Rheum Chapter Notes (4.26.2024)
Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.
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Predicting Infection in Lupus Nephritis
Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN.
This study analyzed 111 non-infected LN patients, 72 infected LN patients, and 206 healthy controls (HCs), looking at patient
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Predicting CKD Outcomes in Lupus Nephritis
An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.
A multicentre observational study of patients with biopsy-proven LN; either proliferative (PLN) or membranous (MLN) lupus nephritis were compared regarding
Self Acupressure in Knee Osteoarthritis
A clinical trial has shown that self-administered acupressure (SAA) is effective in relieving knee osteoarthritis (KOA) patients.
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High risk medications for pregnancy:
MTX- 40% pregnancy loss, 6-10% birth defects
MMF/CYC - 40% pregnancy loss, 25% birth defects
Recommend 2 forms contraception on MMF
Change meds slowly to safe Rx and monitor disease activity at least 3 mos before pregnancy
#RNL2024 @RheumNow
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Canary in a Coal Mine (4.19.2024)
Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.
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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes
A population-based cohort has demonstrated that sodium-glucose cotransporter-2 inhibitors (SGLT2i) use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients with type 2 diabetes (T2D).
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Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
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This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs
Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs
In AC&R
https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
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Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
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Burnout or Retire (4.12.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?
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World Congress on OP, OA & MSK Disorders
EurekAlert!
Bone and musculoskeletal disease researchers and physicians from around the world will meet today in London, UK for the opening of the largest scientific event in the field, the World Congress on Osteoporosis, Osteoarthritis and
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Neuropsychiatric SLE - 2/3 Improved at 12 Months
The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data.
A retrospective cohort study identified 350 NPSLE events (between 1999-2015) defined by ACR definitions and categorized as being:
JAMA: SLE Review
Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
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Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/tuIigaswDK https://t.co/DAh3lgRufA
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Seasonal Pathogens and Henoch-Schönlein Purpura
Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers. The importance of infection was recently shown with nonpharmaceutical interventions (
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1/600 Falls May Die (4.5.2024)
Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com - including problems w/ falls, pain and treatment of Dupuytren’s contractures.
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Serious Infections in Takayasu arteritis
The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.
Mortality in Psoriatic Arthritis
The Annals of Rheumatic Disease reports that mortality risk in psoriatic arthritis (PsA) is about 10% higher than in the general population, primarily from excess comorbidity and with increased risks in women, with longer disease durations.
CBD Products Disappointing for Pain
EurekAlert!
There is no evidence that CBD products reduce chronic pain, and taking them is a waste of money and potentially harmful to health, according to new research led by the University of Bath in the UK.
CBD (short for cannabidiol) is one of many chemicals found naturally in the cannabis
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Korean claims study of #RA & pregnancy (& adverse preg outcomes (APO), shows MTX or LEF use w/in 3 mos of conception assoc w/ incr. in APOs (aOR 2.14-.68). In 5728 preg: 1152 APOs, HCQ most commonly used, DMARD use decreased during preg. https://t.co/7UBsNdpRgx https://t.co/cY1N73FG8Q
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Activity & Pain Tolerance (3.29.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.
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Systemic Score Predicts Still's Disease Severe Complications
A multinational study of adults with Still's disease found that calculating their systemic score at baseline significantly predicted the patients risk for life-threatening outcomes (MAS or death).
Chikungunya Arthritis - 2 studies show benefit of dexamethosone (up to 4mg/d) w/ improved DAS28 scores; Uncertain benefit however with MTX; 133 Brazilian pts studied for 5 mos & 31 pts studied for 8wks. https://t.co/Ko3aRYX0xi https://t.co/rtC4RCRjnU https://t.co/XOoFYw0dR4
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ACR Supports FY 2024 Budget
ACR
The American College of Rheumatology (ACR) today expressed strong support for several key measures included in the Fiscal Year (FY) 2024 budget. The budget allocates crucial funding to the Department of Defense’s Congressionally Directed Medical Research Program (CDMRP) for research on
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