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RheumNow Podcast – Bad Disease & Bad Outcomes (10.9.20)

Oct 08, 2020 7:35 pm

Dr. Jack Cush Reviews the news and journal articles from the past week on

  1. Comparison of 34,128 COVID and 84,585 influenza pts; COVID-19 patients have been more typically been male, younger, and have fewer comorbidities and lower medication use than flu. (data from USA, South Korea, Spain)

  2. Systemic Steroids Reduce Mortality in COVID-19

  3. Lockdown worsening; UK survey 678 patients musculoskeletal diseases pts in late April 2020 shows 53% worsening of Sx; 1/3 had clinic/hosp access probs problems & most (88%) had no probs w/ getting meds; but 44% needed others to help them get meds.

  4. Study of 193 Axial SpA pts with TNF inhibitor switching shows, using stringent outcome measures (ASDAS-ID) shows odds of responding to 2nd TNFi best w/ secondary TNFi failure (OR 7.3) or adverse events (OR 9.1), compared to primary TNFi failure.

  5. Study of 222 RA pts on MTX given anti-GMCSF (otilimab) 22·5 mg, 45 mg, 90 mg, 135 mg, 180 mg, or PBO weekly x 5 wks, then EOW. @wk 24 DAS28-CRP <2·6 5%, 16%. 19%, 14%, 14% respectively and 3% in PBO. Otilimab failed to meet primary endpoint.

  6. Hellenic registry of 385 RA pts on DMARDs finds that, compared to remission or LDAS - those in persistent moderated disease activity had 50-80% more serious adverse events.

  7. Among 4766 mental health pts admitted for Psychosis; 19% ANA tested and only 135 had a positive ANA >=1:160. (15% of those tested). Only 4 met 2019 ACR/EULAR criteria for SLE, and 2/4 met criteria for NPSLE. NPSLE prevalence was 1.5% in ANA+ psychosis Pts.

  8. Classic bony erosion of gout is a punched-out, lytic lesion w/ a sclerotic margin & overhanging edge -- called a G sign, rat-bite erosion or the Martel sign, named after famed U MI radiologist Dr. William Martel who 1st described this gouty erosion in 1968

  9. Among 406 axial SpA patients in the DESIR Cohort, smoking was associated with MRI‐SI joint after 5 years of axial SpA patients and only in blue‐collar job or low education levels; suggesting a possible role for mechanical stress axial SpA.

  10. IL-1 Inhibition Alters Arthroplasty Rates 

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

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