Arkansas Geek Central is the website for Geeks, Nerds, Trekkies/Trekkers, science fiction buffs, cosplayers, programmers, artists, web designers, etc residing in Arkansas. This site was created to inform the Geeks of Arkansas and surrounding areas about upcoming events that are of interest. If you know of any events not posted here, please let us know. Is Arkansas Geek Central for you? If you fit in to one (or more) of the following, this site is for you: * If you ever cosplayed as your favorite anime or sci-fi character. * If you spend more time tweaking your computer than actually using it. * If you ever debated battles between 'The Empire' from Star Wars VS 'Starfleet' from Star Trek. * If you ever tried to calculate the average air speed velocity of an unladen swallow. * You know more than 3 languages, and most of those are not spoken.
Facebook
Categories
Conference (50)
Conventions (238)
Events (157)
Geek Holidays (36)
Get Togethers & Meetings (168)
Groups (5)
Misc Arkansas (1)
Movies (35)
Random Tidbits (1)
Uncategorized (2)
Website (10)
Tag Cloud
The European League Against Rheumatism has updated treatment guidelines for the management of large vessel vasculitis. Jan 01, 2017 Background New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations.
GEEK GROUP LINKS
Computers & Internet
Conventions & Conferences
Costumes & Cosplay
Gaming
Historical
Miscellaneous
Models
Science
Sports
MORE INFO
“The inclusion or exclusion of combinations of csDMARDs within the bullet points elicited long debates within the respective breakout group and the whole Task Force (and the withdrawal of one Task Force member),” according to the report. The wording as it pertains to glucocorticoids has changed from “low-dose short-term” use of them to merely “short-term” because, in Smolen’s words, “There are data that a single IV of 250mg (which is not low dose) leads to excellent results and also that 30mg prednisone daily tapered rapidly gives good outcomes. For csDMARD combinations, the data show that when MTX is combined with glucocortiocids, there is no advantage of also adding further csDMARDs…but adverse events are much more frequent.” The new update instead directs rheumatologists to attempt different csDMARDs if the first does not achieve targets (seventh recommendation), and to attempt the addition of a bDMARD or tsDMARD if that still does not move patients closer to treatment goals (eighth). According to the report, “early intolerance for a csDMARD should not be considered as a treatment failure, which would imply moving immediately to the next phase of the algorithm, but rather require reinstitution of another first csDMARD (replacement).” The second of those two was expanded from the 2013 edition to include tsDMARDs in order to acknowledge the use of Jak inhibitors, which had previously been considered an option following a treatment failure with bDMARDs. “We recommend stratification by risk factors of rapid damage progression,” says Smolen, saying the reprioritization comes now that more data regarding Jak inhibitors have become available. “Also,” he says, “we generally recommend combining bDMARDs and Jakinibs with MTX or other csDMARDs, since the combination appears generally more efficacious than monotherapies.” The ninth and tenth recommendations deal with potential difficulty of the previous two recommendations, logically suggesting that “bDMARDs and tsDMARDs should be combined with a csDMARD; in patients who cannot use csDMARDs as comedication, IL-6 pathway inhibitors and tsDMARDs may have some advantages compared with other bDMARDs,” and then “If a bDMARD or tsDMARD has failed, treatment with another bDMARD or a tsDMARD should be considered; if one TNF-inhibitor therapy has failed, patients may receive another TNF-inhibitor or an agent with another mode of action.” The final two recommendations in the new EULAR update deal with tapering treatment if patients are in remission: the eleventh suggesting if GC use has already been tapered, and a patient is on both a bDMARD and a csDMARD that the bDMARD may be tapered; and the twelfth finally suggesting persistent remission creates an opening for the tapering of the csDMARD. Though the report is expansive and direct, Smolen says there is still much to be learned in order to inform future recommendations. “We still do not know if Jakinibs work after other ones have failed, if IL-6 inhibitors work if others have failed, and there are also no efficacy data available for the use of TNF-inhibitors (or other bDMARDs) after agents with another mode of action have failed,” he told MD Magazine. The full report, “EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update” was published this month in Annals of the Rheumatic Diseases. Joseph Smolen photograph courtesy of the Vienna School of Clinical Research. Related Coverage: RA Study Finds Methotrexate and TNFi Regimen Produced Better Adherence Than Triple Therapy Potential Rheumatoid Arthritis Blockbuster Gets First Approval Rheumatology Community Calls for Collaboration to Fight Arthritis Comorbidities