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RheumNow Podcast – As Good As I Ever Was (7.2.2021)

Jul 02, 2021 2:32 pm

Dr. Jack Cush reviews the news and journal reports from this past week on

  1. Medicare Health care utilization by knee OA pts varies. In nearly 1 million Knee OA (Medicare), 33% ended up with TKR. TKR/arthroplasty assoc w/ more clinic visits; PT, specialist care & intraarticular Rx assoc. w/ less TKR. TKR range 26% to 42% by region. PT associated with lower TKR rates/regions.
  2. CDC: as of 5/15/2021; the rates of flu test positivity was 0.051-0.18% for the 2020-21 flu season - compared to usual rate of 10%-19% before COVID. Actual influenza hospitalizations dropped from 44.2 to 0.8/100 000 population
  3. Higher rate of Parkinsonism in Osteoarthritis? Taiwan Health Insurance claims analysis of 33,360 OA pts (age 50-64 yrs) vs age matched non-OA - found incr risk of Parkinsons in OA pts (aHR=1.41), esp in knee or hip OA (aHR 1.55) group.
  4. Stroke risk is increased in arthritis (RR 1.36, 95% CI: 1.27–1.46); esp for RA (RR 1.38), AS (RR 1.49), PsA (1.33) & gout (1.40); but NOT osteoarthritis (RR=1.03). Apparently Inflammation drives this risk.
  5. Global metanalysis of 67 studies of T2T in gout shows only 34% on ULT achieve a serum urate target. Thus only a minority of gout receive T2T care worldwide. Those on ULT, have low rates of continuous Rx, SUA testing, & achieving SUA target.
  6. BRAVE-AA1 - a Phase 2 trial of 110 pts w/ Alopecia areata Rx w/ either PBO or baricitinib (1, 2, 4 mg); showed significantly greater improvement with Bari 2-mg (33.3%, P = .016) and 4-mg (51.9%, P = .001) versus placebo (3.6%).
  7. Retrospective study of 258 IBD patients undergoing MRE, 17% had MRI sacroiliitis (73% w/ bone marrow edema. Sacroiliitis was significantly associated w/ Female gender, back pain, and later age of CD diagnosis. >two-thirds of these pts never seen a rheumatologist.
  8. GFR decline in 2269 RA pts (15 mos F/U) - Most RA had a GFR decline w/ age. Pts w/ higher DAS28-CRP had more GFR decline. Pts in remission/LDAS had a slower rate of eGFR loss (−0.817 vs −1.283 cc/min per year; P < 0.001)
  9. Analysis of Ph 3 data Tofacitinib in Ulcerative Colitis shows no increase in Cancer; rates equal to that seen w/ Tofa in RA, PsA & other biologics in UC. In 1124 pts (2576 PtYrs) there were 20 cancers, excluding NMSC (IR, 0.75; 0.46–1.16)
  10. Alcohol abuse worsens psoriasis. Prospective study of 266 Psoriasis pts (1/2 biologics; 1/2 ; conventional Rx). Poorer outcomes predicted by alcohol abuse (CAGE score) (regression co-efficient 1.40), obesity (1.84) & conventional Rx (4.39);
  11. The Potential of Rituximab Efficacy in Systemic Sclerosis
  12. Gender Trends in Rheumatology         
The author has received compensation as an advisor or consultant on this subject

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