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Lupus

Rheum Chapter Notes (4.26.2024)

Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.

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Predicting Infection in Lupus Nephritis

Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN. 

This study analyzed 111 non-infected LN patients, 72 infected LN patients, and 206 healthy controls (HCs), looking at patient

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Predicting CKD Outcomes in Lupus Nephritis

An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class.

A multicentre observational study of patients with biopsy-proven LN; either proliferative (PLN) or membranous (MLN) lupus nephritis were compared regarding

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Lupus Accelerating Breakthroughs Consortium Partners with FDA https://t.co/GW7Zy72oIZ https://t.co/AGYY8WDKcK
Dr. John Cush @RheumNow( View Tweet )

Lupus Accelerating Breakthroughs Consortium Partners with FDA

EurekAlert!

The Lupus Research Alliance (LRA), founder and administrator of the Lupus Accelerating Breakthroughs Consortium (Lupus ABC), announced today at the Consortium’s first anniversary meeting an expanded partnership with the U.S. Food and Drug Administration (FDA) with the inclusion of the Center

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JAMA: SLE Review Drs.Siegel & Sammaritano (from HSS in NYC) published an impressive overview of SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide. https://t.co/byr1hRA6rV https://t.co/wZeIdfTlH0
Dr. John Cush @RheumNow( View Tweet )
SLE in JAMA (authored by Drs Siegel & Sammaritano at HSS), impressive, full-read review, Covers: - Presentations: skin, Jts, brain, heme, etc - Treatments - Prognosis - Complications: CV, infx, CA - FAQs https://t.co/7WHYK3DgIf https://t.co/pC2MSCpn52
Dr. John Cush @RheumNow( View Tweet )

Burnout or Retire (4.12.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?

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Is IL-6 a potential therapeutic target in neuropsychiatric lupus (NPSLE)? Just published in the Journal of Neuroinflammation- Some interesting findings from the Putterman lab in a murine NPSLE model... https://t.co/7yn2o7ZRxS

chaim putterman @ChaimPutterman( View Tweet )

Neuropsychiatric SLE - 2/3 Improved at 12 Months

The management and outcomes of neuropsychiatric systemic lupus erythematosus (NPSLE) can be challenging as there is limited data. 

A retrospective cohort study identified 350 NPSLE events (between 1999-2015) defined by ACR definitions and categorized as being:

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JAMA: SLE Review

Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.

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Polycyclic Aromatic Hydrocarbons Increase Lupus Risk A case-controlled study shows environmental exposure to polycyclic aromatic hydrocarbons (PAH) may increase the risk of developing systemic lupus erythematosus (SLE). https://t.co/04MPWwQlUr https://t.co/iTf6EmKLId
Dr. John Cush @RheumNow( View Tweet )
10 SLE pts w/ ITP and thrombocytopenia were Rx w/ belimumab IV (age 34.3 ± 14 yrs). Overall response rate of thrombocytopenia was 90%, w/ improvement in platelets, lymphocyte count, Hgb, dsDNA, C3, C4 and SLEDAI https://t.co/5U7mHoY0fg https://t.co/oOqUJqUNgl
Dr. John Cush @RheumNow( View Tweet )
Neuropsychiatric (NP) Sxs compared in SLE (n 609), controls (463) & IA patients (489). Hallucinations and severe headache were most directly attributable to NP-SLE. https://t.co/JWbyHmpWcq https://t.co/gBubdEjq63
Dr. John Cush @RheumNow( View Tweet )

1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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#RNL2024 @RheumNow @Bweber04 Asymptomatic Lupus has higher rate of atherosclerosis at all age grps 35-44 yo F with SLE: 50X increased risk of MI compared to healthy pts in Framingham RA pts at 1.5x risk of CVD https://t.co/wL4U8Gh5JM

Dr. John Cush @RheumNow( View Tweet )

Polycyclic Aromatic Hydrocarbons Increase Lupus Risk

A case-controlled study shows environmental exposure to polycyclic aromatic hydrocarbons (PAH) may increase the risk of developing systemic lupus erythematosus (SLE). 

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Epigenetics and Autoimmune Skin Disease

EurekAlert!

The central dogma proposed that genetic information predominantly transfers from DNA to RNA during gene expression to make a functional product protein. This absolute theory has been debunked because of the influence of the environment on how genes are transcribed. According to the human

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Autoimmune dz pts have higher risk of macular degeneration. Cleveland Clinic study of 200K AMD vs controls, finds: - SLE (RR 1.73) - Scleroderma (1.65) - Psoriasis (1.48) - Vasculitis (1.48) - RA (1.4) - UC &CD (~1.42) - Sarcoid (1.42) https://t.co/RrXaaqz3Aw https://t.co/9dGoGRCBYu
Dr. John Cush @RheumNow( View Tweet )

Activity & Pain Tolerance (3.29.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, including where you should sit in clinic and why you should worry about secondary Sjogren's in RA.

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Higher Rates of Childlessness in Rheumatic Diseases

A large Finnish population study shows that several rheumatic diseases may impair reproduction and pregnancy outcomes, with significantly higher rates of childlessness or fewer children overall for women.

A nationwide cohort study of 5 339 804 Finnish citizens, born 1964–1984,

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Series of Chronic Cutaneous Lupus responding to anifrolumab. 6 pts (4 DLE, 2 CCLE) betw 37-66 yrs old w/ Dz duration 10.5 yrs, 4 w/ SLE, all refractory to multiple therapies Rx w/ ANIF w/ Skin benefit. 1 developed herpes, 1 had worsening of nephritis https://t.co/6imLq3TDMu https://t.co/BMoIQhRtYs
Dr. John Cush @RheumNow( View Tweet )

Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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91 #SLE pts w/ no baseline synovitis, underwent Ultrasound exams. 10 yrs later, 31 had clinical progression of arthritis. Pts w/ progression, 75% had baseline subclinical synovitis on US vs without progression 77% did NOT have an abnormal US at baseline https://t.co/MN9wkNgsQV https://t.co/ozgvjFI531
Dr. John Cush @RheumNow( View Tweet )

Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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