Announcements & News
Rheumatology at OARSI – 2019
May 14, 2019
Members of the Section of Rheumatology presented research at the Osteoarthritis Research Society International (OARSI) meeting in Toronto during May 2-5, 2019.
OARSI Treatment Guidelines Update
Ingrid Meulenbelt, PhD and Tuhina Neogi, MD, PhD
Moving Towards Patient-Centered Treatment Guidelines for Knee and Hip OA
Tim McAlindon, MD, MPH
SEVERITY OF STRUCTURAL AND INFLAMMATORY FEATURES ARE ASSOCIATED WITH LOWER PRESSURE PAIN THRESHOLDS IN HAND OSTEOARTHRITIS
P Steen Pettersen, T Neogi, K Magnusson, HB Hammer, TK Kvien, T Uhlig, IK Haugen
IMAGING THE SYNOVIUM IN OA
Ali Guermazi, MD, PhD
Plenary Session 4: Pain
Moderated by: Rachel Miller, PhD and Tuhina Neogi, MD, PhD
IS THERE OBJECTIVE EVIDENCE OF NEUROPATHY IN KNEE OSTEOARTHRITIS IN NATIVE OR REPLACED KNEES BASED ON CLINICAL EVALUATION? THE MULTICENTER OSTEOARTHRITIS STUDY
P Ballal, J Scholz, L Frey-Law, N Wang, M C Nevitt, C E Lewis, T Neogi
PHENYLALANINE IS A POTENTIAL NOVEL MARKER FOR RADIOGRAPHIC KNEE OSTEOARTHRITIS PROGRESSION: THE MOST STUDY
G Zhai, X Sun, E Randell, M Liu, N Wang, I Tolstykh, P Rahman, J Torner, CE Lewis, MC Nevitt, A Guermazi, F Roemer, DT Felson
INCREASES IN ACTIVITY DO NOT RESULT IN INCREASES IN CUMULATIVE MEDIAL KNEE LOADING WITH LATERAL WEDGE
RK Jones, A Liu, SC Carter, MJ Parkes, DT Felson
LONGITUDINAL CHANGES IN GAIT WAVEFORMS WITH ACL RECONSTRUCTION
D Kumar, K E Costello, D Chan, M Tanaka, R B Souza, C Ma, X Li
SEX AND RACE RELATED DIFFERENCES IN GROUND REACTION FORCES DURING WALKING AND INTERACTIONS WITH KNEE PAIN AND OSTEOARTHRITIS IN A LARGE COHORT
D Kumar, KE Costello, T Neogi, CE Lewis, N Segal, D Gross, M Nevitt, CL Lewis, DT Felson
GROUND REACTION FORCE PATTERNS IN KNEES WITH AND WITHOUT PAIN AND RADIOGRAPHIC OSTEOARTHRITIS: DESCRIPTIVE ANALYSES FROM A LARGE COHORT
KE Costello, DT Felson, T Neogi, N Segal, CE Lewis, KD Gross, M Nevitt, CL Lewis, D Kumar
RELATIONSHIP OF PATELLOFEMORAL JOINT OSTEOARTHRITIS TO TRAJECTORIES OF PHYSICAL FUNCTION OVER 7 YEARS: THE MOST STUDY
HF Hart, T Neogi, MP LaValley, DK White, Y Zhang, M Nevitt, J Torner, C Lewis, JJ Stefanik
IS THE ASSOCIATION OF BODY MASS INDEX WITH OPIOID USE MEDIATED BY NUMBER OF PAINFUL JOINTS OR DEPRESSIVE SYMPTOMS: THE MULTICENTER OSTEOARTHRITIS STUDY
LC Carlesso, R Jafarzadeh, A Stokes, D Felson, N Wang, NA Segal, L Frey-Law, CE Lewis, M Nevitt, T Neogi
PROSPECTIVE ASSOCIATION OF PHYSICAL ACTIVITY TO FOLLOW-UP FATIGUE IN KNEE OSTEOARTHRITIS: THE MOST STUDY
H O Fawole, JL Riskowski, A Dell’Isola, MP Steultjens, SF Chastin, MC Nevitt, J Torner, CE Lewis, DT Felson
DOES SLOW WALKING SPEED PREDICT ALL-CAUSE MORTALITY AND KNEE REPLACEMENT IN ADULTS WITH KNEE OSTEOARTHRITIS?
H Master, LM Thoma, T Neogi, M LaValley, M Christiansen, D Mathews, L Neely, DK White
HOW SEDENTARY TIME RELATES TO RISK OF WORSENING KNEE CARTILAGE DAMAGE OVER TWO YEARS: THE MULTICENTER OSTEOARTHRITIS STUDY (MOST)
D R Mathews, T Neogi, JJ Stefanik, A Guermazi, FW Roemer, LM Thoma, H Master, MB Christiansen, MC Nevitt, J Torner, DK White
HOW DOES PREVALENCE OF OSTEONECROSIS OF THE KNEE IN THE COMMUNITY COMPARE WITH FINDINGS FROM ANTI-NERVE GROWTH FACTOR TRIALS?: ESTIMATES FROM TWO POPULATION-BASED DATA SOURCES
T Neogi, D Felson, C Peloquin, Y Jin, J Lii, S Kim
TRENDS IN PRESCRIPTION PAIN MANAGEMENT AMONG US ADULTS WITH ARTHRITIS OR BACK PAIN, 1999-2014
A Stokes, KM Berry, K Hempstead, T Neogi
PHYSICAL THERAPY AND UTILIZATION OF INTRA-ARTICULAR THERAPIES IN KNEE OSTEOARTHRITIS: PRELIMINARY FINDINGS FROM A LARGE INSURANCE DATABASE
D Kumar, C Peloquin, LN Marinko, J Camarinos, M Dubreuil, DT Felson
IS THE HYPERTROPHIC PHENOTYPE OF TIBIOFEMORAL OSTEOARTHRITIS ASSOCIATED WITH FASTER STRUCTURAL PROGRESSION? THE MOST STUDY
MD Crema, A Guermazi, DT Felson, X Sun, MC Nevitt, CE Lewis, J Torner, FW Roemer
RELIABILITY OF A NEW SCORING SYSTEM FOR INTRAARTICULAR MINERALIZATION OF THE KNEE: BUCKS (BOSTON UNIVERSITY CALCIUM KNEE SCORE)
A Guermazi, M Jarraya, JA Lynch, DT Felson, M Clancy, M Nevitt, C Lewis, J Torner, T Neogi
CROSS-SECTIONAL STUDY OF INTRA-ARTICULAR MINERALIZATION ON KNEE DUAL-ENERGY COMPUTED TOMOGRAPHY: THE MULTICENTER OSTEOARTHRITIS STUDY
M Jarraya, T Neogi, J A Lynch, M Clancy, DT Felson, M Nevitt, CE Lewis, J Torner, A Guermazi
BONE MARROW LESION SUBTYPE AND SYMPTOMS IN KNEE OSTEOARTHRITIS
T Perry, MJ Parkes, R Hodgson, DT Felson, NK Arden, TW O’Neill
THE ASSOCIATION OF BODY MASS INDEX WITH PAIN SENSITIZATION: THE MULTICENTER OA STUDY
LC Carlesso, D Felson, NA Segal, L Frey-Law, N Wang, CE Lewis, M Nevitt, T Neogi
NEUROPATHIC-LIKE PAIN IN PERSONS WITH HAND OSTEOARTHRITIS AND ASSOSIATIONS WITH QUANTITATIVE SENSORY TESTING
P Steen Pettersen, T Neogi, M Gloersen, K Magnusson, HB Hammer, TK Kvien, T Uhlig, IK Haugen
CONDITIONED PAIN MODULATION AND TEMPORAL SUMMATION IN PERSONS WITH HAND OSTEOARTHRITIS AND ASSOCIATIONS WITH PAIN SEVERITY
P Steen Pettersen, T Neogi, K Magnusson, HB Hammer, TK Kvien, T Uhlig, IK Haugen
RELATION OF SENSITIZATION AND CONDITIONED PAIN MODULATION TO POST-KNEE REPLACEMENT PAIN
T Neogi, N Wang, C E Lewis, M Nevitt, L Frey-Law
TWO APPROACHES TO EVALUATE THE ASSOCIATIONS BETWEEN PATELLOFEMORAL JOINT ALIGNMENT, MORPHOLOGY, RADIOGRAPHIC OSTEOARTHRITIS AND ANTERIOR KNEE PAIN: THE MOST STUDY
EM Macri, T Neogi, I Tolstykh, R Widjajahakim, CE Lewis, JC Torner, MC Nevitt, M Roux, JJ Stefanik
RELATIONSHIP BETWEEN HIP/LOW BACK SYMPTOMS AND PAIN SENSITIZATION IN PEOPLE WITH SYMPTOMATIC KNEE OSTEOARTHRITIS: THE MULTICENTER OSTEOARTHRITIS (MOST) STUDY
HP French, CE Lewis, X Sun, N Segal, CL Lewis, T Neogi
RheumNow article: Omega-3 Rich Fish Lowers Gout Flares
May 1, 2019
Boston researchers have shown that consumption of fish rich in omega‐3 polyunsaturated fatty acids (n‐3 PUFA) leads to a lower risk of recurrent gout flares.
See new article in RheumNow that references results from the Boston University Online Gout Study, published recently in Arthritis & Rheumatology
Recent article on gout highlighted in Healio-Rheumatology
April 18, 2019
A recent article was featured in the online publication 
Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Dietary omega-fatty acids linked to lower risk of recurrent gout flare. Arthritis Rheumatol. 2019 Mar 25 doi: 10.1002/art.40896 [Epub ahead of print] PMID:30908893.
Click here to view
Maureen Dubreuil named as BU-CTSI Pilot Awardee
March 13, 2019
Boston University Clinical and Translational Science Institute (BU-CTSI) is pleased to announce the recipients of the 2018-2019 Integrated Pilot Grant Program.
Maure en Dubreuil, MD, MScIncidence and Predictive Factors for Joint Replacement Surgery in Spondyloarthritis
This study will look at the rates of hip and knee replacement surgeries among people who have ankylosing spondylitis, a form of arthritis causing inflammation in the spine. By examining the surgery rates over time and their relation to medication history, we hope to understand if newer therapies for ankylosing spondylitis help to control arthritis at sites outside of the spine. |
Dr. Tuhina Neogi is new Chief of Rheumatology
January 9, 2019
Dr. Tuhina Neogi is new Chief of Rheumatology
We are delighted to announce that Tuhina Neogi, M.D., Ph.D., Professor, Department of Medicine has accepted our offer to become Chief of the Rheumatology Section effective January 1, 2019. Dr. Neogi received her M.D. from the University of Toronto and Ph.D. from the Boston University School of Public Health. She leads an internationally known research team focused on knee osteoarthritis and gout, pain mechanisms in osteoarthritis, and methodologic issues in rheumatic diseases. She has served on a number of national and international committees and organizations, including guideline writing and FDA committees. Her work has been continuously supported by both NIH and national foundations. She is a past recipient of the prestigious Henry Kunkel Young Investigator Award from the American College of Rheumatology and the Robert Dawson Evans Research Mentoring Award from the Department of Medicine. She is also leading the CTSI’s Research Career Support Program. Dr. Neogi is an exceptional investigator, clinician, mentor, and role model. We are thrilled that she has so enthusiastically embraced this critically important leadership opportunity for our department and look forward to working with her.
As part of our strategy to enhance further the clinical and academic programs in Rheumatology, the Sections of Rheumatology and Clinical Epidemiology will be administratively and programmatically re-unified starting January 1, 2019. I would like to express my gratitude to Drs. Robert Simms (Chief, Rheumatology Section) and David Felson (Chief, Clinical Epidemiology Section) for their thoughtful and generous support of the consolidation of the two sections. Their selfless approach to building rheumatology through the consolidation under Dr. Neogi’s leadership has been both remarkable and admirable. Dr. Simms will be appointed an Evans Scholar and will be further building the Scleroderma Program. Dr. Felson will be assuming a more prominent leadership position within the Clinical and Translational Science Institute and continue to expand his very prominent research program. We are very grateful to Drs. Simms and Felson for their many years of service to the department and look forward to working with them in their new roles.
Posted on Monday, January 7th, 2019
http://www.bumc.bu.edu/medicine/2019/01/07/tuhina-neogi-is-new-chief-of-rheumatology/
Department of Medicine
Boston University Medical Center
715 Albany Street, Evans 113
Boston, MA 02118
(617) 358-3510
Recent article highlighted in Healio
November 27, 2018
A recent article was featured in the online publication
Carlesso LC, Segal NA, Frey-Law L, Zhang Y, Lu N, Nevitt M, Lewis CE, Neogi T. Pain susceptibility phenotypes in those free of knee pain with or at risk of knee osteoarthritis: The Multicenter Osteoarthritis Study. Arthritis Rheumatol. 2018 Oct 11. doi: 10.1002/art.40752. [Epub ahead of print] PMID:30307131.
Click here to view
Recent publication in the news
November 9, 2018
A recent paper, published in October in JAMA Internal Medicine, detailed research in a large observational study exploring the risk of CKD among patients prescribed allopurinol for gout. The research was cited in Internal Medicine News and in the Highlights section of JAMA Network.
Vargas-Santos AB, Peloquin CE, Zhang Y, Neogi T. Association of chronic kidney disease with allopurinol use in gout treatment [published online October 8, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.4463Google Scholar
Recent publication in Arthritis & Rheumatology cited in ScienceDaily and EurekAlert
November 9, 2018
A paper on persistent pain and OA published in Arthritis & Rheumatology in October was referenced in ScienceDaily and EurekAlert
Carlesso LC, Segal NA, Frey-Law L, Zhang Y, Lu N, Nevitt M, Lewis CE, Neogi T. Pain susceptibility phenotypes in those free of knee pain with or at risk of knee osteoarthritis: The Multicenter Osteoarthritis Study. Arthritis Rheumatol. 2018. Epub 2018/10/12. doi: 10.1002/art.40752. PubMed PMID: 30307131.
Tuhina Neogi featured in two podcasts on gout on The Curbsiders
November 9, 2018
https://thecurbsiders.com/podcast/113-gout-uric-acid-targets-urate-therapy
https://thecurbsiders.com/podcast/112-gout-flares-bathtubs-and-firefighting
About The Curbsiders
The Curbsiders is an Internal Medicine Podcast featuring three board-certified Internists as they interview (“curbside”) the experts to provide listeners with clinical pearls and practice-changing knowledge. Join Dr. Matthew Watto, Dr. Stuart Brigham, and Dr. Paul Williams as they serve up some triple-distilled knowledge (and maybe a little humor) for your continuing medical education. No boring lectures here, just the stuff you wish they’d taught in medical school and residency. For more information, visit www.thecurbsiders.com.
The Curbsiders are board-certified Internists practicing in San Antonio, TX. The opinions expressed on this show are those of The Curbsiders and do not necessarily represent the views and opinions of their places of employment. The opinions expressed on this podcast are meant for entertainment and education and should not be used to diagnose or treat any medical condition nor should they be used as a substitute for medical advice from a qualified, board-certified practicing clinician.
Publication highlighting the differential MI risk of various NSAIDs in spondyloarthritis and osteoarthritis
Diclofenac May Boost MI Risk in Patients with Spondyloarthritis
May 7, 2018 • By Marilynn Larkin
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NEW YORK (Reuters Health)—Risk of myocardial infarction (MI) is increased in patients with spondyloarthritis (SpA) who use the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, but not in those who take naproxen, researchers say.
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Maureen Dubreuil, MD, MSc, of Boston University School of Medicine, and colleagues analyzed 20 years of medical records from the U.K.’s Health Improvement Network for adults ages 18–89 with incident ankylosing spondylitis (AS) or psoriatic arthritis (PsA), two forms of SpA. Controls had incident osteoarthritis (OA).
Within each cohort, the team then matched each MI case to four controls without MI.
NSAID use was categorized as a) current (prescription within 180 days prior to index date); b) recent (181-365 days); or c) remote (>365 days).
The daily dosage of diclofenac was 100 mg or more in 92% of individuals with OA, 95% of those with AS and 92% of those with PsA. The most common daily dosage of naproxen was 1,000 mg (55%); the dose was 1,000 mg or more in 56% of patients with OA, 63% of those with AS and 72% of those with PsA.
Among those whose most recent prescription was an NSAID other than diclofenac or naproxen, the most common drugs were ibuprofen (55%), celecoxib (11%), meloxicam (10%), rofecoxib (7%), etoricoxib (5%), indomethacin (3%) and etodolac (3%). All other NSAIDs accounted for 2% or less of prescriptions.
Within the SpA cohort of 8,140 and the OA cohort of 244,339, there were 115 and 6,287 cases of MI, respectively.
As reported online April 19 in Annals of Rheumatic Diseases, current diclofenac use was associated with an adjusted OR of 3.32 for MI in SpA patients. The risk was also increased in those with OA (aOR, 1.26).1
A similar pattern was seen with current use of other NSAIDs (aOR, 1.17), but not with current naproxen use (aOR 0.98).
Because current diclofenac was associated with increased MI risk, the authors also assessed whether recent use (18–365 days from prescription date) conferred risk. The unadjusted OR for recent use in SpA was 1.45, and in OA, 0.94. By contrast, recent naproxen was not associated with an increased or decreased risk in either SpA or OA.
Overall, the authors state, “Current use of diclofenac in SpA was associated with a twofold to threefold risk of MI relative to remote use of any NSAID.”
“[Although] this finding warrants some concern,” Dr. Dubreuil tells Reuters Health, “similar studies should be conducted in other data sets and other populations to help determine if a change in clinical practice is warranted.”
“If confirmed,” she says by email, “it is possible that subsequent treatment guidelines would recommend for or against a specific NSAID as first-line treatment in spondyloarthritis.”
Daniel Solomon, MD, MPH, chief, Section of Clinical Sciences, Divisions of Rheumatology and Pharmacoepidemiology at Brigham and Women’s Hospital in Boston comments to Reuters Health by email, “We know that all NSAIDs confer cardiovascular [CV] risk. However, most patients with normal CV risk who use these agents intermittently will not experience harm. Chronic use of NSAIDs in patients with certain risk factors is associated with substantial potential for CV and other adverse events.”
“The best data we have on these issues comes from large randomized controlled trials, such as PRECISION which tested different NSAIDs across patients with osteoarthritis (OA) or rheumatoid arthritis (RA),” says Dr. Solomon, who was a coauthor on PRECISION.2
“No important differences were found in relative risks across different NSAIDs by disease,” he notes. “In other words, patients with OA and RA experienced the same relative risks by NSAID. However, the CV risk was higher in RA so absolute risks were higher for the RA patients.”
The authors of the current study “specifically examined patients with spondyloarthritis and with OA and found that use of current diclofenac conferred an increased relative risk for CV events compared to past use among both patient groups, but the relative risk was increased for SpA compared with OA,” he says.
“This is interesting and there are biologic reasons why this is plausible,” he says, “but by no means are these results practice-changing. NSAID observational studies are very tricky because of confounding by indication as well as over the counter NSAID use. These results should generate new hypotheses that might be tested in prospective cohorts.”
Patients should not be told to steer clear of diclofenac, he adds. “All NSAIDs, including celecoxib, confer CV, gastrointestinal and renal risk. Patients should not use these agents chronically if they have known CV or renal disease.”
Reference
- Dubreuil M, Louie-Gao Q, Peloquin CE, et al. Risk of myocardial infarction with use of selected non-steroidal anti-inflammatory drugs in patients with spondyloarthritis and osteoarthritis. Ann Rheum Dis. 2018 Apr 19. pii: annrheumdis-2018-213089. [Epub ahead of print]
- Nissen SE, Yeomans ND, Solomon DH, et al. Cardiovascular safety of celecoxib, naproxen or ibuprofen for arthritis. N Engl J Med. 2016 Dec 29;375(26):2519-29. Epub 2016 Nov 13.