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On this week's podcast, Dr. Jack Cush reviews the news: Steroids are easy to start and hard to stop; hold the MTX but not the biologic or JAK, weighing in on avacopan, and age-old messages for old-age patients.
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Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable pathways.
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Dr. Jack Cush reviews the news and journal reports from this past week on Rheumnow.com - including obesity, disappointing durability with GLP-1 drugs, AI diagnoses and worries about CV risk in ANCA-associated vasculitis. And take this week's RheumIQ quiz!
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A EUVAS-sponsored expert panel of 37 specialists across rheumatology, nephrology, dermatology and pathology has published evidence-based guidelines for adult-onset IgA vasculitis (IgAV), which behaves very differently in adults compared to usually self-limited childhood form.
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High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by Zhu et al. presents six cases initially diagnosed as systemic JIA, teaching several important lessons.
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Dr. Jack Cush reviews the news and journal articles this week where RheumNow featured info on cancer, deadly viruses, AI rules, poetry and good moons rising.
Dr. John Cush
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Thai study of opportunistic infx in Pediatric SLE - 177 pSLE, & 38 developed OI (3.4/100PY). Most common OIs: Candida (27%), Aspergillus (13.5%), CMV (13.5%) - lung & skin mostly. Risk factors: Pulse steroids, Dz activity (SLEDAI-2K ≥11) https://t.co/0zjDOnDCEh https://t.co/H7JZ56ItDY
Dr. John Cush
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Upadacitinib is now approved in European Union to treat active polyarticular juvenile idiopathic arthritis (pJIA) ages > 2yrs for those not responding to 1+ DMARDs. In the USA, UPA is approved for pJIA & juvenile PsA https://t.co/Vhx717rw5T https://t.co/hObov1Umgb
Dr. John Cush
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Retrospective study from India on 157 juvenile dermatomyositis (JDM) pts - 44 (28%) had calcinosis. They had a long Dx delay (12 mos), were NXP2+ in 41%, & high risk for Lipodystrophy (39% vs 5%). 39% improved while 61% had static/progressive Dz https://t.co/z5gvqzZV6C https://t.co/9WlzPDZ74w
Dr. John Cush
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Upadacitinib is now approved in European Union to treat active polyarticular juvenile idiopathic arthritis (pJIA) ages > 2yrs for those not responding to 1+ DMARDs. In the USA, UPA is approved for pJIA & juvenile PsA https://t.co/Vhx717rw5T https://t.co/OBMdjsegIq
Dr. John Cush
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FDA has approved baricitinib (Olumiant) for the treatment of pediatric patients 12 years of age and older with severe alopecia areata https://t.co/OTXXQvNruw https://t.co/xrg5ocWyjo
Dr. John Cush
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Indian Single center retrospective study of 28 children ≤18 yrs tested w/ 18F-FDG-PET/MR for pyrexia (PUO). 25% Dx w/ pre-stenotic TAKayasu (mean 13.9 yrs), & 20/21 alternative Dxs. All had Sxs & high ESR/CRP; all Rx w/ GC & MMF, 3 w/ biologics https://t.co/6trs1WssjW https://t.co/EOPIarRhY5
Dr. John Cush
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Epic Cosmos study of GLP-1RA Rxs in 3.5 million children (8–11 yrs) - very few 0.6% recv a GLP-1RA (20,282 kids) - Rx went from 0.03% (2019) to 9.3% (2026-310-fold incr). More likely in older, girls, obese kids. Most GLP-1 kids had severe obesity (93.7 percent) https://t.co/JW6SXxJjA0
Dr. John Cush
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True or False: Compared to adult systemic sclerosis, juvenile systemic sclerosis is more commonly associated with diffuse cutaneous disease and renal crisis.
Test your knowledge in this week's RheumIQ at https://t.co/TBlB4pmnKa. https://t.co/q4wlnCQsny
Dr. John Cush
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39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/PYuvyaPdxA
Dr. John Cush
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Japanese study of 101 864 children shows fertility treatments (ovulation induction, intrauterine insemination, invitro fertilization) increases the risk of Kawasaki Dz. Incidence rates per 100K PYs - 274 for spont conception vs 391 for assisted conception (adj HR 1.42; https://t.co/Ro0beSXAAq
Dr. John Cush
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39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/vflarmwSyv
Dr. John Cush
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Childhood vs Adult onset SLE? Retro Australian Lupus Registry study of 519 SLE pts (68/13% w/ cSLE) found childhood onset had signif more damage (SDI≥1 53 vs 40%; renal Dz 62 vs 37%), more Dz activity, less LLDAS-50 (36% vs 51%) https://t.co/ttBRtSVl5n https://t.co/hoN1t16Za3
Dr. John Cush
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In 2026 Abbvie granted 34 scholarships to students With Inflammatory Diseases. In the last 10 yrs, theyve granted $6 million to >350 students in the US for higher education. These awards up to $20,000 per student renewable up to 4 yrs. https://t.co/DFy5SukB6G https://t.co/9mVkrhL2lo
