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Different Autoantibody Phenotypes in Juvenile and Adult Myositis

d Jack Cush, MD

A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.

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CA-125 & PET/CT screening in 1432 myositis. 125 pts had CA-125 w/in 5yrs of onset - 3.1% false-positives (fibroids, endometriosis) & 14.3% false-negatives. 139 had PET done- 5.5% false-positives (LN, lung nodules), 28.6% false-negatives (missed melanoma, breast or prostate CA)… https://t.co/16KSDmp9Kz https://t.co/6QFl4jhDxp
Dr. John Cush RheumNow ( View Tweet)
Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M

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Dr. John Cush RheumNow ( View Tweet)
Antibiotics May Increase Inflammatory Arthritis Risk A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP) https://t.co/5CEewNqirM https://t.co/FSOFp4N6ks

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Dr. John Cush RheumNow ( View Tweet)
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Higher Cancer Rates (8.16.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.

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Hispanic Patients With Dermatomyositis

d Jack Cush, MD

JAMA Dermatology has published a review of dermatomyositis (DM), focusing on similar and different manifestations of DM.

DM affects all races, but it has been suggested that racial and ethnic minority patients may have more severe disease and a different autoantibody profile. This analysis characterizes the clinical features and outcomes of DM in Hispanic and non-Hispanic patients.

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Anti-Ku + myositis: an acquired inflammatory protein-aggregate myopathy. 92% female, median age 56yrs w/ very hi CK levels, 31% have overlap w/ scleroderma (half of these have ILD). Path shows by myofiber necrosis, MHC-class I/II+, endomysial inflammation https://t.co/7HDUEPmbdi https://t.co/vnSjOph31G

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Dr. John Cush RheumNow ( View Tweet)
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CARRA Consensus Treatment for Refractory Juvenile Dermatomyositis

d Jack Cush, MD

CARRA has developed consensus treatment plans for the use of biologic disease-modifying antirheumatic drugs (bDMARDs) in patients with refractory, moderately severe juvenile dermatomyositis. Juvenile dermatomyositis is the most common form of idiopathic, inflammatory myositis in childhood, with an estimated incidence of 3.2 per million children per year in the United States.

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Medical literature review of suggests low vitamin D status is common in Rheumatic pts. & low vit D levels linked to loss of muscle strength, MSK pain, sarcopenia & falls (esp in IIM, PMR, SLE, RA, SSc) (BUT DOES REPLACING VITAMIN D FIX THESE PROBLEMS???) https://t.co/30IiKj7l4d https://t.co/ydU6FQMTi5

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Dr. John Cush RheumNow ( View Tweet)
3 yr German laboratory study of 71,597 laboratory tests, found 238 positive tests for 13 myositis autoAbs in 209 patients. Pos. results due to Idiopathic inflammatory myopathy in 37(18%), other inflammatory rheum Dz 90 (43%) or NO Rheum Dx 82 (39%) https://t.co/1cQ4LmPEhL https://t.co/1UjuIMdF0M

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Dr. John Cush RheumNow ( View Tweet)
3 yr German laboratory study of 71,597 laboratory tests, found 238 positive tests for 13 myositis autoAbs in 209 patients. Pos. results due to Idiopathic inflammatory myopathy in 37(18%), other inflammatory rheum Dz 90 (43%) or NO Rheum Dx 82 (39%) https://t.co/KKg0X1AyU1 https://t.co/FfVfufaUm4

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of myositis associated - ILD (and treatments), including: - Case examples - Antisynthetase Syndrome - Anti-MDA5 Amyopathic DM - Interstitial Lung Disease in Myositis https://t.co/PhfuuBHOYf https://t.co/OC1GmWkYyO

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of myositis associated - ILD (and treatments), including: - Case examples - Antisynthetase Syndrome - Anti-MDA5 Amyopathic DM - Interstitial Lung Disease in Myositis https://t.co/zQpfstnGy8 https://t.co/XogyyxuVMk

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Dr. John Cush RheumNow ( View Tweet)
No Risk of Interstitial Lung Disease with Methotrexate Use JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM). https://t.co/qauRelAkG0 https://t.co/bhSLYrfzlv

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Dr. John Cush RheumNow ( View Tweet)
#SARD #ILD Who to screen for #rheumatic #diseases For ILD #ACR guidelines Screening May also depend on ILD prevalence Not sure if frequency of screening and how to screen @jeffsparks #ORA24 @ORAexec https://t.co/BcyyYLKvr6

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Janet Pope Janetbirdope ( View Tweet)
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Is Cannabis Safe? (6.7.2024)

d Jack Cush, MD

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

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202 adults w/ idiopathic inflammatory myositis (IIM) studied. Multiple myositis-specific Abs seen in 22% (2/3 w/ tRNA synthetase Abs (ARS+) & half MDA5+). Multiple MSA pts had better survival (HR 0.11), less RP-ILD, fever, rash; more muscle & dysphagia https://t.co/6PCMZJkuNn https://t.co/ElkJzPODaU

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Dr. John Cush RheumNow ( View Tweet)
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"Don't You Know Who I am?" (5.17.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?

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Methotrexate Does Not Increase ILD Risk in Dermatomyositis

d Jack Cush, MD

A cohort analysis of dermatomyositis (DM) patients starting immunomodulators finds that methotrexate use was not associated with an increased risk of interstitial lung disease (ILD).

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Canary in a Coal Mine (4.19.2024)

d Jack Cush, MD

Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.

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