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Moneyball Rheumatology (5.30.2025)
Dr. Jack Cush reviews the book/movie, "Moneyball" and a suggests moneyball strategy is needed to find next level responses for our patients.
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Do SGLT2 and GLP-1 therapies have a role in Lupus?
Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA) were initially developed as glucose-lowering agents for the treatment of Type 2 Diabetes. Since their introduction, they have been noted to have a myriad of other benefits, including cardiovascular and renal protective effects in patients both with and without diabetes. Here, we will review the evidence for SGLT2i and GLP1-RA in lupus.
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Belimumab in SLE with Mucocutaneous or Vasculitis Findings
A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.
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Valves Gone Wild in SLE
Lupus valvulitis is a rare cardiac manifestation of active systemic lupus erythematosus (SLE) and is defined by inflammation of one or more cardiac valves. It is often associated with Libman-Sacks endocarditis, which is characterized by the presence of sterile vegetations on the heart valves.
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JAMA CME review of Immune Thrombotic Thrombocytopenic Purpura (iTTP) - thrombotic microangiopathy w/ hemolytic anemia (MAHA) & thrombocytopenia. iTTP incidence is 2-6 per million. Caused by Abs to ADAMTS13), w/ low ADAMTS13 activity vWF multimers bind platelets https://t.co/bvCexDPBmq
Dr. John Cush RheumNow ( View Tweet)
Annals of Internal Medicine has published a CME review of LYME DISEASE. Most Lyme is Dx by onset of the erythema migrans rashes,. Lyme Ab testing is of low sensitivity at onset but more sensitive w/ time & CNS, CV complications. or Mono- or oligoarticular arthritis https://t.co/FMwQgcadik
Dr. John Cush RheumNow ( View Tweet)
2025 ACR Guideline for the Treatment of SLE
The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE.
https://t.co/2NFwTllLZa https://t.co/i5Q5UfE9v3
Dr. John Cush RheumNow ( View Tweet)
How Living With Childhood-Onset Lupus Impacts Mental Health
Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush RheumNow ( View Tweet)
Emulation Trials in SLE: Real or Fake
Dr. Janet Pope, Ontario, Canada, discusses emulation trials in systemic lupus erythematosus.
https://t.co/wVmMfLVAuQ https://t.co/V4VGVncSE9
Dr. John Cush RheumNow ( View Tweet)
2024 ACR Lupus Nephritis Guidelines: The Controversies
Drs. Maria Dall’Era & Michelle Petri discuss the sticking points in the latest lupus nephritis recommendations.
🗣️ Insightful, honest, and essential for your practice.
📍Full update on RheumNow: https://t.co/KPjyCrMTBr https://t.co/VoOslSqs99
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Dr. John Cush RheumNow ( View Tweet)
IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/sbXW6vNX5y
Dr. John Cush RheumNow ( View Tweet)
Moving Targets in Lupus and Lupus Trials
In the 1990s, developing lupus treatments became a priority, but success was elusive for 20 years. Belimumab was approved by showing only small differences from placebo in trials with 867 patients globally. Its efficacy was confirmed by https://t.co/TekxzTJjwC
Dr. John Cush RheumNow ( View Tweet)
Steroids in Lupus Nephritis: No Free Lunch
https://t.co/yPQuZcnRLH https://t.co/V8GZoslSqV
Dr. John Cush RheumNow ( View Tweet)
NEW for #LUPUS2025—@ern_reconnet–SLICC–@SLEuroSociety expert consensus on the therapeutic management of rare systemic #lupus erythematosus manifestations https://t.co/XwAHpsho57
Free to read with registration on https://t.co/28wkm5ab69 (also free)
@Lupusreference #SLE https://t.co/73K0DKTHye
Links:
The Lancet Rheumatology TheLancetRheum ( View Tweet)
🔺CTD-ILD radiological signs to look out for 👀
#CTD #ILD #UIP #NSIP #Fibrosis #scleroderma #systemicsclerosis #Sjogrens #Lupus
By @IlliasulK https://t.co/hHupTz0bCy
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
JAK inhibitors reduce inflammation while potentially exacerbating the propagation viral infections. They suppress transcription of IFN-stimulated genes in non-infected cells (usually triggered by type I IFNs produced by infected cells) Thus facilitating viral propagation https://t.co/BDzz8pHKxL
Dr. John Cush RheumNow ( View Tweet)
MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/JCeSFmIgxV
Dr. John Cush RheumNow ( View Tweet)
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 https://t.co/fjtUNaYtp9
Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine: Are Your Patients Taking It?
Dr. Nathalie Costedoat-Chalumeau dives into monitoring HCQ levels and what they tell us about patient adherence.
💡Learn how to spot non-compliance early.
👉 Now live on RheumNow: https://t.co/KPjyCrMTBr
#LupusCare https://t.co/8ZiJcFZyKD
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Dr. John Cush RheumNow ( View Tweet)
Shifting the Management Paradigm for SLE and Lupus Nephritis
The paradigm for treating patients with systemic lupus erythematosus (SLE) is rapidly shifting and our patients will surely benefit with improved outcomes.
https://t.co/idxMBTyTwp https://t.co/unxmjVst3D
Dr. John Cush RheumNow ( View Tweet)