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Overview of the VEXAS Syndrome

A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.

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Immunomodulators in the Treatment of Autoimmune Hepatitis Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on https://t.co/KgzjNvrZ7v
Dr. John Cush @RheumNow (  View Tweet)
Is the term polymyositis obsolete?.. now being replaced by dermatomyositis, necrotizing myopathy, inclusion body myositis, antisynthetase syndrome & overlap myositis. Full read overview of inflammatory myositis & new treatments from Joint Bone & Spine https://t.co/X46sptp1Ax https://t.co/QqyMv6fkVS
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1 yr study of falls studied in 100 RA & 80 PsA pts. 33% of RA & 46% of PsA reported falls, w/ a higher frequency in PsA Pts (p=0.02). Falls associated w/ disease duration and HAQ score. As falls are assoc w/ high morbidity & mortality risk, pts should be questioned about FALLS https://t.co/tP7zmGCZcw
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Referral of 304 suspected autoinflammatory Dz (SAID) to a UK national centre for primarily adult SAID in 2022, 121 (39.5%) were diagnosed with SAID, w/ half of these having monogenic Dz. Median Dx delay was 2 to 6 yrs, worse in late-onset SAID. https://t.co/x8VOFyjuVA https://t.co/3R2HdYUlSg
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MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/hvxJRv1r0R
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Case–control study RA pts > 65yrs in US. SEER (cancer) database (2014–2019). Overall cancer risk not associated with use of JAKi (adjOR 1.04), TNFi (0.98) or other bDMARDs (0.98). But, JAKi use was assoc w/ incr risk of lung CA (OR 1.40), esp in Males (2.12) & >2 yrs JAKi. Lower https://t.co/u2psafyN1I
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Don't Stop the DMARDS!! Retrospective study of 91 JIA pts (all types; 36% oligo, 27%poly) all Rx w/ cycles of DMARD therapy. Consistently two-thirds relapsed and flared. Only one-third of JIA patients were able to remain off DMARDs. https://t.co/ifqnMKfhAe https://t.co/bEqAxzRoq6
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Biologic experienced ankylosing spondylitis patient show better retention on TNF compared to IL-17 inhibitors. 148 AS pts (F/U 31 mos), IL-17i drug survival trended better but only signif after 3yrs. More D/C w/ higher BASDAI (HR: 1.3) & ^# prior biologics (HR 1.62) https://t.co/5HXGsV4xol
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Reducing Progression of Psoriasis to Psoriatic Arthritis

MedPage Today

Tumor necrosis factor (TNF) inhibitor therapy was effective in reducing the likelihood that psoriasis would progress to psoriatic arthritis (PsA), a retrospective study indicated.

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Granzyme expression is upregulated in RA, esp early RA. Blood & synovium from early arthritis & TNFi nonresponders (R4RA RCT) gene expression five granzymes, perforin, & serglycin determined by bulk RNA-sequencing data. GZM A, B, H, K, M, PRF-1, SRGN was higher in lymphoid https://t.co/v1rdFZHuuh
Dr. John Cush @RheumNow (  View Tweet)
Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/NMtiQPICpw https://t.co/gVJ0TyuY01
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BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
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JAMA Patient Education Page on what is Interstitial Lung Disease https://t.co/BDbV6I53NH https://t.co/1OtTiJHkdt
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From 1990 to 2021, the global burden of OA from high BMI increased markedly. YLD (years lived w/ disability) rates of OA attributable to high BMI increased from 34 to 50.6 per 100,000 - higher in females, correlated w/ Socio-demographic Index levels https://t.co/RjTJFNEbYm https://t.co/tIqmn9eLQ6
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RABBIT (German biologics register) study shows overall small increase in malignancy w/ JAKi vs bDMARDs. Risks greatest in those ≥ 60 yrs, w/ Hi Dz activity, on ≥3 prior csDMARDs. 2285 JAKi vs 4259 bDMARDs: 88 vs 135 malignancies CAs (IRs 11.6 vs 8.9; adj HR 1.40). JAKi risk https://t.co/AlK2SWn6UR
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Early DMARD Initiation Benefits in Psoriatic Arthritis

Mease et al has published the results of a cohort study showing early initiation of disease-modifying antirheumatic drugs (DMARDs) in patients with psoriatic arthritis (PsA) resulted in better outcomes compared to late initiation.

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#RA linked to 40% incr risk of serious dental Infx. National Inpatient Sample (2016-2022) retrospective study of ~15 million adult inpatient records, 10.7K (0.07%) had oral Infx Hosp. Risk factors included RA (1.9%; OR 1.4, male (1.79), Black (1.23), smoking (1.33) https://t.co/pr4Uf6ywJ7
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1,494 Ehrlangen RA pts - machine learning used baseline variables to predict remission at 6 mos. Best/most predictive results w/ AdaBoost modelingdemonstrated strongest accuracy of 85.71% (based on DAS28, Age, VAS and swollen joints. https://t.co/h9UgUKUFo4

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Japanese cohort study compared 12 pts w/ Stills Dz or intravascular lymphoma. Stills pt had significantly higher ferritin and IL-18 levels and IVL pts had significantly higher sIL-2R levels. https://t.co/Ecd6vNJTc4 https://t.co/KdEcpDeskA
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