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  • Feb 22, 2024
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    The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.

    The rationale to CD19 CAR-T cell transfer is to reset aberrant autoimmunity via deep depletion of B cells with the hope of achieving sustained drug-free remission.

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No clear link between weather and MSK symptoms

EurekAlert!
Feb 22, 2024

There is a longstanding belief that changes in weather conditions, such as impending rain or temperature, can trigger or worsen muscle and joint pain but Australian researchers have found no clear pattern between the two.

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MMPs play pathogenic role in RA-ILD. Multicenter VA study of 2,312 RA pts, 96 had prevalent ILD & Incident ILD developed in 130 (IR 7.5/1,000PY). High MMP-7 increased ILD (adj OR 3.78) & incident ILD (adj HR 2.33). Higher MMP-9 did same https://t.co/W8IuDJCH8e https://t.co/UdiyyUt7jJ
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
UK Clinical Practice Research Datalink matched cohort study compared Gout (152K) to controls (709K) - CV devlopment higher in gout (21% vs 15%; HR 2.58). Moreso in women (HR 1.88). Gout pt had more CKD, HTN, obesity dyslipidaemia, & NIDDM https://t.co/BXCawnuIfa https://t.co/ZMuK9Msesb
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA is 6.6% (4.4% immunosuppressive Dz; 3.9% immunosuppressive meds; 1.8% both); higher in women 7.9% ages 60-69 (9.5%) & Alaskan/Native indian (8.4%) https://t.co/phFPRqpCbJ https://t.co/non7zpQVOL
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
FDA has issued new draft guidance on the "Use of Data Monitoring Committees in Clinical Trials", updating its 2006 guidance document. "..the DMC should have access to safety results as well as comparative efficacy results." https://t.co/F0vKOxCLq9 https://t.co/xBa4Q1ukqo https://t.co/KeBUsYIl6u
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
Serial plasma samples assayed for 92 inflammation-related proteins, during and after gout attacks. 21 were differentially expressed. Gout flares assoc w/ increased IL-6, CSF-1, VEGF-A & tumour necrosis factor superfamily 14 (TNFSF14 was highest) https://t.co/mhIFaljKHv https://t.co/o45Zzn0g9A
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
EMG fibrillation potentials (insertional activity) & positive sharp waves (Fib/PSW) are found in 95% study of 75 pts dx w/ idiopathic inflammatory myositis (44 PM, 17 DM, 7 ADM, 11 IBM); but also in 4 pts not meeting EULAR criteria https://t.co/VsrNjDMGnC https://t.co/OQYnUPJD5o
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024
False positive COVID tests (+Rapid Ag; neg PCR) are rare, 1.7% of 11,297 tests; Persistent false positives seen in 13/191 and usually in women, with autoimmune dz (6/13; RA, SLE etc) & using the Quidel QuickVue rapid antigen test https://t.co/Pqkk7uBVcO https://t.co/m6ylQz00Ih
Dr. John Cush @RheumNow (  View Tweet)
Feb 22, 2024

Eating for Rheumatoid Arthritis

Feb 21, 2024

The majority of practicing rheumatologists at RheumNow Live were unaware of the new ACR guidelines issued in 2022 regarding dietary and lifestyle recommendations for patients with Rheumatoid Arthritis. Dr. Monica Guma reviewed these guidelines during her lecture on the impact of diet on disease activity and therapeutic response.  

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Join our experts, Drs Liebowitz and Mehta, as they provide insights on the differential diagnosis and management concepts in autoinflammatory diseases. https://t.co/r5WjYIdmaT https://t.co/gGdhyDKqtC
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
Week 52 outcomes of 180 lupus nephritis pts (IV, VI, III) from AMP academic centers (rx w/ standard of care) showed 22% complete resp,  22% partial resp, 42% non-responder& 14% undetermined. 8/180 (4.4%) had CR sustained Wk 12 to 52; 10% PR. An unmet need! https://t.co/UfYDKqHq1D https://t.co/zUIgvsZY6m
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
Cochrane Review: How Good is Ultrasound Diagnosing GCA? Is temporal artery ultrasound (US) equivalent or superior to the reference standard of temporal artery biopsy (TAB) when diagnosing giant cell arteritis (GCA)? https://t.co/BWzP3K8dCo https://t.co/DMu19sPMQv
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
Orismilast is a novel oral phosphodiesterase-4 (PDE4) B/D inhibitor studied in phase 2b RCT in 202 moderate-to-severe psoriasis pts vs PBO. At wk 16, Orismilast was better at PASI 75 (40%-49% vs PBO 16.5%; P <.05) and PASI90 (22%-28% vs 8%; P <.05) https://t.co/wSmiO2Hr5W https://t.co/gMiQUfT6EG
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
Mayo study of 1643 #RA pts (Dzduration 7 yrs) found 4 clusters based on # of comorbidities (Cluster 1 [42%] few comorbidities & cluster 4 [7%] > 10). Cluster 1 w/ good prog/survival; but cluster 4 was older, less DMARDs/biologics https://t.co/NTJvuBujdp https://t.co/wZycwYDfFS
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
Vasculitis Pearls Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks https://t.co/RnaHa54F2T https://t.co/aRpAdz1o8y
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024
How do you manage enthesitis? Enthesitis can be a challenge for clinicians to identify, evaluate, and manage in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). https://t.co/9SHM5aZAly https://t.co/KWYnhymsVr
Dr. John Cush @RheumNow (  View Tweet)
Feb 21, 2024

Five Takeaways in PsA/SpA at RNL 2024

Feb 20, 2024

Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls. 

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ARIAA Trial: Abatacept Delays the Onset of RA

Feb 20, 2024

The ARIAA trial tested the utility of IV abatacept in individuals ACPA+ arthralgia patients with subclinical inflammation and showed abatacept to decrease MRI inflammation, clinical symptoms, and risk of future rheumatoid arthritis (RA) development.

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IV zoledronic acid (ZA) of PBO was given to 222 pts with symptomatic knee osteoarthritis (without severe joint space narrowing) and after 7 yrs of F/U, ZA had no effect on Knee OA progression w/ similar TKR Rates (39% vs 30%) https://t.co/P09EvRmApO https://t.co/s5fL1unM45
Dr. John Cush @RheumNow (  View Tweet)
Feb 20, 2024
Retrospective analysis of the Australian Scleroderma Cohort Study, finds 43% of SSc pts have evidence of myopathy. From 1786 participants, 155 had prox. weakness, 24% CK elevation & 4% prox weak+CK^ (latter in more severe SSc) https://t.co/cB4Ul6VMB2 https://t.co/uAIMaotPdv
Dr. John Cush @RheumNow (  View Tweet)
Feb 20, 2024