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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Lacaille et al. Long term harms of previous steroids in RA. CV/infection mortality increase 7% every year/use. Takes 3.5 and 10 years to return to normal after 1 and 2 years use. Never returns to normal if >2 years use @RheumNow #ACR24 Abstr#2673 #ACRbest https://t.co/qcp5mCHmeB https://t.co/keXw5Qg2ld
Links:
Richard Conway @RichardPAConway( View Tweet )
Mortality Risk After Stopping Glucocorticosteroids (GC) in RA.
In a study of 28,078 RA patients:
Mortality risk from CVD ↑ 7.5%/year of GC use; ↓ 1.3%/year after stopping.
Mortality risk from infections ↑ 6.8%/year of GC use; ↓ 4.9%/year after stopping.
Risks normalize 1.5–10… https://t.co/i6cKet1EEV https://t.co/ClMjIly20E
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
PHOENYCS GO, RCT of dapirplizumab, novel CD40Li in SLE
Met primary endpoint (NNT~6 for BICLA) & numerical improvements in many other endpts
1 MI & 1 death from infection over 213 pts
Encouraging for sure! Second phase 3 being launched
#ACR24 @RheumNow Abstr#L16 #ACRbest https://t.co/QwDMKjhFvb
Links:
Mike Putman @EBRheum( View Tweet )
Using longitudinal claims data, this study explores the safety of non-conventional combination targeted therapy in adults with psoriatic arthritis (PsA).
Key findings:
- 42,821 PsA patients analyzed; only 1.1% on combination therapy.
- Increased risk of serious infections:… https://t.co/Jghmz9lkLd https://t.co/YqwJlTKcEi
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Study revealing the Uterine-Joint Axis in female axial spondyloarthritis, highlighting dysbiosis and subclinical uterine inflammation as key factors in disease pathogenesis.
Key findings:
- Distinct microbiota profiles in AxSpA patients vs. healthy controls.
- Significant genital… https://t.co/Cl12ELdjI2
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
A retrospective analysis by Dr. ERayens et al showed that RA pts >/=50y given 2 RZV doses were less likely to develop HZ vs. unvaxxed grp
Incidence of PHN was also lower in the vaccinated group (0.2py vs.1.9py)
RZV is effective in preventing HZ & PhN
@Rheumnow #ACR25 abs0977 https://t.co/JhYBYnLmhl
sheila @RHEUMarampa( View Tweet )
Study on SLE and NMO overlap:
Higher risk of acute cystitis & severe sepsis in hospitalized patients
SLE/NMO overlap patients 3x more likely to develop acute cystitis
2x more likely to develop severe sepsis #ACR24 @RheumNow abst#1529
Bella Mehta @bella_mehta( View Tweet )
Study on severe lymphopenia in SLE:
- Assessed incidence, risk factors, and outcomes
- 11.52% of SLE patients experienced severe lymphopenia
- Higher infection rates during severe lymphopenia period
= No opportunistic infections observed #ACR24 abst#1519 @rheumnow @HSSProfEd
Bella Mehta @bella_mehta( View Tweet )
In case you needed more encouragement for recombinant zoster vaccination in RA patients:
it prevents herpes zoster episodes, in the real world.
RA pts in KP system
n=1926 vaccinated matched 1:3 with non-vaccinated
- HZ reduced 60%
- PHN reduced 88%
#ACR24 ABST0977 @RheumNow https://t.co/BryBrlv9K5
David Liew @drdavidliew( View Tweet )
Global meta-analysis of 61 studies shows TB Preventive treatment (TPT)
- Reduces active TB risk in rheumatic disease patients by 29% (RR: 0.71, CI: 0.57–0.87)
- Best outcomes in high TB-burden countries (RR: 0.51) and with isoniazid for >9 months (RR: 0.52).
- Dual screening… https://t.co/4P1982ngvL
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Infection as a Cause of Death
https://t.co/CwvffN7CcM https://t.co/SwSuAanuEO
Dr. John Cush @RheumNow( View Tweet )
Survey of 779 RA pts in the National Rheumatoid Arthritis Society. Respondents were 95% Caucasian in their 50s with menopause in their 40s. 80% responded that their arthritis was worse during the menopause with 10% being much worse. https://t.co/NqZXK1lLQe https://t.co/k59HD5bKrd
Dr. John Cush @RheumNow( View Tweet )
Peptic ulcer disease is still assoc w/ signif. hospitalization & mortality (10K deaths in USA/Yr). PUD affects 10% of outpts w/ Upper GI pain. 42% are due to H.pylori, 36% from ASA NSAIDs. Complications bleeding (73%), perforation (9%), pyloric obstruction (3%)- JAMA review… https://t.co/1bgagFVlYN https://t.co/8i2j3r1puf
Dr. John Cush @RheumNow( View Tweet )
Gut microbiome changes linked to onset of RA
EurekAlert!
Changes in the make-up of the gut microbiome are linked to the onset of clinically evident rheumatoid arthritis in those at risk of the disease because of genetic, environmental, or immunological factors, suggests research published online in the
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COVID-19 and Long-Term Risk of Autoimmune and Autoinflammatory Disorders
A Korean population based study found that people infected with COVID-19, especially severe COVID-19, had an increased risk of autoimmune and autoinflammatory connective tissue disorders.
While several observational studies have suggested an association between COVID-19 and future
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Long Covid Defined
The National Academy of Medicine and New England Journal of Medicine have published a comprehensive definition of "long COVID".
While COVID-19 has infected over 7 million worldwide, it is estimated that 7% of adults (and >1% of children) or 15 to 20 million Americans have developed
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Advances in the treatment of autoimmune hepatitis
EurekAlert!
Autoimmune hepatitis (AIH) is a chronic, progressive liver disease caused by immune system dysregulation that targets the liver. If untreated, AIH can lead to severe complications, including cirrhosis and liver failure.
An overview of AIH and treatment approaches was recently
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Metanalysis of 26 RCTs suggests JAK inhibitors have a low, but signif. increased risk of infections (vs placebo) (RR 1.39; 1.096-1.76). No risk of tuberculosis or hepatitis, but an incr. risk of H. zoster was seen (RR 1.71; 0.84-3.51) https://t.co/kXOcldz46l https://t.co/Y5OWk4W1NZ
Links:
Dr. John Cush @RheumNow( View Tweet )
Is EBV relevant? It's certainly been linked to the etiol of SLE, RA, Sjögrens, & MS. Ronbinson et al suggests "EBV infection as a potentiator of autoimmune rheumatic diseases" and if Rx targeting of EBV may work in EBV-associated autoimmune diseases. https://t.co/bi630VvHTx https://t.co/tKYtwePaTu
Dr. John Cush @RheumNow( View Tweet )
ANA+ consult (10.18.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Inadequate Zoster Vaccination in Immunocompromised Patients
A VA study of shows that recombinant zoster vaccine (RZV) vaccination in immunocompromised patients or those receiving immunosuppressive medications is insufficient, given these are high risk individuals.
The recombinant zoster vaccine (RZV; or "Shingrix") was FDA approved In 2017 for
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Dot the "i", Cross the "t" (10.11.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.
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Screening to Prevent Multimorbidity in Rheumatic Patients
A population based screening program of patients with chronic inflammatory rheumatic diseases (IRD) demonstrates that systematic screening IRD patients for multimorbidity increased preventive interventions and reduced hospital admissions.
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French cohort study shows that epidermal necrolysis (EN) is a rare, but assoc w/ high rates of in-hospital and postdischarge mortality, esp in elderly and those w/ comorbid conditions. https://t.co/BaMZmer0Fa https://t.co/mrUO419GLP
Dr. John Cush @RheumNow( View Tweet )
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