Arthritis prevalence in the U.S. population has been substantially underestimated, especially among adults younger than 65.
Articles by Arthritis & Rheumatology
Weight Change in Early RA & the Risk of Mortality
Sparks et al set out to investigate whether weight change during the early RA period is associated with subsequent mortality and to evaluate whether there is an RA-specific effect. They investigated weight change during the early RA period, because this is the window of time during which weight change is most likely to be related to RA-specific processes. They found that severe weight loss during the early RA period was associated with a subsequent increased mortality risk both for women with and without RA…
Varus Thrust Is Associated with Progressive Knee OA
To determine if varus thrust, a bowing out of the knee during gait (i.e., the first appearance or worsening of varus alignment during stance), is associated with incident and progressive knee osteoarthritis (OA), these researchers undertook an Osteoarthritis Initiative ancillary study. They also considered hypothesized associations adjusted for static alignment, anticipating some attenuation. Methods: Gait…
Opioid Use in U.S. RA Patients
Nationally, opioid use and addiction are drawing increased scrutiny. An increase in the number of overdoses and addiction to heroin and prescription pain relievers in the past decade has been attributed in part to increased prescribing of opioids for the treatment of pain by physicians. National trends suggest the rate of opioid prescribing plateaued in…
Collaborative Guideline Addresses the Perioperative Use of Antirheumatic Drug Therapy
A new guideline developed by the ACR and the American Association of Hip and Knee Surgeons addresses the perioperative use of antirheumatic drug therapy. Specifically, it provides recommendations on the use of traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib and glucocorticoids in adults with RA; SpA, including ankylosing spondylitis and psoriatic arthritis; JIA; or SLE undergoing elective THA or TKA. The guideline provides recommendations regarding when to continue, when to withhold and when to restart these medications, and the optimal perioperative dosing of glucocorticoids…
Rituximab for Fatigue & Oral Dryness in Primary Sjögren’s Syndrome
These researchers investigated whether rituximab, an anti-B cell therapy, improves symptoms of fatigue and oral dryness in patients with primary Sjögren’s syndrome (SS). The multicenter, randomized, double-blind, placebo-controlled, parallel-group trial included a health economic analysis. There were no significant improvements in any outcome measure with rituximab except for unstimulated salivary flow. The study concludes that rituximab is neither clinically effective nor cost effective in this patient population…
The Biomarkers of Lupus Disease Study
Most SLE clinical trials continue standard background medications being taken by patients at entry, based on assumptions that this minimizes the risk of serious flares and that immunologic interference is minimal. These assumptions are not evidence based, but eliminating polypharmacy in trials studying patients with active lupus remains controversial. These researchers tested the withdrawal of immunosuppressants to make SLE trial results more interpretable…
RA Prevention: A Trial of Methotrexate Vs. Placebo in Patients with Undifferentiated Arthritis
Disease outcomes in rheumatoid arthritis (RA) have improved dramatically since the introduction of biologic agents and improved treatment strategies. Nevertheless, the majority of patients still require prolonged, if not lifelong, therapy. Therefore, the ultimate goal would be to prevent RA. This study analyzed the effect of a one-year course of methotrexate in high-risk UA patients (studied in a previous trial) after post-randomization exclusion of patients without a high risk of developing RA…
Immune-Related Adverse Events with Use of Checkpoint Inhibitors for Immunotherapy of Cancer
Introduction: Major advances in the past two decades have enhanced our understanding of the complex interactions between the immune system and cancer cells and their environment. Genetic and epigenetic alterations in tumor cells result in the expression of diverse antigens that can elicit an immune response, primarily mediated by T cells. Immune responses are regulated…
Herpes Zoster & the Risk of Stroke in Patients with Autoimmune Diseases
Herpes zoster (HZ) infection, also known as shingles, is caused by reactivation of latent varicella-zoster virus infection generally acquired decades earlier. This study was designed to test the hypothesis that the incidence of stroke immediately following HZ infection is increased in patients with autoimmune diseases compared with the incidence of stroke at later time points. Results: In patients with autoimmune diseases, incident HZ was associated with as much as a twofold increased risk of stroke. Prompt antiviral therapy was associated with lower incidence of subsequent stroke…
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