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Is Lupus Just a B Cell Disorder?

I'm very happy to give you some insights entitled, “Is Lupus a B-Cell Disorder”. I will review some aspects, mainly pros and cons, but at the end you may forgive me, I will escape a little bit from a clear yes or no.

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Pregnancy planning, contraception and safe drugs in Pregancy. Featuring Dr. Megan Clowse, Durham NC https://t.co/sZuq475VJv https://t.co/HZv9FuviaR
Dr. John Cush @RheumNow (  View Tweet)
Lupus Unlocked: Antiphospholipid Syndrome https://t.co/pJEsyeGJbW

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If vagus nerve stimulation improves RA; then what if vagotomy? Danish study of vagotomy (1977-1995). 6070 vagotomy matched w/ 60,699 comparators. Truncal vagotomy was assoc w/ signif incr RA incidence (OR 2.62), but not superselective vagotomy (OR 1.05). NO diff in incident OA https://t.co/J2saSRmiNw
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SLE, Antiphospholipid Antibodies, and the Placenta It is well established that women with SLE are at increased risk for adverse pregnancy outcomes, including preeclampsia, preterm birth, and pregnancy loss. However, the pathophysiologic mechanisms driving these complications https://t.co/f8Up1112m9
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Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/bANtWIhtDH
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Emerging therapies targeting the NLRP3-inflammasome (active in Autoinflammatory Dz, Gout, neurodegenerative Dz/Alzheimers). Currently no FDA approved drugs, but many in trials. eg, Oxidized DNA (DAMP) activates NLRP3 & may be blocked by repurposed glycosylase inhibitors to reduce https://t.co/tEdi5OH2fP
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CAR-T and cellular depletion therapies gone wild! Currently there are over 85 different therapeutic candidates aiming to reset the immune system in >380 clinical trials. Review article looks at indications, targets, modalities & outlook. https://t.co/yleR4B48IY https://t.co/tuCTOu5sxa
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Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/hQo9sNn4kg
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Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/EjX6R9QTK3
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Steroids in Lupus Nephritis: No Free Lunch

Today I'm here to talk with you about steroids in lupus nephritis. The impetus for this is the 2024 ACR guideline for the management of lupus nephritis.

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Biologics in Pregnancy Patients With Autoimmune Disease

A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients than those with rheumatoid arthritis (RA), psoriasis (PsO) or psoriatic arthritis (PsA).

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MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/8XMCM2DitR
Dr. John Cush @RheumNow (  View Tweet)
Lupus QD Clinic - Rhupus dsDNA+ SLE Plus CCP+ RA = Rhupus https://t.co/lyV7fgd1vp https://t.co/IKkS0enQH9
Dr. John Cush @RheumNow (  View Tweet)
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/xy1eCjeOYs
Dr. John Cush @RheumNow (  View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/hX2lcjI4Kg
Dr. John Cush @RheumNow (  View Tweet)
MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/9i4fxrZMl0
Dr. John Cush @RheumNow (  View Tweet)
Lupus in an empty house The full house immunofluorescence pattern is the classic histopathologic finding of lupus and lupus nephritis. Glomerular deposits staining for IgG, IgA, IgM, C3 and C1q can help confirm a suspected diagnosis of systemic lupus erythematosus (SLE). This https://t.co/DQWwRJmdqM
Dr. John Cush @RheumNow (  View Tweet)
Assessing and Treating CV Risk Increases in Systemic Lupus For nearly 50 years, the heightened CVD risk in SLE patients has been acknowledged since Urowitz et al.'s 1976 study on lupus mortality. Research consistently shows SLE patients have a 2-10 times higher CVD risk than https://t.co/P1AdxHkiQi
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Emulation trials in SLE: Real or Fake? Recently a landmark paper was published in A&R studying the results of an emulation trial. My colleagues and I were able to write an editorial on this paper and describe emulation trials. https://t.co/0ulYG5xz0J https://t.co/y2jo2SSH83
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