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Multimorbidity predicts flares in rheumatoid arthritis

d Jack Cush, MD

A study from Olmstead county and the Mayo Clinic shows that multimorbidity  and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.

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September to Remember (9.5.2025)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.

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Rheumatoid Arthritis ILD Complications

d Scott Matson, MD

I'm a pulmonologist at the University of Kansas in Kansas City, and I'm excited to talk about one of my favorite topics: treatment complications in rheumatoid arthritis- associated interstitial lung disease or RA-ILD. One of the reasons I think this is a pressing and important topic is what we're dealing with here is a group of patients who have really poor outcomes, even with the significant advances that the rheumatology community's been able to make in the management of the underlying synovial disease.

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Methotrexate significantly lowers Systolic BP

d Jack Cush, MD

Australian researchers have shown that methotrexate (MTX) has another secondary, beneficial effect by significantly lowering systolic blood pressure, and contributes to its well docuented cardioprotive effecs.

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ILD damage fibrosis path

Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA

d Jack Cush, MD

A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD).

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Study of 607 systemic sclerosis (SSc) pts finds Pulm arterial HTN (PAH) in 77 (12.7%). While early immunosuppression didnt reduce odds of PAH (OR 0.74, p=0.495), early mycophenolate was protective(OR 0.12; p=0.048). Only HCQ use signif. improved survival (HR 0.04; p= 0.004). https://t.co/54m8btiMLy
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A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA

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Prospective study of 171 suspected Sjogrens (130 dx w/ SjD) pts compared Dx accuracy - Labial gland Bx best Dx efficacy (AUC 0.90), followed Ro/SSA (AUC 0.79), Omeract score (AUC 0.78). Salv gland US grade 3 strongly predicted +Bx (AUC 0.77) & correlated w/ salivary flow ~-0.5

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6 yr study of Dutch #SLE pts (n 221) - unemployment was high (54%) & increased over time. Employ ed assoc w/ supervisor support, regular working hrs, skill discretion, decision authority. Unemployment most from SLE Sxs (63%) & assoc w/ older, less education, Dz Dur, organ

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EHR analysis of Alaska Tribal Health System finds the prevalence of Sjögren's disease at 199 per 100K adults (primary SjD 129; secondary 70 (RA,SLE)). The age-adjusted incidence 16.6 per 100K Pt-Yrs. Only 5% had salivary gland Bx & 3% met 2016 ACR/EULAR or 2012 ACR criteria https://t.co/4tMdWIGTEi
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Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/F231nz57NY

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SMART study from India finally published. RCT compare split-dose to single-dose oral MTX, in 253 RA pts. Split dose was superior w/ significantly higher EULAR good response at 16 weeks; & reduced need for 2nd DMARD, but had more intolerance and transaminitis. https://t.co/4jBxP2GPZM
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LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn
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Retrospective French Health Data System Immune Checkpt inhibitor (ICI) study. Of 172,363 ICI-Rx adult pts, ICI myotoxicities at 6 months ranged from 0.7% -0.9%. ICI myocarditis & myositis incidence was 0.3%- 0.6%, co-occurring in ∼13–23%. ICI myotoxicity- 1-mo fatality was https://t.co/kOGKM8lC0H
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Connective tissue disease associated with interstitial lung disease (CTD-ILD) market is estimated to be $5.9 Billion USD in 2024 and is projected to grow to 9.3 billion, driven by increase in autoimmune Dz, adoption of biologics, ongoing clinical anti-fibrotic trials https://t.co/UqshQgNOau
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ILD Begins (8.29.2025) Dr. Jack Cush reviews the news and journal reports from https://t.co/V10S4oVFsv. This week news on vaccines, safety of acetaminophen and more. https://t.co/YlOK3X4hkW https://t.co/9cgcDn0xab

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Combined Therapy in Rheumatoid Arthritis Interstitial Lung Disease RA-ILD is a major therapeutic evidence gap in treatment, affecting 8% of patients. It was often under-diagnosed, leading to more severe cases and inflated mortality rates. Despite advancements, RA-ILD, https://t.co/Q8mMxtBgZZ
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Retrospective Korean study of #RA & ILD pts (n 151) - ILD duration & UIP pattern significantly affected prognosis. 62% were non-smokers, DAS28=4.9, UIP in 60%. @4 years, ILD progressed in 58%; mortality=21%. MTX did not affect progression or mortality. https://t.co/1XNcWsAuea https://t.co/hsUWi27OtQ

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Global prevalence of Hidradenitis suppurativa (HS) is 0.99%, but varies globally between 0.67% and 1.46%. HS is assoc w/ female sex. Based on a meta-analysis 22 743 participants, identifying 247 HS pts. https://t.co/TtKdfKiIn3 https://t.co/zOIVUlF5E8

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High unemployment in Dutch SLE patients, linked to SLE Sxs & Dz duration. Supervisor support helps with employment. https://t.co/E5jqmUHqo7
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