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Drug Safety


Lupus Linked With Greater Risk of Cardiovascular Complications of Childbirth

Dec 02, 2022

Pregnant women with systemic lupus erythematosus (SLE) were more prone to cardiovascular complications during delivery, and their risk seems to have increased over the past 15 years, according to national administrative data.

The cross-sectional study supports the role that the

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Rheum Manpower Needs - More Programs! (12.2.2022)

Dec 02, 2022

Dr. Jack Cush reviews the news and journal articles from the past week on

  1. NRMP Results for rheumatology 2022 : - Adult Rheum: 97.8% of 272 fellow positions filled (41% US grads) (371 applied) - Pediatric Rheum: 69.2% of 39 positions filled (54% US grads) (29

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Rheum Drugs & IDSA Guidelines to Treat COVID-19

Dec 01, 2022

The Infectious Diseases Society of America has recently updated its recommendations with regards to the treatment of severely ill, hospitalized COVID-19 infected patients and also about the appropriate use of anti-IL-6, JAKs and colchicine.

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Dec 01, 2022

A UK study suggests the equivalent outcomes when patients with interstitial lung disease (ILD) associated with connective tissue disease (CTD) are treated with either intravenous rituximab (RTX) or cyclophosphamide (CTX), but with fewer adverse events with RTX. 

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Just Can’t Get Enough of Hydroxychloroquine

Nov 30, 2022

When it comes to hydroxychloroquine dosing, issues on efficacy, toxicity and therapeutic thresholds may affect the optimal use of this important drug.

Following are three abstracts presented during the meeting that address these topics.

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Steroid injections worsen knee arthritis

Nov 30, 2022

Two studies comparing injections commonly used to relieve the pain of knee osteoarthritis found that corticosteroid injections were associated with the progression of the disease. Results of both studies were presented today at the annual meeting of the Radiological Society of North America (

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Low Dose IL-2 Therapy in Sjögren’s

Nov 29, 2022

There is a large, unmet need in treating Sjögren’s syndrome, yet a new randomized clinical trial has shown that low-dose interleukin 2 (LD-IL-2) was effective effective and well tolerated in patients with primary Sjögren’s syndrome (pSS), with evidence of restored immune balance.

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lupus SLE

Tyk2 Inhibition Effective in SLE

Nov 28, 2022

Deucravacitinib, an oral, selective TYK2 inhibitor, has demonstrated efficacy in a phase II trial active systemic lupus erythematosus (SLE) patients.

The results of this phase II trial were recently presented at ACR 2022. This  phase II multinational trial enrolled 363 adults with

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Retrospective study looked at 47 adults w/ dermatomyositis treated with tofacitinib. While clinically similar, those on TOFA were were younger (53vs 61), shorter Rx duration (24 vs 53 mos);there was signif CDASI improvement. #ACR22
Medication adherence is a problem I assume that when I prescribe something for patients that they fill the prescription (right away) and take it as planned…or is this a pipe dream? @Janetbirdope weighs in.
FDA is investigating risk of severe hypocalcemia in dialysis patients taking Prolia (denosumab). After an interim safety data review reports of hypocalcemia w/ advanced CKD. Monitor Ca, use Ca & vit D supplements. Await further FDA information
Do oral JAKs in atopic dermatitis cause VTE? Meta-analysis (15 RCTs, 466 993 pts) does NOT show increased risk of VTE associated with AD & JAK inhibitors (HR 0.95) w/ low VTE incidence (0.05%) w/ JAKi and (0.03%) placebo.

Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies

Nov 25, 2022

Discussions regarding family planning, contraception, and pregnancy should be approached at each clinic visit to ensure providers understand patients’ personal goals. These conversations have the potential to decrease the risk of unplanned pregnancies. However, rheumatologists may need to manage

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Steroids in RA: Friend or foe (or both)?

While have come so far from the days of our patients living on massive doses of steroids, we still have many patients who use steroids for our diseases, with increasing data for toxicity, even in low dose. As someone much smarter than me described them, steroids are our best frenemy.

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Thresholds of Hydroxychloroquine Blood Levels

Nov 23, 2022

Hydroxychloroquine remains the backbone of treatment for SLE, and the only drug clinically proven to decrease mortality. Optimization of usage is therefore critical in maximizing benefit and preventing harms. Hydroxychloroquine blood level testing is available in clinical practice and can help

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RA: MACE Events with Opioids vs. NSAIDs

Addressing chronic pain often leads general practitioners and specialists to prescribe opioids. However, opioids (weak and strong) have not demonstrated efficacy in long-term pain management; their chronic use could even worsen pain in users. Opioids prescription is often perceived as being

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Was this a Mistake? HCQ Dose Reductions per AAOS Guidelines

In the wake of the 2016 AAOS Guidelines, rheumatologists dutifully reduced the dose HCQ take by patients with SLE to some number south of 5mg/kg per day. Though I believe the ophthalmologists correctly interpreted a 2014 paper in JAMA Ophthalmology that quoted a much-higher rate of HCQ

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Avoid Abatacept in RA patients with a history of cancer? Dr. Richard Conway ( @RichardPAConway ) discusses abstracts #0267 and #0255 presented at #ACR22.
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ACR 2022 Appraisal, Praise & Critique (11.18.2022)

Nov 18, 2022

It was great to be back at an ACR annual meeting, this one in Philadelphia - Philly was great. A walking town, rich in culture, history and good places to meet and mingle. 

I loved the city, but not the convention center (not easy to navigate). 

The meeting itself was very

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Gender Differences in Axial Spondyloarthritis

Nov 17, 2022

Rheumatic conditions such as SLE and RA exhibit female predominance. In contrast, increasing evidence suggests that gender differences occur in axial spondyloarthritis in terms of time to diagnosis, clinical manifestations, treatment outcomes and quality of life. The exact mechanisms are

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lupus SLE

Dual target blockade may be better than one in SLE

Inhibition of B-cell Activating Factor (BAFF) has revolutionised the treatment of patients with systemic lupus erythematosus. However, outcomes of therapies within the same class (i.e. BAFF-inhibitor) when evaluated in randomised controlled trials have been inconsistent.

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Best of

ACR Best Abstracts - Day 3

Nov 14, 2022

The last day was jammed with important reports and research including the late breaking abstracts. 


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The complexity of opioid use in spondyloarthritis

Nov 14, 2022

A few things we know about opioids: use is common; it’s not efficacious in the treatment of spondyloarthritis; and, there is an opioid epidemic and its users are stigmatized. Abstract 0402 is a retrospective study that looked at patients with psoriatic arthritis or ankylosing spondylitis in the

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PMR spotlight

ACR22: Polymyalgia Rheumatica in the Spotlight

One of the enduring legacies of ACR 2022 for me will be the emphasis on polymyalgia rheumatica (PMR). Despite being highly inflammatory and relatively common, a remarkable paucity of trials have been run in this space. Read on for a quick PMR-roundup from the meeting! 

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Abstr #2192 risk of serious infxn in newborns of mothers on TNFi by placental transfer - % serious infection in TNFi in high vs low placental transfer (2.1% vs 1.6%) - HR (high vs low) 0.98 (95% CI 0.36-2.61) - No significant difference in risk of serious infxn @RheumNow #ACR22