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Advances in the treatment of autoimmune hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive liver disease caused by immune system dysregulation that targets the liver. If untreated, AIH can lead to severe complications, including cirrhosis and liver failure. 

An overview of AIH and treatment approaches was recently published in the Journal of Clinical and Translational Hepatology.

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Survey of UK Rheumatology pts (n 876 found 55% take daily supplements costing £10 to £200 per month (most common: vit D, C, B complex, MVI Omega 3/6). 82% take Prescription, OTC, or non-prescription pain meds, 13% sleep aids. Half of NSAID pts also take OTC supplements… https://t.co/VpMG9SiE1E https://t.co/SJYUfogeVJ
Dr. John Cush @RheumNow (  View Tweet)
211 SSc patients, men and younger women, have lower BMD than the population (Osteopenia in 52% & 16.5% osteoporosis; P=0.001). Low BMD in women assoc w/ Finger ulcers, diffuse involvement, older age, & being post-menopausal https://t.co/E743uu0NgX https://t.co/9se7CSdOoK
Dr. John Cush @RheumNow (  View Tweet)
Nationwide Readmissions Database (NRD) study of 133,187 #RA pts found that 48% were "frail". Hospital readmissions were significantly higher in the RA frail pts (57% vs 31%), & hospitalized, frail patients also had significantly higher mortality (3.36% vs 0.39%) & longer LOS… https://t.co/6lF4wrC87B https://t.co/mWJGIPbEjc
Dr. John Cush @RheumNow (  View Tweet)
A Keto Diet for Autoimmune Disorders? Scientists have long suspected the keto diet might be able to calm an overactive immune system and help some people with diseases like multiple sclerosis. https://t.co/7mX6Ue4FdX https://t.co/qtOwdKfqu4
Dr. John Cush @RheumNow (  View Tweet)
Virtual Yoga Effective in Chronic Low Back Pain A randomized trial of 140 adults with chronic low back pain (CLBP) demonstrated that virtual yoga instruction resulted in significant improvements in CLBP patients compared to the wait-list control group. https://t.co/eQcib2J6Se https://t.co/ooRPXgjY4g
Dr. John Cush @RheumNow (  View Tweet)
JAKi Safety Across Adults With RA, PsA, AS, and nr-axSpA: 15,000 Patient-Years of Data View the safety of a JAKi across the SELECT clinical program, including in the context of active comparators, in a new poster sponsored by AbbVie US Medical Affairs https://t.co/Zi9i5YovSA https://t.co/rqDdimQn3h
Dr. John Cush @RheumNow (  View Tweet)

EULAR Review of Lifestyle Improvements for Rheumatic Patients

A EULAR taskforce has evaluated the effect of lifestyle behaviors in rheumatic and musculoskeletal diseases (RMDs) and concluded that there is moderate evidence for a small benefit for certain dietary components, but overall, high-level evidence regarding dietary exposures on outcomes in RMDs is lacking.

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Weight Loss Drugs and the Loss of Skeletal Muscle Mass

A recent commentary published in The Lancet journal highlights the critical importance of skeletal muscle mass in the context of medically induced weight loss, particularly with the widespread use of GLP-1 receptor agonists.

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ACIP now recommendsa pneumococcal conjugate vaccine (PCV) for all PCV-naive adults >50 yrs. Single dose of PCV (PCV15, PCV20, or PCV21) in adults >50 yrs. Pt 19-64 yrs w/ underlying conditions (prev. recommended) could recv the newly approved PCV21. https://t.co/es4KUuiYqy https://t.co/rVcIgZOLjx
Dr. John Cush @RheumNow (  View Tweet)
In an RCT of colchicine vs PBO in #gout for 6 months shows that colchicine prophylaxis when initiating ULT did not increase the odds of achieving gout remission. https://t.co/kgNzw0UUIq https://t.co/ZdBT0Fp9Gx
Dr. John Cush @RheumNow (  View Tweet)
Cross-sectional study of 176 CASPAR+ PsA patients correlated Dz activity (cDAPSA) w/ SAA, IL-8, IP10 (IFNg/CXCL10), M-CSF, SCGF-β, SDF-1α) (AUC 0.802- 0.835). The panel was significantly better than CRP (AUC = 0.727, p = 0.022). https://t.co/AZq81S6NH0 https://t.co/5eI241gLVj
Dr. John Cush @RheumNow (  View Tweet)
Metanalysis of 26 RCTs suggests JAK inhibitors have a low, but signif. increased risk of infections (vs placebo) (RR 1.39; 1.096-1.76). No risk of tuberculosis or hepatitis, but an incr. risk of H. zoster was seen (RR 1.71; 0.84-3.51) https://t.co/kXOcldz46l https://t.co/Y5OWk4W1NZ
Dr. John Cush @RheumNow (  View Tweet)
New download available! Substitute Inflammatory Measures https://t.co/F8aTXEScMR https://t.co/MVwkiOnL2B
Dr. John Cush @RheumNow (  View Tweet)

A Keto Diet for Autoimmune Disorders?

EurekAlert!

Scientists have long suspected the keto diet might be able to calm an overactive immune system and help some people with diseases like multiple sclerosis.

Now, they have reason to believe it could be true.

Scientists at UC San Francisco have discovered that the diet makes the gut and its microbes produce two factors that attenuated symptoms of MS in mice.

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Iberdomide Efficacy in Cutaneous Lupus berdomide, a cereblon modulator that promotes degradation of transcription factors Ikaros and Aiolos, has been shown in a phase 2 trial to improve outcomes in subacute and chronic cutaneous lupus erythematosus (CLE).… https://t.co/2LtBDOIBrN https://t.co/giVDgZBiyk
Dr. John Cush @RheumNow (  View Tweet)
Over a 16 yr span & 988 LBP referrals - 366 (37%) Dx w/ axSpA, w/ increase in # women w/ axSpA. Mean time to Dx decreased 9.8 yrs (2008) to 1 yr (2023). Greatest delay was LBP onset to GP eval. (3.2 yrs). Referral time improved by organizational change https://t.co/bEmaspJWG4 https://t.co/Jyo1neMGib
Dr. John Cush @RheumNow (  View Tweet)
Serial MRI study of SI & lumbar (LS) joints in 24 early axSpA (Sxs < 5.5yrs) over 3 yrs, showed: - SIJ developed bone marrow edema, sclerosis & erosion. - LS: fat lesions decreased & erosions increased. - Facet joint inflammation (in t0) significantly influenced yr 3. LS bony… https://t.co/czBPVXYHYa https://t.co/6ByhsXONtf
Dr. John Cush @RheumNow (  View Tweet)
FDA's perspective on the use of artificial intelligence in drug development. - FDA is committed to a risk-based regulatory framework that promotes innovation & protects Pt safety - Est. CDER AI Council to coordinate, develop, & support internal & external AI-related activities… https://t.co/BLCYmBBJMY https://t.co/fMie3oOfmn
Dr. John Cush @RheumNow (  View Tweet)
An 11 yr study of 2187 #RA pts Rx w/ 3068 treatment courses of biologics or JAki, found 275 new cases of #CKD . Compared w/ CTLA4-Ig, TNFi significantly lower CKD rates (HR 0.67), whiile JAKi higher CKD rates (HR 2.16). https://t.co/2Y5BuDzJRs https://t.co/e81lOhOMjX
Dr. John Cush @RheumNow (  View Tweet)