The Evidence Based Rheumatology Podcast: Recent Episodes
Michael Putman
A weekly podcast for physicians interested in evidence based medicine and rheumatology. Find the papers at ebrheum.com
A new therapy for SLE! This one is a CD40-CD40L blocker, which has some nice new-things to inhibit. The study itself was a qualified success and the podcast got a bit more rant-y than it should have been, but hopefully you get a kick out of it.
Paper: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00691-4/fulltext
Another day, another B cell drug. This one adds an interesting option for IgG4-RD, offering a "maybe less efficacious maybe less toxic" pathway. I could see folks being excited for this, especially in a disease where non-scary-manifestations are relatively common.
Also, check out boardsbank.com!
Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2601337
Big trial this week in the NEJM investigating the IL17 inhibitor secukinumab in PMR. Well worth a read, I would bet on FDA approval in the near future. Some interesting tidbits and of course a weird safety thing we now have to grapple with.
Be sure to go to boardsbank.com! Free rheumatology board review, >1000 questions!
Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2602567
Really interesting study this week comparing the IL17 inhibitor ixekizumab WITH the GLP1 inhibitor tirzepatide to ixekizumab alone. Raises some interesting questions about what worked here and whether or not it matters how it worked.
Paper: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.70134
Newsletter: http://autoimmunedevreport.com/
Great trial this week looking at brepocitinib in dermatomyositis. Looks like a winner, expect it will be approved. Where it fits in our approach to IIM is an open question, but nice to have another option.
Study: https://www.nejm.org/doi/10.1056/NEJMoa2503531
JC Companion: https://autoimmunedevreport.substack.com/
Good RCT this week, investigating the CD20 B cell inhibitor obinutuzumab for SLE. Sign up for my newsletter if you would like to have a read-along companion piece!
Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2516150
Landing Page: https://ebrheum.com/
Substack: https://autoimmunedevreport.substack.com/
Quick podcast this week about a nifty head to head study that I had previously missed. Worth reading if - like me - you're still trying to figure out how the heck to manage osteoporosis.
Paper: https://pubmed.ncbi.nlm.nih.gov/28755782/
Today I cover the recent publication of the RESET-RA study, which evaluated vagal nerve stimulation to treat rheumatoid arthritis. Have a listen in full, but let me be clear upfront: I do not think this works and will not be referring any patients to receive it. This will forever be my pivotal example of the effect of unblinding, but would love to hear if you think different!
Paper: https://www.nature.com/articles/s41591-025-04114-7
Supplement (see S4): https://www.nature.com/articles/s41591-025-04114-7#Sec27
Surprisingly (unbelievably?) impressive RCT evaluating the Blys/APRIL inhibitor "telitacicept" for patients with SLE (mixed SLE and SLE-LN). Very curious to see where the FDA goes with this one.
Paper: https://www.nejm.org/doi/full/10.1056/NEJMoa2414719
Ever wonder how often you really need to check "monitoring" labs? If so then this is the podcast for you! Bryant England mentioned this during his excellent Year in Review session at ACR Convergence 2025. I've been meaning to cover it and finally got around to doing so. Have a listen and share with friends!
Paper: https://pubmed.ncbi.nlm.nih.gov/40854212/
Covering a very interesting study this week, which investiaged the PDE4B inhibitor nerandomilast for patients with progressive pulmonary fibrosis (specifically including 325 patients with autoimmune ILD). Would have been yet another ho hum trial if not for the big reveal... have a listen to find out!
Article: https://www.nejm.org/doi/full/10.1056/NEJMoa2503643
Another episode looking into safety this week! Tackling that pesky issue of TNFs and CHF. Be sure to subscribe to my newsletter and check out the papers below!
Newsletter: https://sprw.io/stt-ee87b4
ATTACH: https://pubmed.ncbi.nlm.nih.gov/12796126/
RENEWAL: https://www.ahajournals.org/doi/10.1161/01.cir.0000124490.27666.b2
Observational Studies: https://pubmed.ncbi.nlm.nih.gov/23155221/
Covering an interesting but ultimately disappointing post hoc study of multiple upadacitinib trials in RA. Initially some hope for clarity in the "Do JAKs cause all the badness?" questions, but ultimately landing me about where I have been since ORAL-SURVEILLANCE was published
Paper: https://www.sciencedirect.com/science/article/pii/S0003496724423091
Interesting read this week - I cover a nifty little paper that presented data about adrenal insufficiency after stopping prednisolone, published in JAMA Open in March 2025.
Open Access Journal Here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831668
Interesting NEJM trial this week comparing methotrexate to prednisone for pulmonary sarcoidosis.
Paper available here: https://www.nejm.org/doi/full/10.1056/NEJMoa2501443
Podcast this week about the recently published SELECT-GCA study, which evaluated the use of the janus kinase inhibitor upadacitinib (Rinvoq) for patients with new and relapsing GCA. Successful trial and an interesting topic. Paper itself here: https://www.nejm.org/doi/full/10.1056/NEJMoa2413449
This week I cover another of my newsletters, though I mostly use it as a skeleton to riff on a common (and challenging) issue for rheumatology consultants; diagnosing HLH. Check out the guidelines themselves here and have a listen to the podcast!
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00273-4/fulltext
Another day, another b cell podcast. Seems to be all the rage! This week I discuss the recently published NEJM trial of the anti CD20 agent obinutuzumab in lupus nephritis. Worth a read and listen, paper can be found here: https://www.nejm.org/doi/full/10.1056/NEJMoa2410965
What do you do when observational data and RCTs conflict? This week I'm covering the "real world PEXIVAS" study that was done by the French Vasculitis Study Group. Great read, interesting issues, have a listen and be sure to share with friends!
One of my rare case-report podcasts, a topic that I typically avoid. The craze about CAR-T has also made me a little crazy, though, so I wanted to share what I think may be the ultimate destination for "more B cell depletion than rituximab" strategies.
Article: https://www.nejm.org/doi/full/10.1056/NEJMc2407150
Podcast this week about overdiagnosis! Currently one of my favorite topics and something that I think will be an emerging issue in our field. We recently published a Viewpoint in Lancet Rheumatology (https://pubmed.ncbi.nlm.nih.gov/39341221/) addressing this issue. I'm going to read from it and after that will be giving a few final (spicy) thoughts on the topic. Hope you find it worthwhile! s
New RCT in a new disease with a new drug! But is it as shiny as one would hope? Interesting discussion today about what a trial means, how it will affect practice, and how we could do better as a field. Happy holidays everyone!
Reading one of my recent newsletters this week, this one about PMR tapers. Be sure to subscribe at ebrheum.com if you want access to the visuals and upcoming editions!
Quick rundown of an important rheumatology RCT this week, discussing the IL-5 inhibitor benralizumab for the treatment of relapsing/refractory EGPA.
MANDARA Study: https://www.nejm.org/doi/full/10.1056/NEJMoa2311155
Important methodology podcast this week, covering a lot of ground with expert epidemiologist Rishi Desai. Really enjoyed our conversation and glad to be publishing today!
**House Keeping Note: we actually recorded this ~15 months ago but I somehow lost the audio... which somehow re-appeared! #technology
STAR-RA: https://pubmed.ncbi.nlm.nih.gov/35027405/
Exciting podcast this week about the upcoming / impending use of CAR-T in rheumatology. Highly recommend rheumatologists learn about this now; it's going to be a big thing for many years to come. In a future episode I will lay out my case for skepticism, but for now I think a good run down of the first big published series will be enough!
NEJM CAR-T Case Series: https://www.nejm.org/doi/full/10.1056/NEJMoa2308917
Nature Review Article: https://www.nature.com/articles/s41584-024-01139-z
This week's podcast will be a quick read of one of my newsletters. The title basically speaks for itself! Find the newsletter and my other work at ebrheum.com
At ACR23 I had a twitter-disagreement about steroid tapers from PEXIVAS with Mike Walsh, the lead author on the PEXIVAS trial. He kindly agreed to join me for a moderated discussion. Loved hearing his perspective and have to admit he pulled me closer to his practice... but not all the way there. Longer podcast than usual but I prefer to release audio uncut and this took as long as it needed! Hoping y'all enjoy.
Articles referenced during the podcast:
PEXIVAS: https://www.nejm.org/doi/full/10.1056/nejmoa1803537
PEXIVAS DAH Subset: https://www.atsjournals.org/doi/10.1164/rccm.202308-1426OC
Fussner Abstract: https://acrabstracts.org/abstract/characteristics-and-outcomes-of-participants-with-and-without-diffuse-alveolar-hemorrhage-in-the-plasma-exchange-and-glucocorticoids-in-severe-anca-associated-vasculitis-pexivas-trial/
Walsh Meta Analysis: https://pubmed.ncbi.nlm.nih.gov/35217545/
Rheum4Debate is back!
In this episode I moderated a debate between two pulmonologists about RA-ILD. As a reminder, Rheum4Debate is an Oxford-style debate show, where two debators disagree over a motion during 3 rounds of discussion. The motion for todays show was:
“Asymptomatic patients with rheumatoid arthritis and high risk features for interstitial lung disease should be screened using pulmonary function testing and a high resolution CT scan”
Joshua defended the motion and Scott argued against it. I thoroughly enjoyed the discussion and am sure you will as well!
Nice study this week on an important topic. Can we prevent the development of rheumatoid arthritis by initiating DMARDs during a preclinical phase? Lots to discuss: what does it mean to be "pre-clinical?" How does this fit with other studies of this nature?
Check it out! https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02650-8/fulltext
Informative podcast this week with Dr. Alexander Oldroyd, the first author of the recently published "International Guideline for Idiopathic Inflammatory Myopathy-Associated Cancer Screening." The article itself appeared in Nature Reviews Rheumatology and provides what I think is a very useful framework for approaching this issue.
Article: https://www.nature.com/articles/s41584-023-01045-w
Quick methodology episode this week discussing the concept of "fragility" in randomized controlled trials of lupus. Really enjoyed discussing this paper and was grateful to have been a part of it. Get the text here: https://lupus.bmj.com/content/lupusscimed/11/1/e001068.full.pdf
Today I'm taking another twitter discussion into the podcast realm! Dr. Bhaskar Dasgupta has published hundreds of papers about polymyalgia rheumatica and giant cell arteritis, including a recent publication in Nature Reviews: Rheumatology that piqued my interest (https://www.nature.com/articles/s41584-023-00976-8).
In this podcast we discuss screening for GCA among patients with PMR, what it means to have a diagnosis, the role of novel IL-6 inhibitors, and many other topics. Have a listen and follow me @ebrheum and Dr. Dasgupta @profbdasgupta
Interesting topic and interesting paper this year, including discussion of observational biases, positive and negative controls, and interpreting data as it comes.
Paper: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2810259
Important trial on the podcast this week! I take a deep dive into the recently published SAPHYR study, which evaluated the use of the IL6 inhibitor sarilumab for patients with PMR. A few aggravating quibbles but overall a very useful trial and an important step forward for patients with PMR.
Article: https://www.nejm.org/doi/full/10.1056/NEJMoa2303452
This week I took a twitter disagreement from the impersonal world of twitter to the podcast world of a back and forth conversation. Really enjoyed talking to Dr. Len Calabrese about monoclonal antibodies, FDA regulatory pathways, and life in general.
Excited to share an editorial that I wrote along with Cody Bruggemeyer and Desh Nepal, two trainees with me at the Medical College of Wisconsin. We discussed what I believe to be a pervasive (but seldom discussed) issue in rheumatology RCTs: unblinding. I suspect many of our studies suffer from this. Have a listen!
Happy to share the FIRST randomized trial in CPPD today. It's kind of a weird study but worth a quick discussion.
https://www.sciencedirect.com/science/article/pii/S2665991323001650
This week I dive into the health related quality of life measures that were reported in the ADVOCATE study. I found them overall somewhat convincing and they have affected my practice. Have a listen and be sure to follow along. Find my work at ebrheum.com
Quick episode this week from a recent Perspective piece I had published in the New England Journal. Have a listen or a read!
https://www.nejm.org/doi/full/10.1056/NEJMp2304828
Podcast this week discussing key opinion leaders (KOLs) and pharmaceutical companies. Please subscribe to my newsletter (ebrheum.com) and be sure to share the podcast with friends!
Nice quick RCT rundown this week, covering the ALLHEART study, a pragmatic RCT of urate lowering therapy to reduce cardiovascular disease. Quick listen for a useful teaching point!
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01657-9/fulltext
Today I cover the recently published long-COVID study from Norway. It's a great paper that challenges much of the prevailing wisdom. I think there are some interesting limitations, but anyone who sees post COVID patients (aka all of us) would do well to read it. Or have a listen here!
PDF: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802893
Fun study this week from JAMA Network Open and the French Vasculitis Study Group. They used a target trial emulation (one of my favorites) to ask whether RTX > CYC in AAV (another one of my favorites). I tried to use this to compare between observational and randomized data.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799018
This week I hope to debunk one of rheumatology's "paradoxes." We love to talk about these and subject our fellows to memorizing them for the boards. We often use them to guide clinical practice, but I suspect that many "paradoxes" are actually the result of shoddy epidemiology. Todays' paper from JAMA dermatology covers one that I have heard frequently, which is that steroids cause psoriasis flares. I hope you enjoy!
Follow me @ebrheum and check out my newsletter where I cover more of these (links on ebrheum.com)
Today I'll be reading one of my recent newsletters! It's kind of a fun run-down of my anti-azathioprine stance. As I say in the piece, some patients may benefit from azathioprine and I am not saying it is an entirely useless drug or that nobody should ever prescribe it. Rather, I am just saying that it is likely the worst option for nearly every indication for which it could be prescribed.
Please subscribe AND JOIN my newsletter if you would like to support my writing and podcasting! https://t.co/RIzRvWnSfv
Today I review a recent large meta analysis of randomized controlled trials of statin use. Super interesting findings that have changed my clinical practice. Check out the paper here and listen to the episode!
Paper: https://www.thelancet.com/article/S0140-6736(22)01545-8/fulltext
"Internet driven cult" editorial: https://pubmed.ncbi.nlm.nih.gov/28738422/
Change of pace today! I interviewed Jason Liebowitz and Phil Seo about their new book entitled "Clinical Innovation in Rheumatology: Past, Present, and Future." I thoroughly enjoyed the book and had a great time interviewing them about some of their "futuristic" topics. Grab the book (or better yet, have your division get some copies) at the link below and be sure to share the podcast with friends!
https://www.routledge.com/Clinical-Innovation-in-Rheumatology-Past-Present-and-Future/Liebowitz-Seo/p/book/9781032074917
Quick episode this week to share an editorial I recently wrote with Jay Patel and Anisha Dua. We cover one of my least phrases in medicine, the "diagnosis of exclusion."
Hope you enjoy! Find the original paper here: https://academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keac278/6584804
Exciting (negative) results from a large RCT on the podcast this week as well as a (mini) rant about how we should be spending our time as rheumatologists and the false security of ineffective treatments.
Let me know what you think on twitter @ebhruem
https://www.nejm.org/doi/full/10.1056/NEJMoa2202106
Interesting case-crossover study today evaluating the association between HCQ dosing and risk of SLE flares. Super worth your time to read the paper or listen to this episode!
https://jamanetwork.com/journals/jama/article-abstract/2796634
Podcast is back! This week I discuss a pivotal RCT in dermatomyositis. Check it out and be sure to subscribe to my newsletter at ebrheum.com!
Mixing it up again this week to discuss an editorial by Miguel Hernan and a systematic review of target trials in rheumatology. It's kind of a fun free-form stream of consciousness. Hope you enjoy! Links:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888052/
https://pubmed.ncbi.nlm.nih.gov/32381560/
Quick episode today. I wanted to share an editorial that was recently published in Rheumatology, where I and co-authors (Shannon Tai and Natalie Anumolu) discuss lessons from recent trials in AAV and SLE.
Link to editorial: https://pubmed.ncbi.nlm.nih.gov/35438142/
After some delay, I finally get around to discussing ORAL-Surveillance, a post-marketing safety study of tofacitinib for rheumatoid arthritis. It's an incredibly important trial that will likely affect how all of us practice for the foreseeable future. Link to paper:
https://www.nejm.org/doi/full/10.1056/NEJMoa2109927
After a winter hiatus, the podcast is back! Today I wanted to dive into a 'hotbutton' issue - the question of whether (or not) COVID-19 vaccines "work" for patients with rheumatic diseases. My answer is an emphatic "yes," albeit with a few caveats. Here are the papers I discuss:
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(22)00034-0/fulltext
https://pubmed.ncbi.nlm.nih.gov/35441151/
Hello again! Snappy episode this week about the exciting LoVAS trial, which compared a reduced dose steroid taper for ANCA vasculitis. Be sure to drop by my website at ebrheum.com to subscribe to my newsletter!
In this episode, I talk with Dr. Andy Abril, Chair at the Division of Rheumatology at the Mayo Clinic in Jacksonville Florida. Dr. Abril is one of the lead authors for the 2021 ACR Guidelines on Takayasu’s arteritis.
This project was done in partnership with the Vasculitis Foundation. To review the complete guidelines, visit https://dev.vasculitisfoundation.org/2021-acr-vf-vasculitis-guidelines/ or vasculitisfoundation.org. You can find them on Twitter @vasculitisfound and I am @ebrheum. Thanks for listening!
In this episode, I talk with Dr. Jason Springer, Co-Director of the Vanderbilt Vasculitis Center, about the guidelines for PAN He is one of the lead authors for the ACR/VF Guidelines for Polyarteritis Nodosa.
This project was done in partnership with the Vasculitis Foundation. To review the complete guidelines, visit https://dev.vasculitisfoundation.org/2021-acr-vf-vasculitis-guidelines/ or vasculitisfoundation.org. You can find them on Twitter @vasculitisfound and I am @ebrheum. Thanks for listening!
On today's episode I discuss GCA with Dr. Mehrdad Maz. He is the Division Director of the Kansas University Allergy, Clinical Immunology and Rheumatology Section and served on the Steering Core Committee of the ACR-VF Vasculitis Treatment Guidelines. We cover a lot of great topics!
This project was done in partnership with the Vasculitis Foundation. To review the complete guidelines, visit https://dev.vasculitisfoundation.org/2021-acr-vf-vasculitis-guidelines/ or vasculitisfoundation.org. You can find them on Twitter @vasculitisfound and I am @ebrheum. Thanks for listening!
In today's episode, I talk with Dr. Mehrdad Maz about the newly published guidelines for giant cell arteritis (GCA). Dr. Maz is the Division Director of the Kansas University Allergy, Clinical Immunology and Rheumatology Section. He serves on the Steering Core Committee of the ACR-VF Vasculitis Treatment Guidelines.
This project was done in partnership with the Vasculitis Foundation. To review the complete guidelines, visit https://dev.vasculitisfoundation.org/2021-acr-vf-vasculitis-guidelines/ or vasculitisfoundation.org. You can find them on Twitter @vasculitisfound and I am @ebrheum. Thanks for listening!
The guidelines have finally arrived! I'm kicking off the series today with a conversation about the ANCA vasculitis guidelines. My guest is Dr. Sharon Chung, the director of the UCSF Vasculitis Clinic and the lead investigator on the ACR/Guideline committee. She provided a LOT of great insights; have a listen and let us know what you think!
This project was done in partnership with the Vasculitis Foundation. To review the complete guidelines, visit https://dev.vasculitisfoundation.org/2021-acr-vf-vasculitis-guidelines/ or vasculitisfoundation.org. You can find them on Twitter @vasculitisfound and I am @ebrheum. Thanks for listening!
Hopping in this week to round out my thoughts on ADVOCATE (avacopan in AAV) and covering the recently published AURORA trial for SLE nephritis. Back to the Vasculitis Guidelines Podcast after as soon as they are released!
In this episode we'll be introducing the process by which the 2021 ACR/VF guidelines were produced. My guest is Dr. Sharon Chung. She's the director of the UCSF Vasculitis Clinic and the lead investigator on the guideline committee. Please follow along with future episodes - you can find me @ebrheum and the Vasculitis Foundation is at @vasculitisfound and their website vasculitisfoundation.org.
Welcome to the first episode of the Vasculitis Guidelines Podcast! In Episode 1, I interview Joyce Kullman, Executive Director of the Vasculitis Foundation, about collaborating with the ACR in updating these guidelines, and how patients with vasculitis will ultimately benefit from them. We discuss the complex process of updating these critical guidelines involve years of input from researchers, physicians, and patient themselves.
Steroid free remission! Or is it? This week I discuss a really exciting trial in ANCA vasculitis.
I stole some time to tackle a pressing issue for rheumatologists - to hold or not to hold immunosuppression in patients who are receiving a COVID19 vaccination. We obviously don't have any data on this, but I have always loved this study on influenza vaccination. PDFs at ebrheum.com/twts and follow me on twitter @ebrheum!
We have a great show for you this week! Anisha Dua will be moderating a debate between myself and Max Konig on this motion: "Hydroxychloroquine levels should be monitored in patients with SLE." I learned a ton and thoroughly enjoyed it. Be sure to vote on the post-debate twitter poll to decide the winner!
This week I cover another of my meta-research projects, this one on systematic review and meta analysis (SRMA) growth as compared to randomized clinical trial (RCT) growth. Short and to the point - hope you enjoy! I highly recommend checking out the associated graphs - just take a quick peek at some point while listening. Find them on my twitter handle @ebrheum
Active comparator trial! Always my favorite. Lots of fun topics in this one, including noninferiority trials, crafty endpoints, and PROs. Check it out and let me know what you think! @ebrheum
Another day, another lupus trial, another round of endpoint shenanigans. Why does that matter? How big is the benefit from belimumab in SLE nephritis? Will this save lives and prevent ESRD / RRT? I try to tackle these issues this week and (hopefully) avoid getting myself in trouble. Hope you enjoy the episode! Let me know what you think @ebrheum on twitter!
Great paper to discuss this week - one that may be too good to believe? I highly recommend checking out the pdf first (ebrheum.com/twts) - their graphics are wonderful and do a great job of conveying their message. Also, check out the "2-5-10" rule that I referenced! This is required reading for anyone who rotates with me - easily one of the most useful EBM papers I have ever read.
Quick podcast this week that expands on issues I discuss in Episode 55. Go back and listen to that one first if you have time! I think this is an important issue and it's one I'd like to highlight. Let me know what you think @ebrheum and please share with friends!
The podcast is back! I tune in briefly here to explain where I've been, what I'm doing, and where this will be headed. Feel free to skip right ahead if you'd rather just dig back in!
PEXIVAS has landed! This week I go over the trial and my take on it's results. Impressive undertaking that answered two questions for a subset of patients with AAV - well worth the time to kick back and read the trial in full. Let me know what you think about the podcast @ebrheum!
(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/article/fda-approves-nintedanib-for-ssc-ild-but-temper-your-expectations/
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 sure to vote in the post-debate motion on twitter as well! Find me @ebrheum, Dr. Dua @anisha_dua, and Dr. Fantus @sarahfantus.
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) argued FOR the motion and Dr. Anisha Dua (@anisha_dua) argued AGAINST the motion.
PLEASE be sure to fill out the post debate poll and let us know what you think! You can find it on my twitter account @ebrheum!
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 episode at ebrheum.com!
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 ebrheum.com!
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://emcrit.org/toxhound/tramadont/
All the papers! https://tinyurl.com/yyll5qof
Follow me @EBRheum.
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
This week we tackle two RCTs and try to figure out what to do with etanercept, methotrexate, and placebo (or the lack thereof). Good opportunity for jumping into more PsA trials in the near future - lots of IL-somethings to talk about! Remember to follow the podcast @EBRheum to give feedback and for updates!
We're back! This week I discuss work I did for the rheumatology winter clinical symposium on the quality of RCTs in the rheumatologic literature. Be sure to follow the twitter handle for a descriptive slide and to weigh in on the podcast! @ebrheum
Double episode this week and then I'll be taking the holidays off. I decided to combine two trials of immunotherapy for secondary prevention of cardiovascular disease, the CANTOS trial (canakinumab vs. placebo) and the CIRT trial (methotrexate vs. placebo). It was a good opportunity to debunk both therapies and take a few pot shots at observational trials, "bioplausibility," and surrogate endpoints. Both papers are available on my box account here.
Interesting trial this week pitting an elaborate nurse led group against suboptimal usual care. Suboptimal usual care lost pretty badly, but what to make of this? And does it support the rheumatologist side of the treat to target controversy? Listen to find out and be sure to follow on @EBRheum if you have your own thoughts!
Great article that (kind of) proves something a lot of us already believed; non-opioids management of chronic pain is preferable to opioid management. Lots of caveats, there, as this was a pragmatic trial (literally) with a number of interesting limitations. Follow me @EBRheum to give feedback and go here to get all of the papers!
Every 25 episodes I'd like to step back and touch base about where the podcast is headed. Thanks to everyone who has been listening! Apologies for nothing exciting or useful this week.
Interesting trial this week evaluating a fixed schedule of rituximab vs. a tailored approach to therapy. See you all at ACR this week!
Solid RCT this week that may rock your faith in all those pesky knee injections! Worth a listen before you do another. Find the original article here as usual.
Great article this week on stress related disorders and their relationship with subsequent autoimmune disease. One of my favorite recent papers from my least favorite way to do a study! Remember, all my articles can be found here!
Quick episode today on a small prospective trial on ustekinumab for giant cell arteritis. Papers can all be found here!
This weeks episode discusses the utility of the ACE level in sarcoidosis. Lots of LRs, sensitivty, and specificities today!
This week we discuss the pivotal RAVE trial in all it's rituxan justifying glory. I've also added a handy Box link with all of the papers I've discussed, so check it out if you'd like to follow along! Link here.
Quick podcast this week on the utility of an ANA. It's a frequent reason for referral (17% in this series) to rheumatology offices and this is a useful paper for context. Find the paper itself here.
A recent retrospective study on a rare condition - catastrophic antiphospholipid syndrome - caught my eye in the Journal of Rheumatology this week. I thought it would be a good opportunity to talk about unmeasured confounding and introduce a rare condition that new fellows need to know about. Find the paper itself here.
Short but impactful paper this week on the association between steroids and scleroderma renal crisis. Find the original paper here.
Getting back to our usual format, this week we'll discuss the GIACTA trial, which compared various schedules of tocilizumab to various schedules of placebo and prednisone. It's an important trial that has changed the face of GCA and will be a refreshing RCT to discuss before we dive back into garbagey data next week.
Welcome back! This week we're doing something a little different and discussing a few important studies on the ribosomal P in neuropsychiatric SLE. We also have theme music! Let me know what you think about both on twitter @EBRheum.
Today we'll discuss an important trial on febuxostat (ulloric), which raises important concerns about its safety from a cardiovascular perspective. Be sure to tune in to the #RheumJC discussion that will be happening this Thursday!
Short podcast today on an old RCT addressing the utility of hydroxychloroquine (plaquenil) in lupus. It's an oldie but goodie and one that I enjoyed talking about.
This week we'll discuss the recently published ACR Workforce Study, which estimates a substantial deficit in the workforce by 2030. We'll consider how dire the situation actually is - checkout the paper itself here.
This week the rheumageddon is postponed (yet again) because I researched a paper about the HScore, a scoring criteria for hemophagocytic lymphohistiocytosis (HLH), during a clinical vignettes presentation for fellowshiop. It made sense to do a podcast about that paper and save the rheumageddon for next week. Hope y'all enjoy! Paper can be accessed here.
Quick podcast tonight reflecting the Rheumatology Journal Club (@RheumJC) discussion! I joined as they discussed the use of abatacept in patients with rheumatoid arthritis who develop ILD. It's our first observational trial, so it's ripe for critique! Find the original paper here.
This week we'll discuss a randomized controlled-ish trial, the RIM study. It pits rituximab against placebo as well as... rituximab? We'll talk about how their design convincingly demonstrated that ritixan does not have a benefit over placebo for 8 weeks, but may or may not work after that. Find the trial itself here.
This week we'll discuss a recent trial on mepolizumab - and IL-5 inhibitor - for eosinophilic granulomatosis with polyangiitits. Find the paper here and be sure to follow us on twitter @JBRheum!
Today we'll be discussing the ALMS trial, which pitted cellcept against cyclophosphamide. It's a good trial that has had profound influences on our practice and well worth a read. Access the paper itself here.
Welcome back! Before we talk about cellcept for lupus nephritis, I decided we should flash back to 1996 and discuss one of the early trials that brought us cyclophosphamide. It's a quick discussion that will help set us up nicely for ALMS this Sunday. Remember to follow us on Twitter @JBRheum for updates! Access the paper here.
This week we'll be discussing a trial addressing a controversial topic - starting allopurinol during an acute attack of gout. It's a short podcast on a short paper, but one that could have a big impact on your practice. Be sure to follow us on Twitter @EBRheum! Access the paper itself here.
This week we'll be discussing the recent SCOT trial, which pitting myeloablative autologous stem cell transplant against standard care of cyclophosphamide. Be sure to follow us on Twitter at @EBRheum and checkout @RheumJC for a great online discussion of the trial! Access the paper itself here: https://tinyurl.com/y9xdkvzs
Today we discuss the 2014 JOQUER paper, a randomized controlled trial of hydroxychloroquine (plaquenil) vs. placebo. You can find the paper here: https://tinyurl.com/ydbb6to9
Today we discuss a recent letter in JAMA-Internal medicine. Find the original paper here and be sure to subscribe to the podcast!
Welcome to the Evidence Based Rheumatology Podcast! A (very) brief introduction to the podcast.