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Higher Medical Costs with Corticosteroid Use
Rheumatoid arthritis (RA) health insurance claims database study from Japan shows that RA patients initially treated with glucocorticoids (GCs) and disease-modifying antirheumatic drugs (DMARDs) experienced greater medical costs and healthcare utilization than patients not trea
Combined Therapy in Rheumatoid Arthritis Interstitial Lung Disease
Rheumatoid arthritis interstitial lung disease (RA-ILD) represents a major therapeutic evidence void in our current treatment paradigm. RA-ILD is common, with clinically significant disease seen in 8% of patients. In the past RA-ILD was frequently under-diagnosed, leading to identification of a disproportionate volume of severe cases and subsequently inflating the mortality statistics. However, RA-ILD, particularly in the progressive pulmonary fibrosis phenotype, retains a poor prognosis. I would propose a new framework for RA-ILD treatment.
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ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.
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ACR Urges Alaska and Montana to Strengthen Rheumatology Care
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ACR
The American College of Rheumatology (ACR) is calling on Alaska and Montana to seize the opportunity to address critical gaps in rheumatology care by accessing funding from the Rural Health Transformation Program (RHTP), provided by the One Big Beautiful Bill Act (H.R.
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Might systemic autoimmune Dz related anti-protein arginine methyltransferase 5 (PRMT5). ELISA study of 33 SSc, 87 RA, & 31 controls. Vs controls, anti-PRMT5 Abs seen in SSc (48% vs 0; AUC 0.9) & RA (15% vs 0; AUC 0.768). PRMT5 Abs signif assoc w/ ILD & ANA positivity. https://t.co/svjjtQQsIY
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MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/eu1IpaXGL8
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Wait! FDA approved the Chikungunya Virus Vaccine 2 yrs ago, but just pulled the vaccine, Ixchiq, citing serious safety concerns (specifically CBER reports of >20 serious adverse events, including 21 hospitalizations, 3 deaths, w/ 1 fatality directly linked to vaccine-derived https://t.co/aaC38VX7rF
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Recombinant zoster vaccine effective in #SLE without flare. Retrospective Medicare & commercial claims data on pts given 2 RZV doses, matched 1:4 to unVAX. 3592 pts F?u ~1.5 yrs. Vax effectiveness 70% in Medicare; 54% commercial. SLE flare rates HR 0.91& 0.94. https://t.co/WCBOQhb4Ad
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Primary CNS angiitis - an uncommon vasculitis affecting brain, spinal cord, or leptomeninges, typically B/L, but here are 48 pts w/ unilateral PACNS. Dx is made by imaging, wall imaging (VWI), perfusion, spectroscopy. Histology shows small-to med vessel lymphocytic vasculitis https://t.co/xtD7wBT1J2
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App-based exercise is noninferior to PT supervised exercise, the latter has better adherence. RCT of 68 pts w/ hip/knee OA Rx w/ either PT surpervised exercise BIW x6 wks vs app virtual exercise TIW x 6wks. Pain & Sxs equal betw grps, but Adherence better w/ PT/F2F Rx https://t.co/BTZsi0bzdL
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Osteoporosis in Older Men
JAMA has publish an invited commentary on Screening for Osteoporosis (OP) in Older Men. They point out that a simple screening strategy for older men based on previous fracture history and bone density screening at age 70 or 75 years is a reasonable https://t.co/bpa4N4mdOp
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Ambient Dictation Works and Reduces Burnout
Passive documentation of clinic visits using artificial intelligence (AI)-drafted notes was linked to reduced burnout and improved well-being, a survey study from two academic medical centers suggested.
https://t.co/Tu3sOfZUBI https://t.co/WiC3uJeFEC
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Methotrexate intolerance in rheumatoid arthritis
Methotrexate (MTX) is the most commonly used DMARD in rheumatoid arthritis (RA); however, there is significant intolerance to this drug among adult RA patients - especially at doses above 15 mg per week.
https://t.co/aizooTPNTe https://t.co/FZ52bwHBfq
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Lupus Core Dataset for Research
SLE is a complex and potentially life-threatening autoimmune disease. Part of the complexity stems from how it can differ from person to person – giving rise to marked heterogeneity in not only manifestations, but also in disease course and https://t.co/jHD9L3Bc2Y
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RA has lower risk of colorectal cancer (CRC). Korean claims compared 41K RA pts 1:5 vs 204K non-RA. RA had signif. decreased risk for CRC (HR 0.89), main in seroneg RA (HR 0.79) but not seropos RA (HR 0.93). Inverse assoc mainly w/ rectal CA (HR 0.63) & women (HR 0.80). https://t.co/dudG4Is5oj
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China study of 670 SpA pts rx w/ sulfasalazine betw 2016 to 2023 (469 pure AS; 201 w/ peripheral Sxs). SSZ Signif. reduced peripheral Sxs development (HR 0.49) and improved disease activity in both pure axial and axial-with-peripheral Sxs. https://t.co/5HdQCos9yM https://t.co/tTMScQDHBq
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My Cancelled Lecture Slides
Dr. Cush records his "Life Lessons (that keep changing) in Rheumatology Lecture.
https://t.co/uqj0J6Ii3e https://t.co/ePLc3xnCsF
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Physical Therapy Underprescribed
Just one patient in six was referred for physical therapy (PT) within 15 days of being treated for knee pain at one major U.S. health system, researchers found, despite nearly universal consensus that PT should be recommended in most https://t.co/WM4NA6p2Pg
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Prenatal acetaminophen linked to increased autism and ADHD
Researchers at the Icahn School of Medicine at Mount Sinai have found that prenatal exposure to acetaminophen may increase the risk of neurodevelopmental disorders, including autism spectrum disorder and ADHD, in https://t.co/Zpo9dymPPf
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Antibiotics are not linked to Autoimmune disease in kids
The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, https://t.co/46Q0GFZQiw
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