Systemic autoimmune rheumatic diseases are associated with increased rates of adverse pregnancy outcomes, including spontaneous abortion, preeclampsia, fetal growth restriction (FGR) and prematurity. In this study population, preclinical rheumatic disorders were associated with an increased risk of FGR, preeclampsia and small-for-gestational-age infants. The impact of these findings and their utility in screening for fetal growth restriction/preeclampsia need to be confirmed in population studies…
Clazakizumab for Adults with Active PsA
This is the first clinical trial of an IL-6–targeted therapy in PsA. Clazakizumab may be an effective treatment option for musculoskeletal aspects of PsA, but because of the lack of a dose response in this study, further studies are required to confirm the appropriate dose. The safety profile is consistent with the pharmacology of IL-6 blockade and prior clinical experience with this antibody in rheumatoid arthritis…
Placebo Outperforms Glucosamine/Chondroitin Sulfate for Knee OA
(Reuters Health)—Glucosamine sulfate and chondroitin sulfate are not more beneficial than placebo treatments for patients with knee osteoarthritis, a recent trial suggests. In a double-blind study, researchers investigated the efficacy of a medicine that delivered both glucosamine and chondroitin sulfate. The 164 participants all had osteoarthritis and moderate to severe knee pain. Half the participants…
Secukinumab Inhibits Structural Joint Damage in Active PsA
Psoriatic arthritis (PsA), a chronic inflammatory arthritis characterized by structural damage to the joints, has been associated with reduced health-related quality of life, disability and reduced life expectancy. The joint changes in PsA are characterized radiographically by a combination of erosive and proliferative bone changes, including erosive joint destruction, fluffy periostitis and pencil-in-cup deformities. Radiographic…
Patients with PsA, Cutaneous Psoriasis May Undergo Hip Replacement
A recent study of patients with psoriatic arthritis and cutaneous psoriasis found that these patients do not have a higher risk of worse outcomes after total hip arthroplasty compared with patients with osteoarthritis…
Arthritis Prevalence on the Rise, Creating Challenges for Healthcare System
Updated projections suggest that arthritis and arthritis-attributable activity limitation will remain large and growing problems for clinical and public health systems, which must plan and create policies and resources to address these future needs. By 2040, the number of U.S. adults with doctor-diagnosed arthritis is projected to increase 49% to 78.4 million. Can the healthcare system accommodate these projected increases? Not without changes. By 2025, the expected demand for rheumatologists is expected to exceed supply by 2,576 adult and 33 pediatric rheumatologists…
Diffuse Alveolar Hemorrhage Secondary to Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: Predictors of Respiratory Failure and Clinical Outcomes
A variety of immune and nonimmune pathophysiologic mechanisms causing the disruption of alveolar capillaries with bleeding into the alveolar spaces can lead to diffuse alveolar hemorrhage (DAH). Immune-mediated mechanisms can cause DAH with or without the presence of capillaritis. The antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) syndromes—granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA)—are the…
Inflammation May Sensitize Patients with Osteoarthritis to Pain
A recent editorial in Arthritis & Rheumatology explored the role of sensitization, not nociception, as a key mechanism of pain for patients with knee OA, as well as inflammation’s role in pain perception. Recent research of synovitis and joint effusion supports the idea that early prevention or treatment of sensitization may be paramount to reducing long-term pain in patients with knee OA…
From the Expert: Dr. Michael Weisman Discusses the Challenges of Enthesitis
A recent review in Arthritis & Rheumatology examined advances in addressing the pathophysiology, genetics and treatment of enthesitis for patients with spondyloarthritis. And author Michael Weisman, MD, notes that challenges remain in understanding the genetics and triggers of enthesitis…
New Guideline: NSAIDs Effective in Treating Ankylosing Spondylitis & Nonradiographic Axial Spondyloarthritis
In February, new recommendations were released for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis, noting that NSAIDs may be the best initial treatment for the diseases, with TNF inhibitors as second-line therapies. The guideline was the result of a joint effort by the ACR, the Spondylitis Association of America and the Spondyloarthritis Research and Treatment Network…