Wednesday, 20 Nov 2019

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RheumNow Podcast – Fight or Switching (DMARDs) (10.18.19)

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

  1. Study of RA complications from National Inpatient Sample data (2005-14) show #RA higher risk for MI (OR 1.03), COPD (1.67), CVA ( 2.2), renal Dz (1.42), EtOH abuse (2.73). Mortality trend increased significantly for CHF (P = 0.025) & AFib (P = 0.042) https://t.co/NzKPWsyKgA
  2. UK population study of 6591incident RA patients shows comorbidity increased all-cause mortality (aHR 1.26; 1-1.6). Joint destruction had no effect, but COPD was associated with significantly more mortality (COPD HR 2.84; 1.13-7.12). https://t.co/6ULPvq34qh
  3. Evaluation of ANA testing in sytemic autoimmune dz (AID) finds low titers have low PPV. Highest PPV was for centromere pattern in PSS, w/ a PPV of 29% (1:160), 42% (1:32), 77% (1:640) & 82% (1:1280). Speckled PPV was low unti 1:1280 (PPV 71% for AID) https://t.co/JbDDXAOxOu
  4. Single center study of anti-PhosphoLipd Abs in 149 Bx proven lupus nephritis pts 36% had APL Abs (18.8% IgG, 18.1% IgM, 10.7% B2GlyP, 8.1% LAC). F/U of 156 mos - APL+ had lower 10 yr survival (91 vs 99%). lower GFR, more thrombotic events & miscarriage https://t.co/U5ra02wMmX
  5. RISE registry: among 7,274 RA pts w/ serial data [RAPID3 (78.9%) & CDAI (34.2%)]. Amongst those w/ moderate/high disease activity, frequency of DMARD change was low (36%-55%). Less likely to change was elderly, Combo DMARDs or biologics. https://t.co/IppHCxJWk1
  6. Followup of 783 tofacitinib‐treated psoriatic arthritis patients finds increases in LDL and HDL 9% to 14% after 3 and 6 months of therapy with a low risk of HTN or MACE events https://t.co/fh6UbmF3lr
  7. Comparison of 69 SLE pts w/ C/S+ infection vs 69 SLE without infx shows that serum procalitonin did not distinguish those w/ infection, BUT C-reactive protein did successfully identify those SLE patients with infection https://t.co/HMHqfaP0Cg
  8. Taiwanese Claims data study shows the risk of opportunistic infection in ~77K autoimmune pts shows OI highes in PM/DM cases (61.3/1000PY), followed by SLE (43.1/1000PY), SSc (31.6), RA (25), and pSS (24.1). OI risk highest during 1st year https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-019-1997-5
  9. Reminder: Statin induced myopathy is occurs in less than 1%; rhabdomyolysis and necrotizing myositis are very rare. HMGCR Abs against (HMG-CoA) reductase are seen 2- 3 of every 100,000 patients treated with statins. https://t.co/44DGaHEGjo
  10. High Dose Statins Increase Odds of Osteoporosis  
  11. One-Third of Psoriatic Arthritis Patients Will Need Joint Surgery  
  12. Stress and the Risk of Incident Inflammatory Arthritis   
  13. Joint Injections: Are They Worth the Risk?  

 

Disclosures: 
The author has received compensation as an advisor or consultant on this subject

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