My selection of ACR2012 Sjögren’s Syndrome Abstracts (1)

17 November 2012 Leave a comment

It is early November, and that is usually the time of the year for the annual meeting of the American College of Rheumatology (ACR). Indeed the ACR 2012 convention has just ended while adding this blogpost. It took place in Washington, D.C., from November 9-14. I did not physically attend it, but -and that’s new- I would almost say it has been the first scientific meeting I could almost attend virtually (live video- and aaudiostrems from the meeting would provide a strikethrough for the word “almost” in this sentence). Thousands of tweets from all kinds of authors attending the ACR 2012 convention passed in my Twitter timeline. Whilst on a previous occasion one could make a nice survey of topics discussed at the ACR or (european counterpart) EULAR meetings by downloading a transcript of all tweets with the meeting’s hashtag via Symplur, on this occasion one could speak of a twitter tsunami. The tweets containing the hashtag #ACR2012 were so numerous that the previously mentioned transcript downloads via Symplur no longer satisfied my objective to obtain a nice survey of the meeting (this might change when Symplur decides to add more query features then only filtering based on a specified time-interval, i.e. if one could filter all tweets containing the #ACR2012 hashtag including the word “gout” it could still deliver a nice transcript of what came by via Twitter on the topic gout). Read more…

Categories: meeting report

Dutch study suggests that COX-2 inhibiting NSAIDs should also always be prescribed with gastroprotective drugs

18 April 2012 Leave a comment

In clinical practice conventional (classic) NSAIDs are usually prescribed together with proton-pump-inhibtors (PPI) as concomitant gastroprotective agent (GPA). In patients not at risk for gstro-intestinal problems the COX-2 inhibtors group within the NSAIDs are not necessarily prescribed with concomitant GPA. I.e. when the COX-2 blocking agents were introduced, the reduced risk for gastro-intestinal bleedings was an important factor for drug registration by the authorities as well as in marketing for the pharmaceutical companies. However, from the classic NSAIDs the risk of gastrointestinal bleeding is well known as side-effect, especially when not (continuously) taking PPI. For the COX-2 inhibitors data on gastrointestinal complications when not or not continuously taking PPI were relatively lacking. A Dutch study was performed (and published today in Arthritis and Rheumatism) on the effect of adherence to a gastroprotective drug regimen with COX-2 blocker use. The investigatrs concluded that BOTH for classic NSAIDs as well as for COX-2 blockers the risk of developing gastrointetinal complications rises remarkably when PPIs are not taken as concomitant medication on a daily base.

Further analysis found that for every 10% decrease in GPA adherence, there was a 9% increase in the risk of gastrointestinal complications. “Our findings show that with every three day reduction of GPA coverage per 30 days of COX-2 inhibitor use, the risk of upper GI events increases 9%,” concludes Dr. Valkhoff.

Read more…

Clinical research on Sjögren’s Syndrome continues, also in the Netherlands

7 April 2012 Leave a comment

Fatigue remains a major symptom encountered in Sjögren’s Syndrome, and this phenomenon has already been documented in quite a number of studies. A recent Dutch study (published in this month’s Annals of the Rheumatic Diseases) adds to that series and suggests that fatigue in patients with Sjögren’s syndrome might be reduced by targeting both physical activity and physical activity cognitions.

Find a link to the abstract here.

Basic research on Sjögren’s Syndrome continues, also in the Netherlands

28 March 2012 Leave a comment

A recently published thesis by Nienke Roescher from the University of Amsterdam further contributes to the difficult and ongoing search on how to tackle the disease Sjögrenś sydnrome. Although as a rheumatologist I am more into clinical research, the evolving knowledge obtained from basic (laboratory) research is of invaluable importance in guiding the way to find a cure for this disease.

Nienke Roescher concluded her thesis as follows:

The research presented herein summarizes the current knowledge on cytokines and their presence in SS, it identifies immunological targets in mice with an SS-like disease and shows that local gene therapy can be successful for the treatment of the inflammatory salivary gland component of a SS-like disorder in mice. The chance for success of this approach depends on proper timing and should be aimed at the right target.

Read more…

American College of Rheumatology classification criteria for Sjögren’s syndrome: A data-driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance Cohort – Shiboski – 2012 – Arthritis Care & Research – Wiley Online Library

27 March 2012 4 comments

Ginkgo biloba (Tavonin) for Raynaud’s Phenomenon, should one give it a try?

25 March 2012 Leave a comment

Although some new treatments have become available for the treatment of Raynaoud’s Phenomenon (whether primary or secondary), it remains a condition that is quite frequently encountered by a rheumatologist in the outpatient-clinic. A condition from which patients suffer quite a lot, even (or should one say typically) also in seasons other then wintertime. Treatment with Ilomedin – a prostacyclin analog- infusions are known to be of benefit in a number of severe cases, although the exact optimal dosing regimen (how many (series of) consecutive infusion treatment days) is unknown. It is also an expensive treatment, and the same holds true for a somewhat newer kid-on-the-block bosentan (named Tracleer in the Netherlands) which essentially is put forward in severe cases in systemic sclerosis with formations of pitting scars resulting from digital ulcera.

However, even for this more advanced and expensive treatment options success rates of treatment differ quite a lot (e.g. “bosentan is not effective in systemic sclerosis-related Raynaud’s Phenomenon without pre-existing digital ulcers” is concluded in this 2009 study), in other words the one-fits-all of alternatively optimal flowchart of medications for the succesfull treatment of severe Raynaud’s Phenomenon in the end still comes down to classic trial and error (with rationale of course). Read more…

A report from the field: abatacept administered triweekly

14 March 2012 2 comments

Sometimes you have those tiny observations from daily clinical practice that are just too short as a message to post to a journal in the field, even in the format of a “letter-to-the-editor” but are also too important not to share with others. These are often the particular case observations rheumatologists share with each other on scientific meetings (i.e. in the meeting area or during dinner, not in the plenary sessions themselevs). These shared reports from the field often form a cnsiderable part of the take home messages when traveling home having attended a scientific meeting. It’s a pity that such practical advice or observations from colleagues although very worthwile are scarce to find upon scientific literature searches. The reason, I guess, is probably that others think the same of an example I will be giving in this blogpost as I do, i.e. the message is too “small” (in number of reported cases and length of content one would share) to send it in to a peer-reviewed scientific journal. As a result, these valuable personal observations of fellow rheumatologists are mainly shared amongst colleagues that are physically met in real lfie, and not shared to a broader audience by using the web. In my opinion blogging such reports from the field could be a very nice way to make also these valuable personal n=1 or n=2 observations from the field avaiiable on internet searching (e.g. Google will for sure pick up this one when someone might type in abatacept triweekly in the near fiture, especially when tags are attached to blog postings). So I would like to make a call to worldwide rheumatologists reading my blog not to hesitate blogging about their own observations from the field too tiny to publish but to relevant not to share (by blogging). Read more…