Rheum Round-up: Arthritis Medication Updates - A New Methotrexate?, Tocilizumab In COVID-19

Here are the top stories recently covered by DocWire News in the rheumatology section. In this edition, read about upadacitinib versus methotrexate in rheumatoid arthritis, tocilizumab in COVID-19, uncemented versus cemented total knee arthroplasty, and how dementia affects surgery outcomes.

Methotrexate is one of the most common drugs used to treat rheumatoid arthritis (RA). When used early, disease-modifying antirheumatic drugs (DMARDs) can be clinically beneficial for RA patients. However, a study found that treatment with upadacitinib in patients with little or no exposure to DMARD methotrexate may have better outcomes as opposed to trying methotrexate.

Arthritis drugs have taken the spotlight in many COVID-19 trials. Two of the latest studies to come out assessed the efficacy of tocilizumab and found that it may reduce mortality rate in COVID-19 patients, although not without adverse events.

Despite total knee arthroplasty (TKA) becoming increasingly more common, debate remains on the optimal approach. One aspect of the debate is whether cemented versus uncemented TKA is superior. In a recent study, researchers compared the costs and cost-effectiveness of cemented versus uncemented TKA one year postoperatively, as well as short-term functional outcomes. The authors concluded that costs were comparable between the two options.

Dementia patients undergoing common surgical procedures may be at greater risk of in-hospital mortality, non-home discharge, and longer hospital length of stay (LOS), according to new research. For dementia patients being treated for fracture or dislocation of the hip and femur, compared to patients without dementia, the odds ratio (OR) for in-hospital mortality was 1.16 and for home discharge was 0.66; the mean difference in hospital LOS was 0.24 days. For total or partial hip replacement, the ORs for in-hospital mortality and home discharge for dementia patients versus those without dementia were 1.41 and 0.19, respectively; the mean difference in LOS was 1.21 days.