The Evidence Based Rheumatology Podcast

(Yet) another RCT this week!  Nice investigator initiated trial with many wonderful strengths and a few crippling flaws. Great opportunity to think about a common problem in practice as well as a separate common problem in trials! 

This week I talk about the recently published TULIP 1 and TULIP 2 trials that assessed anifrolumab for active SLE.  Great to see a new drug in this disease state; interesting to think through how these trials played out.  Get the papers and the pod at ebrheum.com and follow me @ebrheum if you'd like to share feedback! 

Happy New Year!  This week Dr. Anisha Dua (@anisha_dua) and Dr. Sarah Fantus (@sarahfantus) debate this motion: "In MTX non-responders with RA, triple therapy (adding HCQ & SSZ) should be first line."  Please be sure to VOTE AGAIN on twitter (@ebrheum) after you have listened! 

This week I go back to a topic from episode 42, the SENSCIS trial and nintedanib for SSc-ILD.  The way this medication has been received and a recent article I wrote for The Rheumatologist gave me a nice jumping off point to cover a few more issues from this. Be sure to follow me @EBRheum to let me know what you think! The corresponding article is available here: https://www.the-rheumatologist.org...

Surprising RCT this week discussing the HOPE trial, which pitted 10mg prednisone against placebo for inflammatory hand OA. I do think this will change my practice, but in a far narrower sense than the headline would suggest. Check it out and find all my other content at ebrheum.com! 

Rheum4Debate is back!  This week we have Dr. Anisha Dua arguing in support of the motion, "Patients with newly diagnosed GCA should start glucocorticoids WITH tocilizumab over glucocorticoids alone."  I argue against the motion and Dr. Sarah Fantus was kind enough to moderate.     In our pre-debate poll, 51% supported the motion, 34% disagree with the motion, and 15% were undecided.  Please be sur...

Super brief "checking in" podcast this week.  In short, say "hi" at ACR, write me a review on apple podcasts, send this to a friend, and keep listening :). 

Today I dive into the emerging therapies for psoriatic arthritis, focusing on the IL17i ixekizumab and the recently published SPIRIT-H2H trial. It's a great combination of my favorite thing in RCTs (head to head trials) and my least favorite thing in RCTs (RCTs that were designed in such a way that they don't answer the question I want to know).  

This week I revisit an old paper - the 2013 ADACTA trial that assessed tocilizumab and adalimumab for patients who cannot take or were intolerant of MTX.  

This week I decided to discuss the question of HCQ and retinal toxicity.  It has been controversial the past few years and we're all trying to get a handle on how to approach this. The Hopkins SLE group released this fascinating study on a large group of patients who had blood levels tracked. Worth a read and (hopefully) a listen!  

Finally got around to tackling rituximab in SLE.  This is a tough topic: lots of people feel passionately one way or another, flawed observational data supports its use, flawed RCTs did not find significant benefit, and patients are left in the lurch.  I tried my best and came away more confident than ever that there's no clear answer.  I hope you enjoy; please send me feedback on twitter @ebrheum...

This week I tackle an interesting cohort study that Jack Cush (@RheumNow) mentioned in his podcast.  It's a nice opportunity to discuss bDMARDs in the "real world" (AKA Sweden).  Follow me @ebrheum and let me know what you think of the episode! 

Finally got around to tackling the JAKi this week.  I decided to focus on SELECT-COMPARE, which pitted upadacitinib (selective JAK1 inhibitor) against adalimumab and placebo.  I briefly discuss other JAKs and my thoughts on the future of this area. Get the paper and others at ebrheum.com and follow me @ebrheum! 

Back this week to discuss an interesting paper in the NEJM.  Lots of interesting issues, most notably historical controls and their limitations.  Find all my work at ebrheum.com! 

This week I'll discuss an important paper in systemic sclerosis, the recent SENSCIS trial that compared 150mg nitedanib to placebo.  I wind up coming down pretty hard on this drug; I think it's hype has vastly outpaced its utility. Get the paper itself at ebrheum.com and follow me on @ebrheum to give feedback! 

Welcome back!  This is the second episode of Rheum4Debate, an oxford-style debate show for the field of rheumatology.  In this podcast we'll tackle the question of bactrim prophylaxis in patients receiving cyclophosphamide.  The motion was:  “Bactrim prophylaxis should be prescribed to all patients with SLE who are receiving cytoxan and over 20mg of prednisone daily” Dr. Pankti Reid (@panktireid)...

Exciting episode this week!  This is the FIRST of a new podcast series entitled Rheum4Debate, an Oxford style debate show for the field of rheumatology.  We are planning to release one episode a month; each have a moderator and one physician on each side of a controversial motion.  Be sure to VOTE on whether you agree or disagree with the motion AFTER you have listened to the podcast! Get the epis...

This week a nice case control study out of Mayo challenged my own bias against MTX in GCA.  This prompted a deep dive into the literature, including 3 RCTs and meta analysis.  At the end of the day, I'm more (almost) fully convinced that MTX offers a (mediocre) benefit.  Follow me on twitter (@ebrheum) to share your thoughts and find all of the PDFs at my Box on ebrheum.com. 

The FDA recently approved romosozumab for high risk post menopausal osteoporosis, but gave it a black box warning for cardiovascular disease.  This week I'll cover the data that led to it's approval despite such dire warnings.   Get the papers themselves here and be sure to follow the podcast on twitter @ebrheum or sign up with your favorite podcast aggregator at ebrheum.com

This week I pair the recently published TRACE-RA trial assessing the efficacy of atorvastatin in primary prevention of cardiovascular disease. It offered a great opportunity to also go after the recent Nature publication "Scientists rise up against statistical significance," which has (inexplicably) gotten so much high praise.   Subscribe to the podcast / my twitter feed and find the papers at ebr...

This week I discuss the phase 2 trial on baricitinib in SLE.  Though it's early times (and the total flop of rituxan in ME/CFS recently can attest to this), this was a large phase 2 and I'm hopeful it carries through to the ongoing phase 3 trials.  Follow me on twitter and find all the papers / links at my new landing page, ebrheum.com !

#RheumJC week!  I hope you all tuned into the online journal club #RheumJC, but if you did not I put up a podcast about the paper we discussed. Yet another epidemiological misadventure into unmeasured confounding and in this case confounding by indication.  Take home... maybe consider not using Tramadol, as you already should have not been doing?  Article I reference in the podcast:  https://emcri...

In this week's episode I depart briefly from discussing papers in the rheumatology literature to dive headfirst into the recent controversy over eggs and cardiovascular disease. Our patients eat eggs too, so I figured it would still be applicable. Please join the conversation @EBRheum! Find all the papers here: https://tinyurl.com/yyll5qof

This week I'll tackle an interesting topic in giant cell vasculitis - the utility of FDG PET. This was a good paper but one that I used to discuss important concepts, including negative predictive value and pretest probability.  Hope you enjoy!  Please give feedback @EBRheum! Find all the papers here: https://tinyurl.com/yyll5qof

Finally addressing this ultrasound business.  I decided to cover two somewhat similar trials, which seem to come to the same conclusions regarding U/S and treat to target strategies.  However, the question addressed was narrow and the role of ultrasound remains to be determined.  Get this paper (and all the others) here: https://tinyurl.com/yyll5qof