-term opioid therapy stopped in recent years and medication changes often were abrupt, not tapered, an observational study showed.