Dec 22nd, 2019 - NEW YORK (Reuters Health) - New European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria can be used to identify patients with systemic lupus erythematosus (SLE) in an unselected group of patients hospitalized for pericardial effusion (PE), new findings show. "Overall, in patients with pericardial effusion and positive ANA, the diagnosis of SLE cou...
Elizabeth Shane, MD
Dec 18th, 2019 - Several studies published over the last few years have shown declining rates of diagnosis and treatment of osteoporosis in older adults. In part, this may be due to declining ability to diagnose osteoporosis because declining reimbursement for dual x-ray absorptiometry has made it less available to patients and doctors.
Dec 18th, 2019 - Treatment of osteoporosis in older adults at increased risk for fractures declined from 2010 to 2014, based on a study of nearly 900,000 individuals. Courtesy University of Alabama at Birmingham Dr.
Dec 18th, 2019 - ATLANTA – Use of high-concentration topical capsaicin was associated with reduced pain, a longer duration of clinical response, and was well tolerated in patients with knee osteoarthritis, compared with lower concentrations of capsaicin and placebo, according to recent research presented at the annual meeting of the American College of Rheumatology. Jeff Craven/MDedge News Tim Warneke While the.
M. Alexander Otto
Dec 17th, 2019 - ATLANTA – Hydroxychloroquine (Plaquenil) 400 mg/day starting by pregnancy week 10 reduces recurrence of congenital heart block in infants born to women with anti-Ro antibodies, according to an open-label, prospective study presented at the annual meeting of the American College of Rheumatology. M.
Dec 17th, 2019 - The American College of Rheumatology and the European League Against Rheumatism have released the first classification criteria for IgG4-related disease. Although it was first recognized as a distinct disease in 2003, investigators have since learned that IgG4-related disease (IgG4-RD) is not particularly rare.
Dec 12th, 2019 - This transcript has been edited for clarity. Matthew F. Watto, MD: As usual, we're coming in hot. This is the Curbsiders. I am Dr Matthew Watto. Here are my two wonderful cohosts, Dr Stuart Brigham and Dr Paul Williams. Tonight we are going to be talking about osteoarthritis (OA). We had a wonderful interview with Dr Tuhina Neogi, the chair of rheumatology at Boston University School of Medicin...
Dec 12th, 2019 - ATLANTA – Patients with Raynaud’s phenomenon and puffy fingers, disease-specific antibodies, and/or nailfold video capillaroscopy abnormalities were more likely to progress to systemic sclerosis within 5 years than were patients without those features, according to recent results from the Very Early Diagnosis Of Systemic Sclerosis (VEDOSS) study presented at the annual meeting of the American C.
Dec 11th, 2019 - NEW YORK (Reuters Health) - Treatment with the interleukin-17 inhibitor ixekizumab (Taltz, Lilly) significantly improves signs and symptoms of non-radiographic axial spondyloarthritis (nr-axSpA), according to results of the COAST-X study. The results of the phase-3 randomized controlled trial were presented in November during a plenary session at the American College of Rheumatology (ACR) annua...
M. Alexander Otto
Dec 11th, 2019 - ATLANTA – Adenosine deaminase 2 above the upper limit of normal is 86% sensitive and 94% specific for distinguishing macrophage activation syndrome from active systemic juvenile idiopathic arthritis, making it perhaps the most potent blood marker yet identified to differentiate the two, according to a report presented at the annual meeting of the American College of Rheumatology. Dr.
Dec 11th, 2019 - ATLANTA – Treatment of polyarticular-course juvenile idiopathic arthritis with tofacitinib led to significantly fewer disease flares and greater improvement in disease activity than with placebo in a phase 3, multinational, randomized, double-blind, controlled withdrawal study presented at the annual meeting of the American College of Rheumatology. Jeff Craven/MDedge News Dr.
Dec 9th, 2019 - ATLANTA – Patients taking biologics who received latent tuberculosis testing on an annual basis were unlikely to convert from a negative QuantiFERON test to a positive result, which suggests that the test may be unnecessary for patients without new tuberculosis risk factors, according to research presented at the annual meeting of the American College of Rheumatology. In addition, nearly all of.
Dec 9th, 2019 - ATLANTA – Patients with rheumatoid arthritis were more at risk of postoperative infection because of a high Charlson Comorbidity Index or longer surgery time than because of perioperative use of antirheumatic medications, according to a presentation at the annual meeting of the American College of Rheumatology. Jeff Craven/MDedge News Dr.
M. Alexander Otto
Dec 9th, 2019 - ATLANTA – Soon-to-be-published gout guidelines from the American College of Rheumatology will recommend dosing allopurinol above 300 mg/day to get serum urate below 6 mg/dL, even in people with renal impairment. M.
Denis Poddubnyy, MD
Dec 6th, 2019 - The findings from the C-axSpAnd study that Jonathan Kay, MD, and colleagues reported at the annual meeting of the American College of Rheumatology are not surprising. Earlier studies in patients with ankylosing spondylitis showed that short symptom duration is one of the best predictors of good treatment response to TNFi therapy.
Dec 5th, 2019 - New data relevant to the treatment of systemic lupus erythematosus (SLE) were presented at the 2019 annual meeting of the American College of Rheumatology in Atlanta. Dr Michelle Petri, who heads the Johns Hopkins Lupus Center, discusses key findings, including the results of two important clinical trials on the anti–interferon receptor blocker anifrolumab. TULIP 1, the first of the two phase 3...
Dec 3rd, 2019 - ATLANTA – Upadacitinib (Rinvoq), a selective Janus kinase 1 (JAK1) inhibitor, significantly improved the signs and symptoms of active ankylosing spondylitis, compared with placebo, in the randomized, placebo-controlled, phase 2/3 SELECT-AXIS 1 study. Dr.
Nov 25th, 2019 - NEW YORK (Reuters Health) - Patients with rheumatic diseases who are on tumor-necrosis-factor inhibitor (TNFi) therapy can safely receive the live varicella zoster vaccine, without risking vaccine-related infection, a new study suggests. "Because patients with rheumatic diseases are at higher risk for reactivation of herpes zoster, also known as shingles, prevention of this painful condition is...
Nov 25th, 2019 - ATLANTA – Patients with moderate to severe osteoarthritis of the hip and knee who took the investigational anti-nerve growth factor monoclonal antibody tanezumab experienced a significantly higher rate of joint safety events than that of patients who received NSAIDs as part of a recent randomized, double-blind, active-controlled, phase 3 study. Jeff Craven/MDedge News Dr.
Nov 23rd, 2019 - ATLANTA – Gout is associated with an increased risk of both fatal and nonfatal cardiovascular disease events, according to a large population-based health data linkage study in New Zealand. Sharon Worcester/MDedge News Dr.
Nov 21st, 2019 - ATLANTA — "Immunotherapy operates on this very simple principle: a patient's cancer can be eradicated if we can just instruct the immune system to eradicate it," said Ryan Sullivan, MD, associate director of the melanoma program at Massachusetts General Hospital in Boston. "But for patients with autoimmune disease, it comes with a catch." Immunotherapy helps a patient's immune system locate and...
Nov 21st, 2019 - ATLANTA – Ixekizumab (Taltz) provided significantly greater improvement in joint and skin symptoms, compared with adalimumab (Humira), in biologic-naive patients with active psoriatic arthritis (PsA), according to final 52-week safety and efficacy results from the randomized SPIRIT-H2H study. Dr.
Nov 21st, 2019 - ATLANTA – Adding ixekizumab (Taltz) to conventional background medications significantly improved the signs and symptoms of nonradiographic axial spondyloarthritis (axSpA) in the randomized, double-blind, placebo-controlled phase 3 COAST-X trial. Sharon Worcester/MDedge News Dr.
Nov 21st, 2019 - ATLANTA – Patients with systemic sclerosis aged 44 years and younger in the United States now have mortality comparable to that of the general population in that age group, according to recent results presented at the annual meeting of the American College of Rheumatology. Dr.
M. Alexander Otto
Nov 21st, 2019 - ATLANTA – Rituximab (Rituxan) is superior to azathioprine (Imuran) for preventing ANCA-associated vasculitis relapses in patients with histories of previous relapses, according to a randomized trial of 170 patients presented at the annual meeting of the American College of Rheumatology. Dr.
Nov 19th, 2019 - NEW YORK (Reuters Health) - Changes in atmospheric and environmental factors may contribute to organ-specific disease exacerbation in patients with systemic lupus erythematosus (SLE), according to a new study. The study found "strong associations between atmospheric variables and fine particulate matter concentration over the 10 days prior to a patient visit and organ-specific lupus flares at t...
Nov 18th, 2019 - NEW YORK (Reuters Health) - Children born to mothers with chronic inflammatory diseases who took non-tumor-necrosis-factor inhibitor (TNFi) biologics or tofacitinib while pregnant appear to be at low risk of developing serious infections, a new analysis suggests. "Our findings help to address the important knowledge gap in biologic and small-molecule drug safety in pregnancy and our data are re...
Nov 18th, 2019 - ATLANTA — Virtual reality can help patients with movement issues, but only if it is done correctly and tailored to individual patients, said Robert Ferguson, a neurorehabilitation clinical specialist who focuses on such therapy. Clinicians "are reading the research and they are applying it wrong," he explained. "The evidence suggests that it's not about the virtual reality, it's about how you u...
Nov 18th, 2019 - ATLANTA – Elderly-onset and young-onset rheumatoid arthritis patients initiating treatment with biologic disease-modifying antirheumatic drugs (bDMARDs) respond similarly with respect to clinical improvement at 48 weeks and adverse events, data from a large registry in Japan suggest. Sharon Worcester/MDedge News Dr.
Nov 17th, 2019 - The prevalence of arthritis in children with Down syndrome is at least two times greater than previously reported, findings from a new study suggest, but the diagnosis is often missed or significantly delayed. There are several reasons for this, including a lack of awareness on the part of clinicians and parents that children with Down syndrome can be at high risk for what's known as arthropath...
Nov 17th, 2019 - Congress has appropriated almost a billion dollars in 2018 and 2019 so that the National Institutes of Health (NIH) can address the opioid epidemic. About half of that money is to address pain management, reported Charles Helmick, MD, who works on the NIH Helping to End Addiction Long-term (HEAL) initiative, which supports research into pain. "Reducing prescribed opioids means addressing arthri...
Nov 15th, 2019 - ATLANTA – Patients with nonradiographic axial spondyloarthritis who received secukinumab with or without loading doses showed improvements in physical function, quality of life, inflammation, and other disease signs and symptoms, according to results from a phase 3 study presented at the annual meeting of the American College of Rheumatology. Jeff Craven/MDedge News Dr.
Nov 14th, 2019 - ATLANTA — A first look at new guidelines for the treatment of gout was presented here at the American College of Rheumatology (ACR) 2019 Annual Meeting. A key update is to use a treat-to-target strategy with urate-lowering therapy for all patients with gout. The draft guidelines recommend starting patients on a low-dose urate-lowering medication, then increasing the dose to reach and maintain a...
Nov 14th, 2019 - ATLANTA — Young adults with chronic illnesses are not being asked the right questions on surveys of patient-reported outcome measures, warns an international focus group. Younger adults saw the outcomes on daily functioning as outdated, said Erika Mosor, MSc, from the Center for Medical Statistics, Informatics, and Intelligent Systems at the Medical University of Vienna, who is president-elect ...
M. Alexander Otto
Nov 13th, 2019 - ATLANTA – Tumor necrosis factor inhibitors almost quadrupled the risk of psoriasis in children with inflammatory bowel disease, juvenile idiopathic arthritis, or chronic nonbacterial osteomyelitis in a review of 4,111 patients at the Children’s Hospital of Philadelphia. Dr.
James Sullivan, Jeffrey Katz 2 and Elena Losina, Brigham and Women's Hospital et. al.
Nov 13th, 2019 - Background/Purpose: Knee OA is a disabling condition affecting over 14 million adults in the US. NSAIDs provide only short-term pain relief, creating the need for additional pain management. Growing evidence indicates that chronic knee OA pain is associated with centralized pain pathways. Based on these considerations, ACR and OARSI recommend or conditionally recommend the use of duloxetine. Th...
Roy Fleischmann, Mark Genovese, Ricardo Blanco et. al.
Nov 13th, 2019 - Background/Purpose: The goal of RA treatment is to achieve clinical remission or, at minimum, low disease activity (LDA). Modification of initial csDMARD therapy with the addition of a biologic (b) DMARD, such as a tumor necrosis factor inhibitor (TNFi), or Janus Kinase inhibitor (JAKi) may be needed following an inadequate response (IR).1 Switches in mechanism of action have been advocated in ...
Kristin Wipfler, Teresa Simon, Patricia Katz et. al.
Nov 13th, 2019 - Background/Purpose: Legalization of cannabis use is rapidly increasing worldwide, raising the need to evaluate trends and medical implications. A systematic literature review showed inconsistent results on tolerability and safety of cannabis-based medicines for any chronic pain . Additionally, little is known about the use and effectiveness of cannabis in rheumatic diseases . We sought to...
Nnenna Ezeh, Kevin Buhr, Cordellia Nguyen et. al.
Nov 13th, 2019 - Background/Purpose: DLE is a rare, disfiguring disorder in children. Small retrospective studies suggest 20-25% of patients progress to SLE. Progression risk factors are poorly understood, but DLE has been associated with delay in SLE diagnosis and reduced access to care. This multicenter retrospective cohort study aimed to describe baseline characteristics and clinical phenotypes of pediatric ...
Celine van de Laar, Martijn A.H. Oude Voshaar, Carly Janssen et. al.
Nov 13th, 2019 - Background/Purpose: To assess the cost-effectiveness of various combinations of urate lowering therapy (ULT) and anti-inflammatory treatment in the management of newly diagnosed gout patients, from the Dutch societal perspective. Methods: The Anakinra versus Treatment as usual in the Treatment of ACute Gout (ATTACG) study was the primary data source for this study. Since only patients with ...
Bhaven Mehta, Jennifer Franks, Yiwei Yuan et. al.
Nov 13th, 2019 - Background/Purpose: We analyzed a phase 2 study designed to assess the efficacy of abatacept in patients with diffuse Systemic Sclerosis (SSc). In this work, we analyze data from ASSET and seek to confirm the hypothesis that patients in the inflammatory subset on abatacept show a significant decline in modified Rodnan Skin Score (mRSS), which is correlated to modulation of pathways related to t...
Mitsuhiro Akiyama, Hui Zhang, Ryu Watanabe et. al.
Nov 13th, 2019 - Background/Purpose: Giant cell arteritis (GCA) is an autoimmune vasculitis that causes aortic arch syndrome, blindnesss, and stroke. Embedded in granulomatous infiltrates, CD4 T cells persist over long periods in the inflamed vessel wall where they drive wall remodeling, intramural neoangiogenesis, intimal hyperplasia and luminal occulsion. To survive and function in a nonlymphoid tissue enviro...
Chenyang Lu, Phillip Campbell, Jonatan Hervoso et. al.
Nov 13th, 2019 - Background/Purpose: Rheumatoid arthritis (RA) is an inflammatory disorder characterized by synovial hyperplasia, inflammatory cell infiltration and pannus formation. We have shown that soluble CD13 (sCD13) induces angiogenesis, monocyte and lymphocyte chemotaxis and arthritis through G protein-coupled receptors (GPCRs). However, the receptor for sCD13 is not yet defined. Methods: A GPCR screeni...
Ashley Visser, Marie Feser, Chelsie Fleischer et. al.
Nov 13th, 2019 - Background/Purpose: Systemic autoimmunity associated with RA precedes the onset of inflammatory arthritis (IA) by several years. In particular, the presence of systemic anti-cyclic citrullinated peptide (CCP) antibody is a strong predictor of developing classified RA in the future. However, the mechanisms involved in the transition from systemic anti-CCP to IA classifiable as RA are unknown. Ou...
Joyce Chang, Taylor Goldberg, Sarah McGuire et. al.
Nov 13th, 2019 - Background/Purpose: There is a need for clinically useful measures of cardiovascular (CV) risk in pediatric-onset SLE (pSLE). Nocturnal blood pressure (BP) non-dipping (loss of the physiologic nocturnal decline in BP) is a reversible marker of CV risk and potential treatment target that can be reproducibly measured by ambulatory blood pressure monitoring (ABPM). We assessed the frequency of non...
Yvonne Golightly, Carolina Alvarez, Liubov Arbeeva et. al.
Nov 13th, 2019 - Background/Purpose: Musculoskeletal injury is a known risk factor for osteoarthritis (OA). Cumulative effects of comorbid conditions on the association of injury and OA have not been previously examined. The purpose of this study was to clarify associations between knee injury and radiographic knee osteoarthritis (rKOA) and determine whether associations vary by sex, race, body mass index (BMI)...
Pravitt Gourh, Sarah Safran, Steven Boyden et. al.
Nov 13th, 2019 - Background/Purpose: Systemic sclerosis (SSc), or scleroderma, is a heterogeneous disease that is divided into limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc) forms based on the extent of skin involvement, and internal organ involvement also adds to phenotypic variability. The three main internal organ complications are interstitial lung disease (ILD), pulmonary arterial hypertension (PA...
Alicia Rodriguez-Pla1 and Robert W Simms, University of Arizona/Banner Health Medical Center, Tucson et. al.
Nov 13th, 2019 - Background/Purpose: Population mortality studies in the United States have previously reported a progressive increase in the scleroderma (SSc) mortality rates from 1959 to 2002. Identification of areas with clusters of higher mortality rates is important to implement targeted interventions and may provide clues about possible etiology factors, especially environmental. In this study, we aimed t...
Elsa Vieira-Sousa, Pedro Alves, Ana Maria Rodrigues et. al.
Nov 13th, 2019 - Background/Purpose: Psoriatic arthritis (PsA) dactylitis is associated with an increased risk of erosions and higher disease activity. Dactylitis treatment strategies are however controversial due to the absence of evidence from randomized controlled trials studying dactylitis as a primary outcome. The objective of this trial was to assess the efficacy of golimumab in combination with methotrex...
Matthew O'Dell, Logan Duryee, Lynell Klassen et. al.
Nov 13th, 2019 - Background/Purpose: Recently we have shown that both malondialdehyde-acetaldehyde adducts (MAA) and citrullinated proteins (CIT) are co-localized in joint and lung tissues of patients with rheumatoid arthritis (RA). Therefore, to investigate the possibility that these post-translational modifications pose a synergistic pathogenic role in RA, human synovial fibroblasts and lung epithelial cells ...