Dr. Quotes (11.8.2024)
Dr. Jack Cush reviews the news and journal reports from this past week from RheumNow.com.
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What are the predictors of fracture in #SLE?
🦴Prednisone! Even at low doses ≤5mg
🦴Stroke
🦴Caucasian race
🦴Female
🦴Low BMD
Try to avoid steroid use. If they are needed, IM triamcinolone or IVMP preferable to oral GC.
Ab2679 #ACR24 @RheumNow
Mrinalini Dey @DrMiniDey( View Tweet )
Conaghan et al. LEVI-04, neurotrophin-3 inhibitor in knee OA. 518 patients. Significant improvements in WOMAC pain and function, and PGA. So sign of any increase in rapidly progressive OA (as with NGF inhibitors) @RheumNow #ACR24 Abstr#L15 https://t.co/qud4wTAikY https://t.co/0wjjG4U4bf
Links:
Richard Conway @RichardPAConway( View Tweet )
How long is a long acting #intra-articular #steroid #injection in #knee #osteoarthritis?
#IA steroids can be q3monthly
#RCT of IA #fluticasone #propionate
Was superior to #placebo
Seemed to last approx 24 weeks
➡️ sub analysis in moderate pain, BMI<30
#ACR24 @RheumNow #2106 https://t.co/QBFCqXd1Q8
Janet Pope @Janetbirdope( View Tweet )
#Artificial #Intelligence can detect #osteoporosis
On #CXR
To detect #thoracic #vertebral #fractures
> 100000 #chest #radiographs - test and validation cohorts found + results on ROC
Helpful -sometimes vertebral changes are
Not read on CXRs
#ACR24 @RheumNow @ACRheum #2116 https://t.co/NxEaH0AKJv
Links:
Janet Pope @Janetbirdope( View Tweet )
#Publication #bias to Nth degree.
>1/3 of registered #postmeno #osteoporosis trials are NOT #published
👇search of trials
673 published
Vs
489 not published 890000 pts
MOSTLY when performed in the USA
No accountability for NOT publishing
#ACRbest #ACR24 @RheumNow #2122 https://t.co/UyMMbHhvvV
Janet Pope @Janetbirdope( View Tweet )
Ren et al. XG005, compound with NSAID and neuropathic like effects, in knee OA. At week 4 significant improvements in WOMAC pain, stiffness, function, and primary endpoint of walking pain @RheumNow #ACR24 Abstr#L08 https://t.co/gQDwAmzI4G https://t.co/b22XC7rXnE
Links:
Richard Conway @RichardPAConway( View Tweet )
RA patients affected by frailty at a younger age
in @VARA frailty associated with lower BMD
But frailty is modifiable!
#GeriRheum
#ACR24 @RheumNow ABST#2140 https://t.co/BoTGoESB43
Jiha Lee @JihaRheum( View Tweet )
A#2528
Hes1/Piezo1 Pathway - role in osteocyte response to mechanical stimulus
Yoda1 - Piezo1 agonist shown to help fx healing in mice
Piezo1 decrease in GIOP
Basic sci research shows activation of pathway promotes mechanical stress response, decr GIOP
#ACR24 @RheumNow
Eric Dein @ericdeinmd( View Tweet )
Does adding a Clofutriben (HSD-1 inhibitor) w/ prednisone minimize the risks of steroid toxicities in #PMR patients?
VS placebo, PMR patients who received Clofutriben + Prednisone had substantial reductions in bone, lipid, and glycemic control parameters
@RheumNow #ACR24
Akhil Sood MD @AkhilSoodMD( View Tweet )
The precise mechanism of action of GIOP is not known. Decrease in osteocyte LCN is observed. Abstr#2528 @RheumNow #ACR24 https://t.co/fazUUy03fQ
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
📢Late-breaking #2003 🔑 Cappelli et al @jhrheumatology finds hip OA is NOT a significant risk factor for #ICI-IA 🔴#ICI-IA linked to lower mortality #ACR24 #ACRBest @RheumNow
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
Older RA patients in RISE with high disease activity show a higher incidence of hip and major osteoporotic fractures. Practice T2T and monitor bone health closely!
#ACR24 @RheumNow ABST#1748 https://t.co/7MCAIrfXhp
Jiha Lee @JihaRheum( View Tweet )
Can we do more to routinely assess fracture risk in RA?
In RA pts ≥65, hip fracture & MOF are more common in pts with active disease, worse with higher disease activity
➡️Need better and more frequent bone health assessments in our RA pts
Ab1748 #ACR24 @RheumNow https://t.co/whfnLnkpLd
Mrinalini Dey @DrMiniDey( View Tweet )
Petri recommends IM triamcinolone as safer than prednisone dosing per FLOAT trial, decreased risk of fx
@RheumNow #ACR24
@jhrheumatology https://t.co/vhMRdSkBAA https://t.co/novlGcss6x
Links:
Eric Dein @ericdeinmd( View Tweet )
2024 Clinical Practice Guideline for Chronic Nonbacterial Osteitis (CNO) in adults from Leiden University Medical Center. This includes a consensus definition, diagnosis, and treatment approach with multidisciplinary care and imaging. Key recommendations highlight the use of… https://t.co/iK6ZFAu0M6
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Harkins @DrTrishHarkins et al. People with PMR exhibit an accelerated physical aging phenotype at baseline. High rates of frailty (41%), pre-frailty (28%), cognitive impairment (74%!), sarcopenia (23%), osteoporosis (21%) @RheumNow #ACR24 Abstr#0740 https://t.co/4ZT8VtGi1W https://t.co/xBQ5CLlb5A
Links:
Richard Conway @RichardPAConway( View Tweet )
Hypophosphatasia:
🦴Inherited disorder of metabolism with low tissue nonspecific alkaline phosphatase (TNSALP)
🦴Impaired bone mineralisation
🦴Accumulation of pyrophosphate
🦴1/100,000-300,000
🦴6 main forms
@RheumNow #ACR24
Mrinalini Dey @DrMiniDey( View Tweet )
⭐️Top tip from Dr Laura Carbone:
🦴Rule out hypophosphatasia before starting bisphosphonate or denosumab in patients with low ALP
#ACR24 @RheumNow
Mrinalini Dey @DrMiniDey( View Tweet )
Risk for atypical femoral fracture:
🚨Asian race - 4-6x higher risk
Duration of use is greater risk than older age
Higher risk when given for osteoporosis than cancer treatment
- Compare: osteonecrosis of jaw more common with cancer Rx
#ACR24 Review Course
@RheumNow https://t.co/V8cD5QWNGp
Eric Dein @ericdeinmd( View Tweet )
Genes Linking RA and Osteoporosis
People with rheumatoid arthritis often develop osteoporosis, a more serious condition, as a result of the bone damage caused by immune cells and as a side effect of certain medications.
https://t.co/hEJc77gcln https://t.co/bmsV70riUc
Dr. John Cush @RheumNow( View Tweet )
Genes Linking Rheumatoid Arthritis and Osteoporosis
EurekAlert!
Rheumatoid arthritis is a common disease affecting an estimated 17 million people worldwide. The disease is caused by immune cells attacking the joints and can result in pain, swelling, and damage to the cartilage and bone. People with rheumatoid arthritis often develop osteoporosis, a more
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SPRINGBOARD: Extended-release Intra-articular Corticosteroid Injection in Knee OA
A phase 2 trial of EP-104IAR (long-acting, fluticasone propionate) has shown 14 weeks of clinically meaningful pain relief in knee osteoarthritis (OA).
Claims study presented at SASM mtg by HSS orthopedists found among >100k Hip/Knee replacement surgeries, the 19% who used CPAP (OSA) had significantly fewer ER visits and postop complications. https://t.co/kg7oCRndqH https://t.co/WRcxUD3c6V
Dr. John Cush @RheumNow( View Tweet )
Alendronate Atypical Fractures Back In Court
Reuters reports that a U.S. appeals court on Friday revived more than 500 lawsuits alleging that Merck failed to warn that patients taking alendronate for osteoporosis may be at increased the risk of atypical femoral fractures.… https://t.co/DWXsFyzfWs https://t.co/HhROUArYBE
Dr. John Cush @RheumNow( View Tweet )
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