Best of 2021 -Jack of All Subspecialties (12.31.2021)

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In this episode, Dr Jack Cush reviews the news, journal articles and FDA warnings from the past week on RheumNow.com

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal life or childhood did not increase risk of JIA. #RheumNow https://t.co/Md0zBm5Txl

Alendronate may protect against type 2 Diabetes. Data from National Danish Patient Registry, presented at the EASD meeting compared 160k T2DM & 500k controls, T2DM following alendronate adjusted OR=0.64; 0.62-0.66; ⋗8yrs OR=0.47 https://t.co/RYEZodUZtv

Analysis of 508 #RA pts (over 10 yrs) in the BeST study shows joint swelling at baseline resulted in half w/ re-swelling later and significantly increased risk of same joint swelling during follow-up (OR 2.37, 95% CI 2.30 to 2.43, p⋖0.001) https://t.co/a7zH4YRAkq

Finnish Pop study 939 #RA pts shows highest healthcare costs linked to high Dz activity & comorbidity. Clusters: C1) young w/ low costs & activity, C2) chronic pain, disability, fatigue, C3) high cost/dz activity, less pain, C4)comorbidities w/ $$$  https://t.co/Azc35zyA9J

A longitudinal study from Iceland shows an increasing number of native joint infections (NJI), with iatrogenic, postarthroscopic infections being of particular concern. Read more… https://t.co/j3gzZ9g0QV

Case controlled study suggests that intraarticular steroid injections is associated with increased (HR 8.56; 3.29-22.3) risk of rapidly destructive hip disease (RDHD); at a rate of 5.4% (5.1 mos post injx) w/ JSN, osteolysis, fem head collapse https://t.co/grX5bO4495

Biosimilar update: 31 FDA approved biosimilars, but only 60% made it to market. 2015 to 2019, drug spending grew 6.1%, biologic spending grew 14.6%; biologics are 43% of US drug spending. Most biosimilars at ~30% discount.  https://t.co/4paYH8yVLQ

Study Finds U.S. Generic and Biosimilar Savings Totaled a Record $338 Billion in 2020  https://t.co/hPR0nGd6jp

Can I get the INFLUENZA and COVID Vaccines together? The CDC says: "YES...both vaccines can be given at the same visit, people should follow the recommended schedule for either vaccine.... ideally get a flu vaccine by the end of October."  https://t.co/T49zm6Cxyc

MMWR shows the safety of a 3rd (booster) dose of the mRNA vaccine to be same as the 2nd dose AEs. V-safe data on 3rd dose (n=12,591) showed local or systemic effects (79% or 74%) to be same as 2nd dose (78% or 76%)  https://t.co/LcD0ARlWJ2

CDC Advises COVID-19 Vaccines for Pregnant Women https://rheumnow.com/news/cdc-advises-covid-19-vaccines-pregnant-women

U.S. Preventive Services Task Force (USPSTF) reaffirmed its recommendations that pregnant women at a high risk of preeclampsia should take a daily aspirin regimen at the end of the first trimester  https://t.co/DiV7p6g8vL

Is Acetaminophen Potentially Hazardous in Pregnancy?  https://rheumnow.com/news/acetaminophen-potentially-hazardous-pregnancy

#RA patients had an an increased risk of mortality after CABG (HR 1.50; 1.28-1.77); and a higher risk of MI following CABG (HR 1.61; 1.28-2.04). A retrospective Finnish study comparing RA (n= 378) to nonRA patients (n = 7560)  https://t.co/cGGsrLs1V2

Early Diastolic Dysfunction in Premenopausal Women with RA  https://rheumnow.com/news/early-diastolic-dysfunction-premenopausal-wom…

108 pts with autoimmune cytopenias (TTP, ITP, AIHA, etc) were given COVID vaccination showing low rate of post-vax flares. Signif HEME decreases in 7.4% of AIHA & ITP; mild decrease in 10% AIHA and 20% ITP, w/ no Rx change https://t.co/OaHILar57z

Global SECURE-IBD trial on IBD drugs and COVID shows that severe COVID-19 outcomes were not associated with the use of biologics and mesalamine/sulfasalazine, AZA, 6MP, MTX combo Rx or biologics (TNFi, IL-12/23, IL-23, integrin inhib)  https://t.co/MO4i5ngKkr

Questions & Cases
Approach to dental surgery while on bisphosphonate
Recurrent shingles while on adalimumab
Myositis after COVID-19 vaccine

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