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2 Minute Medicine ® - Rheumatology

Collection of high-impact paper summaries that have been hand-picked, written and peer-reviewed by practicing clinicians. Provides 2 minute summarization and application to bedside care. Updated weekly.

https://read.qxmd.com/read/101001956/bimekizumab-safe-and-effective-for-treatment-of-moderate-to-severe-hidradenitis-suppurative
#1
SUMMARY
Neel Mistry, Teddy Guo
1. Significantly more patients in the bimekizumab group than placebo reported improved clinical response at week 16. 2. Treatment-related adverse events were infrequent with one fatality across both treatment groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Hidradenitis suppurativa (HiS) is a chronic inflammatory disease with limited therapeutic options. Bimekizumab, a monoclonal IgG1 antibody that inhibits interleukin (IL)-17F and IL-17A, has shown potential in treating this condition. This randomized controlled trial aimed to assess the safety and efficacy of bimekizumab in patients with moderate-to-severe HiS...
June 13, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001935/resistance-training-not-superior-to-neuromuscular-exercises-for-hip-osteoarthritis
#2
SUMMARY
Junghoon Ko, Kiera Liblik
1. In this randomized controlled trial, progressive resistance training (PRT) was not superior to neuromuscular exercise (NEMEX) in improving functional performance in patients with hip osteoarthritis (OA). 2. PRT was not superior to NEMEX in improving patients’ hip pain or hip-related quality of life. Evidence Rating Level: 1 (Excellent) Study Rundown: OA is a degenerative joint disease characterized by the breakdown of cartilage between bones, which results in pain, decreased range of motion, and impaired quality of life...
June 6, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001932/corticosteroid-injections-not-found-to-be-associated-with-fracture-risk-in-elderly-cohort
#3
SUMMARY
Donika Yakoub, Alex Chan
1. In a cohort of older adults, the use of corticosteroid injections (CSIs) was not associated with increased fracture risk, regardless of osteoporosis status. 2. The cumulative dose of CSI used over four years was also not a predictor of fracture risk. Evidence Rating Level: 2 (Good) Corticosteroid injections (CSI) are commonly used in the management of musculoskeletal (MSK) pain, particularly in older adults. While they are formulated to prolong their presence locally at the injection site, there is some systemic absorption of CSIs...
June 6, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001912/osteoporosis-prevalence-in-patients-undergoing-peritoneal-dialysis-is-not-correlated-with-vitamin-d-levels
#4
SUMMARY
Paary Balakumar, Alex Chan
1. In patients undergoing peritoneal dialysis, osteoporosis is highly prevalent but does not correlate to 25-vitamin D levels. Evidence Rating Level: 3 (Average)  One complication in patients with chronic kidney disease (CKD is increased bone turnover and decreased bone density. Bone mineral density (BMD) indicates bone mass and mineralization. It is determined using a Dual-Energy X-ray Absorptiometry (DEXA) scan at both the posteroanterior lumber spine (L1-L4) and the hip (femoral neck or total proximal femur)...
May 23, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001892/low-lower-limb-muscle-mass-index-with-weight-bearing-activity-increases-incidence-of-osteoarthritis
#5
SUMMARY
Jayden Berdugo, Alex Chan
1. Increased incidence of radiographic knee osteoarthritis was associated with high amounts of weight-bearing activity only in those with a low lower-limb muscle mass index (LMI). 2. There was no association identified between symptomatic knee osteoarthritis and weight-bearing activity, total physical activity, or non-weight-bearing activity.  Evidence Rating Level: 1 (Excellent)  Osteoarthritis is an inflammatory joint disease involving the degeneration of joints along with chronic pain and limited mobility...
May 12, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001890/reverse-total-shoulder-replacement-may-be-a-viable-treatment-option-for-shoulder-osteoarthritis
#6
SUMMARY
Jayden Berdugo, Alex Chan
  1. Reverse total shoulder replacement (RTSR) was examined as a potential treatment for end-stage shoulder arthritis. 2. After analysing the risk factors, RTSR was shown as a potential alternative treatment to total shoulder replacement for those with an intact rotator cuff. Evidence Rating Level: 1 (Excellent) One treatment for end-stage shoulder arthritis that is increasingly popular is shoulder replacement therapy. Reverse total shoulder replacement (RTSR) has previously been used for rotator cuff arthropathy but has expanded its use for other indications despite a lack of supporting evidence...
May 11, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001755/interleukin-23-receptor-antagonist-improves-psoriasis-symptoms
#7
SUMMARY
Jayden Berdugo, Kiera Liblik
1. In this randomized controlled trial, treatment with JNJ-77242113 improved psoriasis symptoms as compared to a placebo. 2. JNJ-77242113 showed a dose-response relationship, with higher doses eliciting stronger treatment effects. Evidence Rating Level: 1 (Excellent) Study Rundown: Psoriasis is an immune-mediated inflammatory disease primarily affecting the skin and joints. The immune process is mediated by Interleukin-23, which plays a key role in T-cell activation. In the past, biologics have been used as treatments for psoriasis; however, they have limitations...
February 15, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001725/klkb1-gene-editing-therapy-reduces-kallikrein-levels-in-hereditary-angioedema
#8
SUMMARY
Nhat Hung Benjamin Lam, Kiera Liblik
1. In this randomized controlled trial, gene-editing therapy targeting the kallikrein B1 gene ( KLKB1 ) led to a significant reduction in plasma kallikrein levels among adults with hereditary angioedema (HA). 2. Trial participants also saw a reduction in angioedema attacks in the following 16 weeks and had no severe adverse events.  Evidence Rating Level: 1 (Excellent) Study Rundown: HA is a rare autosomal dominant genetic disease characterized by unpredictable and potentially fatal attacks of swelling in the gastrointestinal tract, the larynx, and tissues throughout the body...
February 5, 2024: 2 Minute Medicine
https://read.qxmd.com/read/101001644/elevated-systemic-inflammation-markers-associated-with-increased-prevalence-of-hypertension
#9
SUMMARY
Rhianna Davis, Alex Chan
1. Higher scores for systemic inflammatory markers including the systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were significantly associated with risk for hypertension. 2. There was also a significant difference in mean arterial pressures (MAP) in patients with higher quartile scores for the above markers.   Evidence Rating Level: 2 (Good) Hypertension is itself a potent risk factor for several adverse cardiovascular outcomes, representing an important public health concern globally...
December 23, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001608/methotrexate-alleviates-pain-among-patients-with-hand-osteoarthritis-and-concurrent-synovitis
#10
SUMMARY
Neel Mistry, Teddy Guo
1. Methotrexate 20 mg once weekly resulted in significant pain reduction among patients with hand osteoarthritis of the inflammatory phenotype. 2. Adverse events in the treatment group were comparable to the placebo group. Evidence Rating Level: 1 (Excellent) Study Rundown: Hand osteoarthritis is a debilitating condition with limited treatment options. Topical therapy, oral analgesics, and non-pharmacological therapy are used to reduce pain and improve function; however, these have shown limited clinical benefit...
December 5, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001599/anxiety-may-be-linked-to-c3-and-c4-levels-in-patients-with-systemic-lupus-erythematosus
#11
SUMMARY
Ashley Jackson
1. In this cross-sectional study, there was a significant negative correlation between anxiety scores and C3 levels in patients with systemic lupus erythematosus (SLE), and a weak correlation between anxiety and C4 levels. 2. However, there was no statistically significant association between depressive symptoms and C3 or C4 levels. Evidence Rating Level: 3 (Average) Anxiety and depression are common mental illnesses that are often comorbid with chronic health conditions. Systemic lupus erythematosus (SLE) is an autoimmune condition that is characterized by chronic inflammation...
November 28, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001571/sarilumab-increases-remission-rate-in-patients-with-polymyalgia-rheumatica-relapse
#12
SUMMARY
Junghoon Ko, Kiera Liblik
1. In this randomized controlled trial, patients with polymyalgia rheumatica (PMR) flares who received sarilumab with a prednisone taper demonstrated increased sustained remission rates compared to those who received a placebo plus prednisone taper. 2. Sarilumab use led to increased rates of adverse events leading to treatment discontinuation compared to placebo, including neutropenia, arthralgias, and diarrhea. Evidence Rating Level: 1 (Excellent) Study Rundown: PMR is an autoimmune condition that causes significant joint pain and discomfort...
November 15, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001565/spesolimab-may-improve-quality-of-life-in-patients-with-generalized-pustular-psoriasis-flares
#13
SUMMARY
Neel Mistry, Teddy Guo
1. Efficacy of spesolimab appeared to be dose-dependent with high-dose spesolimab leading to a significantly longer time to GPP flare-up versus placebo. 2. There were no treatment-related deaths or hypersensitivity reactions across groups. Evidence Rating Level : 1 (Excellent) Study Rundown: Generalized pustular psoriasis (GPP) is a rare but chronic skin condition with a high morbidity. Spesolimab is an anti-interleukin-36 monoclonal antibody that may lead to rapid symptom resolution in patients with GPP flares...
November 14, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001550/recovery-of-knee-function-from-total-knee-arthroplasty-associated-with-improvement-in-depression-symptoms
#14
SUMMARY
Soroush Nedaie, Alex Chan
1. Total knee arthroplasty was found to decrease the incidence of depression among patients to 85% at 6 months follow-up. 2. Higher pre-operative Beck’s Depression Scale scores corresponded to worse knee function scores post-operatively. Evidence Rating Level : 2 (Good) Knee surgical procedures in relation to osteoarthritis are increasingly common due to rising life expectancy, but they entail complications, leading to higher financial burdens, reduced recovery time, and lower quality of life. Depression, with an estimated prevalence of 29...
November 8, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001503/sodium-glucose-cotransporter-2-inhibitors-may-decrease-incidence-of-recurrent-gout-flares
#15
SUMMARY
Soroush Nedaie, Alex Chan
1. Over a one-year period, the incidence of recurrent gout flares in patients with gout and diabetes was significantly lower in those who initiated sodium-glucose cotransporter-2 inhibitor (SGLT2i) treatment compared to other antidiabetic treatments. 2. Patients who initiated an SGLT2i experienced a lower risk of all-cause mortality relative to the comparison cohort.   Evidence Rating Level: 2 (Good) Study Rundown: Gout, the most common inflammatory arthritis, has exhibited rising prevalence and incidence globally...
October 11, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001477/budesonide-may-be-effective-for-slowing-renal-function-decline-in-patients-with-iga-nephropathy
#16
SUMMARY
Neel Mistry, Teddy Guo
1. Reduction in time-weighted glomerular filtration rate (GFR) decline was significantly greater in Nefecon versus placebo. 2. Majority of adverse events were mild-to-moderate in nature with no treatment-related deaths. Evidence Rating Level: 1 (Excellent) Study Rundown : IgA nephropathy is a chronic immune-mediated kidney disease with marked proteinuria. Nefecon, a novel, targeted-release form of budesonide, is designed to inhibit galactose-deficient IgA1 (gd-IgA1) within the gastrointestinal tract, although little is currently known...
September 29, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001467/cognitive-behavioural-therapy-effective-for-fibromyalgia-pain
#17
SUMMARY
Donika Yakoub, Alex Chan
1. This randomized controlled trial found that an 8-week cognitive behavioural therapy (CBT) intervention was more effective than fibromyalgia (FM) education in reducing pain catastrophizing and improving pain interference scores. 2. Functional magnetic resonance imaging (fMRI) demonstrated that pain catastrophization was associated with increased ventral posterior cingulate cortex (vPCC) activation, and that post-CBT, patients showed reduced firing in the somatosensory and salience networks.  Evidence Rating Level: 1 (Excellent) Fibromyalgia (FM) is a chronic rheumatic condition causing widespread pain throughout the body, fatigue, and a range of other symptoms, often leading to negative affect and reduced quality of life...
September 25, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001456/combined-digital-intervention-may-be-effective-for-osteoarthritis-pain
#18
SUMMARY
Davy Lau, Alex Chan
1. Following total knee replacement (TKR) for osteoarthritis, patients randomized to a combined digital intervention experienced less pain, less disability, and increased physical activity at 12 months follow-up, compared to care usual. Evidence Rating Level: 1 (Excellent) Patients who undergo total knee replacement (TKR) for osteoarthritis (OA) may continue to have ongoing pain and limited function, with some reports showing that 10% of patients are dissatisfied at 2 years of follow-up. Digital interventions are one strategy shown to improve pain and increase activity after TKR...
September 19, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001444/baricitinib-is-safe-and-effective-for-treatment-of-refractory-juvenile-idiopathic-arthritis
#19
SUMMARY
Neel Mistry, Teddy Guo
1. Time to disease flare was significantly shorter in the placebo group versus baricitinib. 2. There was no difference in serious adverse events between the baricitinib and placebo groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Juvenile idiopathic arthritis (JIA) is defined by the onset of polyarticular joint pain before age 16 and can severely affect an individual’s quality of life. First-line treatment for JIA includes nonsteroidal anti-inflammatory drugs (NSAIDs) and biologic disease-modifying antirheumatic drugs (DMARDs), however, many patients with JIA continue to experience refractory symptoms...
September 14, 2023: 2 Minute Medicine
https://read.qxmd.com/read/101001424/low-dose-glucocorticoids-for-rheumatoid-arthritis-do-not-increase-blood-pressure
#20
SUMMARY
David Xiang, Kiera Liblik
1.  In this pooled analysis of randomized controlled trials, low-dose glucocorticoids taken over a two-year period did not increase patient blood pressure. 2. Low-dose glucocorticoid use was associated with an increase in weight of one kilogram on average.  Evidence Rating Level: 1 (Excellent) Study Rundown: Glucocorticoids are commonly used in the management of rheumatoid arthritis (RA), though are often associated with adverse events such as weight gain and hypertension. However, there is a gap in knowledge as to understanding whether glucocorticoids are truly the cause of these adverse events...
September 6, 2023: 2 Minute Medicine
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