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.