Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me (jackcush@rheumnow.com) or recording your suggestion using the “Ask Cush Anything” link on our website.
Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush.
- Is PMR the Next Indication for Tocilizumab? About half of patients with steroid-dependent PMR were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, a randomized phase III trial showed. https://t.co/LUMG4NnZzs
- IL-6i in Behcets? Lit Review finds 25 articles papers, 74 pts (31 TNFi naive, 45 TNFi prior Rx). Pts Rx w/ tocilizumab IV. TCZ given for vascular, CNS , ocular & mucocutaneous. TCZ was effective in 87% TNF naive & 80% in TNFi Experienced pts. https://t.co/jdJ9H04lnE https://t.co/yoxrKiIVW2
- Yoga Fails to Benefit Knee Osteoarthritis The Annals of Internal Medicine has published a study showing online yoga education and an unsupervised yoga program may improve physical function did not improve knee pain after 12 weeks and 24 weeks. https://t.co/tmWu4t3vgX https://t.co/bJCYaCIcGE
- Cohort Hip & Cohort Knee (CHECK) study of biomarkers (serum hs-CRP, sCOMP, sPINP sOC and urine uCTX-2) in1002 pts w/ hip or knee OA. Shows CRP, uCTX-2 & sPINP (OR 1.11-1.40) were assoc w/ nocturnal & walking pain, but not fatigue https://t.co/EOU6i24KLO
- Are we set for the next “Twindemic”? – Continuation and evolution of COVID BA.5 to? – Flourishing Influenza in a population who has vaccine burnout? Some predicting severe flu based on Australia’s 2022 flu season, climate change, more https://t.co/qWuhWjaAFa
- Metanalysis of 25 studies examined effects of NSAID therapy on COVID-19 outcomes and confirms NSAIDs do not increase the likelihood of SARS-CoV-2 infection and do not worsen outcomes in patients with COVID-19. https://t.co/FAJ58stmv1
- Colchicine vs cimetidine in PFAPA (Periodic fever, aphthous stomatitis, pharyngitis, adenitis) syndrome. 72 pts given COL vs CIM x 3 mos: # of febrile attacks was significantly decreased by both Rx (noninferior to each other) https://t.co/MO7IQ0e8gf
- NIH: 27 pts w/ ROSAH (retinal dystrophy, optic N. edema, splenomegaly, anhidrosis, headache) syndrome, due to dominant mutation ALPK1 – an autoinflammatory Dz w fevers, HA, Abnl CNS MRI, deforming arthritis, AA amyloidosis . https://t.co/Pyb3QNrPnB
- Retrospective study of PFAPA < 18yrs, 336 pts, Boys=Girls, peak onset ~age 1 yrs (less w/ yrs); 90% 1st Sxs under 5 yrs & <3% after age 10 yrs, Common Sxs: pharyngitis w fever, Cx adenitis, aphthous stomatitis, atyp skin rash. Incidence 0.86/10K/Yr https://bit.ly/3C2AzHc
- Is there link between PsA & autoinflammatory Dz? Study of 120 #PsA pts found 31% w/ AID gene variants (AP1S3, PLCG2, NOD2, NLRP12, all monoallelic variants adn 1/2 genes assoc w/ autosomal dominant disorders. https://t.co/KaL7jheDZ6 https://t.co/09CSW2W3tn
- Italian study of Apremilast in 356 #PsA (age 60yrs) pts Followed ~17 mos, shows retention rate @ 12, 24 & 36 mos to be 85.6%, 73.6%, & 61.8%. D/C primarily for inefficacy (18-34%), GI Sx (24%). Best persistence w/ oligoarthritis https://bit.ly/3Spgalg
- Clinical Profiles Seen with NXP-2 Antibodies A recent review of the myositis associated autoantibody NXP-2 profiles its clinical associations with dermatomyositis (DM), calcinosis, severe myositis and, in some reports, with cancer. https://t.co/DTNohe66n1
- STAR-RA study – real world claims data shows tofacitinib doesnt increase malignancy risk. Study of 83,295 pts (10,504 TOFA). Risk of malignancy w/ TOFA not increased (HR 1.01) w/ RWE or RCT-duplicate cohort (HR 1.1; 95% CI 0.85, 1.62) https://t.co/GIIvs2cK3s
- Deep Vein Thrombosis reviewed in current Annals of Internal Medicine – VTE is the 3rd most common CVD, seen in 5% of population. Half of VTE assoc w/ transient preventable risk factors. Direct oral anticoagulants are effective and safer https://t.co/6utxivuwf6
- RINOMAX Trial studied single dose of 500 mg rituximab IV in myasthenia gravis – 47 MG pts randomized to RTX or PBO, after 4 mos RTX response (71% vs 29%) superior to PBO. Further studies are needed https://t.co/XvAWRH8fUz
- Propensity matched pairs (n=237 872) of perioperative pts – gabapentin users and nonusers shows perioperative gabapentin use had significantly more delirium (RR 1.28), antipsychotic Rx (1.17 ) & pneumonia (1.11) vs nonusers post surgery https://t.co/UAZs7Vqy6O
- Metals & Hyperuricemia (HU) (20 studies, 63,283 participants): Increased HUA risk arsenic (OR 1.7), calcium (OR 1.76), cadmium (OR 1.19), & lead (OR 1.56), BUT lower w/ molybdenum (OR 0.8). No effect w/ Cu, Fe, Mg, Zn, Cd, Co, Al, Hg, Tl https://t.co/xmdBCCBuEk
- Hydroxychloroquine Dosing and SLE Flares JAMA cohort study examining HCQ dosing in patients with SLE suggests that HCQ doses of 5 mg/kg per day or less, was associated with a higher risk of lupus flares, including moderate or severe lupus flares.https://t.co/B5HqxWDqD3 https://t.co/4crIFBV9XP
- USPSTF Recommends Screening for Anxiety and Depression
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