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Curbside Consults are cases submitted by our rheumatology colleagues as challenging therapeutic or safety issues. Answers are based on experience, with added evidence from the medical literature and published guidelines. Here are four new cases.
Systemic lupus erythematosus (SLE) is associated with an increased risk of cardiovascular disease (CVD). The cardioprotective benefits of aspirin (ASA) are well known and the ancillary CV and diabetogenic effects of hydroxychloroquine (HCQ) have also been shown.
The U.S. Food and Drug Administration (FDA) has approved the IL-23 inhibitor, Tremfya (guselkumab), for patients with moderate to severe plaque psoriasis.
Dr. Jack Cush reviews highlights from the past week on RheumNow.com:
Systemic inflammation (from underling inflammatory polyarthritis) clearly accelerates atherosclerosis with a resultant increase risk of cardiovascular disease.
The 12 month POET study analyzed 817 rheumatoid arthritis (RA) patients who achieved remission or low disease activity (LDAS) for ≥6 months and then randomized 2:1 to stopping or continuing their TNF inhibitor.
Acute diffuse lung infiltration in patients with systemic lupus erythematosus (SLE) requires prompt evaluation for diffuse alveolar hemorrhage (DAH) when patients have low levels of hemoglobin and complement compound C4 and symptoms of hypoxia.
Among older patients using medium to high doses of the anti-inflammatory steroid prednisolone, treatment with the osteoporosis drug alendronate was associated with a significantly lower risk of hip fracture, according to a study published by JAMA.
Rituximab, a chimeric anti-CD20 monoclonal antibody, has been effectively used in the treatment of multiple autoimmune disorders for over two decades. But the response to rituximab has been shown to not be as effective in SLE as it is in RA.
Data made public by the Centers for Medicare & Medicaid Services shows that drug and device makers made nearly $8.2 billion in payments to U.S. physicians and teaching hospitals in the last year. Since 2013, CMS has been tracking physician payments as part of the Affordable Care Act.
The FDA has approved both IV and SC ORENCIA (abatacept) for the treatment of adults with active Psoriatic Arthritis.
It is well-known that patients with systemic autoimmune diseases are at risk for Pneumocystis jirovecii pneumonia (PJP) and although infrequent, it carries a high mortality. A new study shows lymphopenia and steroid use increases the risk of PJP.
Dr. Jack Cush reviews highlights from the past week on RheumNow.com:
Pianta, et al have published their findings in the Journal of Clinical Investigation showing that two novel autoantigens, GNS and FLNA, are highly expressed in synovium and share a sequence homology with gut microbesa; thereby providing a potential link between gut mucosal and joint immunity in rheumatoid arthritis.
Researchers from Augusta University have examined exosomes from patients with knee osteoarthritis (OA) to enhance our molecular understanding of the pathogenesis of OA. (Citation source http://buff.ly/2tuDZ3v)
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