Articles By Jack Cush, MD
The Global Burden of Rheumatoid Arthritis 2017
The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) from 2017 analyzed the burden of rheumatoid arthritis (RA) for 195 countries between 1990 to 2017 and surmised that RA is a major global public health challenge, with increasing prevalence and incidence rates.
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Outcomes in Juvenile Idiopathic Arthritis
Arthritis Research & Therapy reports on a prospective cohort of children with juvenile idiopathic arthritis (JIA) shows that the incidence has held steady at 12.8/100,000 children, but that the frequency uveitis and the need for orthopedic surgery has decreased in the last 20 years.
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Frequent DMARD Discontinuations During Rheumatoid Pregnancies
A Canadian population-based study shows that pregnant women with rheumatoid arthritis (RA) frequently discontinue their DMARD medications, especially in the first trimester.
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Methotrexate and the Risk of Lung Disease
Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.
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Novel Inhibition of MSU Crystal Inflammation
Researchers from Washington State University have shown that inhibition of tumor growth factor-β (TGF-β)-activated kinase 1 (TAK1) can effectively downregulate inflammatory mediators and suppress inflammation caused by gout.
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The Shame Behind Adalimumab Biosimilars
JAMA has an article this week on the shift from biologic drugs to less expensive therapeutic biosimilar agents. The impact of biosimilars can be easily represented by the shift from adalimuamb - a biologic with nearly $19 billion in sales in 2018 - to any one of the four FDA approved biosimilars for adalimumab (see the daily download for slides on new adalimumab and other biosimilars).
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Common Physician HIPAA Violations
A nice review by Physician Sense and MDLinx discusses potential physician violations of current HIPAA law, largely driven by the digital age and common work flows. Several mistakes you you be aware of and avoid, include:
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RheumNow Podcast – The Shoes Maketh the Doctor (10.25.19)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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FDA Issues Boxed Warning and Recommendations for Breast Implant Use
The U.S. Food and Drug Administration has issued a new draft guidance document calling for a boxed warning and delineation of risks with breast implants.
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Patients Prefer Nurse Led Care for their Gout
Despite the well known, well publicized treat-to-target (T2T) goal of a serum uric acid (SUA) level 6 mg/dl, this goal is seldom achieved ( 40%) in clinical practice and patient adherence has been unacceptably low. A recent study shows that nurse-led care led to better outcomes in gout including patient acceptability, long-term adherence, and less flares.
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