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RheumNow Podcast - Top 13 Rheumatology Centers (7-31-20)

Jul 31, 2020 9:05 am

Dr. Jack Cush reviews the news and TOP 13 list of Best Rheumatology Hospitals.

  1. Based on a small number of studies (n = 5), there is little evidence to support the superiority (efficacy & safety) of Loading dose regimens when starting biologic (abatacept, certolizumab and secukinumab) therapy.
  2. Safety & efficacy of rituximab in Older RA (>65; n=97) vs younger (<65yrs; n=276) showed no difference in drug survival over 2 yrs (72% vs 74%)or SDAI activity. BUT.. there were more SIE (14.2 vs 6.6/100 PY) & pneumonia (10.7 vs 5.1/100 PY) in older pts
  3. Metanalysis of 10 studies ( 534 patients) shows that exercise in ankylosing spondylitis improves pain, function and disease activity.  Statistically signif improvement in pain (P<0.0001), BASDAI (P <0.00001), and BASFI (P<0.00001), but not CRP and ESR.
  4. Lenabasum (cannabinoid rcptr agonist) studied in Systemic Sclerosis - LEN (n=27) vs PBO (n=15). At wk 16 LEN had better responses by CRISS (skin) score (0.33, vs 0; P=0.07) w/ reduced gene expression for inflammation & fibrosis & improved skin histology
  5. Analysis of administrative health data (1984‐2016) on 12984 #RA pts shows RA w/ psychiatric comorbidities (depression, anxiety, bipolar, schizophrenia) had more additive visits (10.9), hospitalizations, hospital days (3.6), more drugs (7.3) & FP visits
  6. CHMP of the EMA (European Medicines Agency) has recommended approval of filgotinib (Jyseleca) for moderate to severe active rheumatoid arthritis (RA) in adults not responding to DMARDs. The daily drug has been studied at 100mg and 200 mg doses.
  7. Down syndrome-associated arthritis (DA) presents as a seronegative erosive polyarthritis. Besides an Avg 19-month delay in Dx, most are treated same as JIA but JIA agents are often poorly tolerated & less effective in DA. Prevalence=8.7/1000 Downs kids
  8. Retropective study of 22 French severe COVID-19 pneumonia pts - 10 Rx w/ standard-of-care vs 12 with SOC plus IV anakinra (300 mg⋅d−1 x5 d, tapered over 3 d). All of anakinra pts rapidly improved w/ no deaths, less O2, No mech ventilation (P < 0.01)
  9. Colchicine Benefits COVID-19 Patients
  10. Rising evidence of the link between hyperuricemia & hypertension, yet not enough that lowering uric acid (SUA) lowers HTN & its consequences. Some evidence SUA leads to suggest that activation of the renin-angiotensin; would blocking RA mimic ULT #gout
  11. Methotrexate Improves Pegloticase Efficacy and Tolerability 
  12. The Burden of Gout
  13. 2020 Best Rheumatology Hospitals
The author has received compensation as an advisor or consultant on this subject

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