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APEX Study: Inhibition of structural damage progression with Guselkumab in Psoriatic Arthritis

d Jack Cush, MD

Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active psoriatic arthritis (PsA) and shown to have both clinical and radiographic benefits at weeks 24 and 48.

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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis

d Jack Cush, MD

JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).

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Seeking Musculoskeletal Care

d Jack Cush, MD

A report entitled The Burden of Musculoskeletal Diseases in the United States (BMUS) report was published by the US Bone and Joint Decade (USBJD) with input from rheumatology, orthopedic surgery, physical medicine and rehabilitation regarding musculoskeletal care.

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Rheumatology Supply and Demand (2009 - 2024)

d Jack Cush, MD

A retrospective review of US rheumatology manpower and training between 2009 and 2024 shows that US rheumatology training has become competitive with an increasing surplus of applicants compared to available training positions, which have also increased over time.

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ACR Applauds Bipartisan Support for Prior Authorization Reform Bill

d ACR

The American College of Rheumatology (ACR) today commended the more than 295 bipartisan, bicameral cosponsors of The Improving Seniors’ Timely Access to Care Act, which, if enacted, would reform the prior authorization process for Medicare Advantage plans.

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25-Hydroxyvitamin D levels and Lupus Outcomes

d MedPage Today

Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said.

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Retrospective review of 113 AOSD pts, median age 45yrs, ferritin 4626 (IQR 1169–14,239). Advanced Rx (IVIG, IL-1, IL-6) required in 15 (13.3%), NOT predicted by ferritin levels, either measured continuously or by quartiles. Ferritin is not a reliable biomarker in AOSD. https://t.co/pHEPeIf9u2
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual

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Review of neonatal Fc receptor (FcRn) blockers, being developed by J&J, argenx & UCB, showing utility in autoimmune dz as they reduce autoantibodies. FcRn inhibitor market may be worth USD 3.3 billion by 2035. Approved for myasthenia gravis & being developed in Sjögren’s, SLE, https://t.co/mBUla87dK5
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Japanese ANSWER cohort (3623 RA pts on bDMARDs or JAKi) included looked at T2T in 118 RA pregnancies. 93% had full-term deliveries; 85% w/ remission or LDA maintained throughout preg. 35/118 cont' bDMARDs during preg & had signif lower DAS28-CRP vs those D/C (n 24) (P = 0.007). https://t.co/uG8m7RzSiU
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Serum IL-1Ra levels are elevated in Lg vessel vasculitis - 21 active, Rx naive LVV pts (13 GCA, 8 TAK), IL-1Ra higher in TAK (465 pg/mL) & GCA (385 pg/mL) vs NLs (170). IL-6 also incr. in LVV, but IL-1β & IFN-γ incr in GCA & ^ IL-17in TAK. IL-1Ra correlate w/ CRP in GCA & https://t.co/TFDpK5DqcJ
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Australian Vaccine study (2019 - 2021) - w/in 12 mos of b/tsDMARD initiation 73% (11,225/15,460) recv influenza vaccination. High-dose Flu vax used in 28% in 60–69 yo, but > 80% older than 70yo. Only 9.7% recv pneumococcal & 2.4% zoster Zostavax or Shingrix) vax w/in 6 months of https://t.co/xoGTWMUi1L
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Metanalysis of 56 articles & 72,677 RA pts w/ a Dz duration of 9.7 yrs looked at biologic persistence. In csDMARD-IR, over 5 yrs TCZ (66%) & golimumab (62%) best. In bDMARD-IR, ABA (45%) & ETN (41%) best. Lower Rx survival predicted by steroids, hi Dz activity, & female https://t.co/tepL0A9Fwb
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PROSPERO meta-analysis shows an effect of diet on #RA risk. 8 independent studies (n=270,121) showed a reduced risk of incident RA with Anti-inflammatory (OR 0.56; 0.31–0.99), Mediterranean (OR 0.88; 0.78–0.99), and HEI (OR 0.60; 0.25–1.47), but not DASH diets https://t.co/Qr9lXWRAED
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Treating During Pregnancy (11.14.2025) | RheumNow https://t.co/sTv7O6YcnA https://t.co/KT0qGFJu0O

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RNL 25 Replay: Rheumatoid Arthritis Enjoy these excerpts from the RNL 2025 meeting, and join us for RNL 2026 in Dallas, TX - registration is now open! Visit https://t.co/o78Pc8LPsQ for complete details https://t.co/10AWx98UAk https://t.co/16FdwSu9he

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Postmenopausal women on estrogen hormone therapy (HT) had a modest incr risk (HR 1.33; 1.32-1.35; P < .001). of a new autoimmune Dz over next 5-10 yrs (vs those not on HT) TriNetX study of 889,413 HT vs 2,6 mill (not HT) - 6.7% vs 5.3% developed autoimmune dz at 5 yrs. https://t.co/fsi32XIzLe
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Retrospective cohort study adult RA patients shows that TRIPLE Positivity (RF + /ACPA + /ANA +) was consistently associated with higher disease activity at baseline and 12 months of follow-up and lower rates of sustained remission compared to RF + /ACPA + /ANA- https://t.co/mLRCzczqXH
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Can EMR Treatment Suggestions Improve Decision Making? In a new study, researchers from Northwestern University and the University of Sydney identified a “sweet spot” in clinical decision-making. By presenting just the right number of treatment alternatives in the EHR system, https://t.co/X0eHDIk3Uw
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Hospital Mortality in Dermatomyositis A cohort study reveals that hospitalized patients with dermatomyositis have a higher in-hospital mortality rate in the presence of active rash, interstitial lung disease, and an elevated neutrophil-to-lymphocyte ratio at admission. https://t.co/6WIFVJT9w7
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