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Panacea of Prednisone & Cannabis (5.16.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com.  Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!

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Smoking & Autoantibodies in Rheumatoid Arthritis

Jack Cush, MD

Investigators from the Netherlands have published their findings that smoking is a risk factor in rheumatoid arthritis (RA), led by the induction of local autoimmune responses at mucosal sites (in the lungs) and exemplified by RA-specific autoantibodies. 

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2024 Management of Familial Mediterranean Fever Recommendations

Jack Cush, MD

A EULAR/PReS combined task force has developed recommendations for the management of Familial Mediterranean fever (FMF), the most common monogenic autoinflammatory disease worldwide. These evidence-based recommendations update the 2016 recommendations developed for rheumatologists and other HCPs who care for FMF patients.

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Vitamin D for Prevention of Disease

Jack Cush, MD

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults.

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Post-treatment Lyme Syndrome

EurekAlert!

Symptoms that persist long after Lyme disease is treated are not uncommon — a 2022 study found that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). Yet doctors puzzle over the condition’s causes and how to help their patients through symptoms ranging from severe fatigue and cognitive challenges to body pain and arthritis.

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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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Genetic Sequencing in Rheumatology

Jack Cush, MD

Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic sequencing in the field of rheumatology. 

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Smoking & Autoantibodies in Rheumatoid Arthritis Investigators from the Netherlands have published their findings that smoking is a risk factor in rheumatoid arthritis (RA), led by the induction of local autoimmune responses at mucosal sites (in the lungs) and exemplified by https://t.co/SQa3PrRnOI
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Deep remission in SLE – what is it, and can we achieve it? Recent reports on lupus patients treated with CAR-T cells targeting CD19+ B lymphocytes have sparked excitement. This is due to the patients experiencing ongoing clinical remission without further treatment after two https://t.co/rdBkIhfWWd
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Single center study of 2741 ANA tests: 65% ANA negative, 31% ANA+ w/ nuclear staining patterns, & 2.0% ANA+ w cytoplasmic staining. Cytoplasmic - most were reticular, dense fine speckled next. Reticular assoc w/ primary biliary cholangitis (w/ Abs against M2). Dense fine https://t.co/SfBY9BShax
Dr. John Cush RheumNow ( View Tweet)
Single center study of 2741 ANA tests: 65% ANA negative, 31% ANA+ w/ nuclear staining patterns, & 2.0% ANA+ w cytoplasmic staining. Cytoplasmic - most were reticular, dense fine speckled next. Reticular assoc w/ primary biliary cholangitis (w/ Abs against M2). Dense fine https://t.co/JI7iGvw8xp
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Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/2bKY9NtnCD
Dr. John Cush RheumNow ( View Tweet)
Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/dTT9X49DIt
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Hyperpigmentation in SLE Young complex SLE patient develops blue-grey/slate colored hyperpigmentation on her arms and legs - From? Features Dr. Jack Cush https://t.co/yoKU7rJp8y https://t.co/Kh0tZLJ8SX

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Retrospective study of 131 childhoold SLE pts found lymphopenia (in 53%) significantly correlated w/ higher anti-dsDNA and increased disease activity. (r = −0.63). Lymphopenia assoc w/ more nephritis (72%), HTN (24%), leukopenia (36%) & neuropsychiatric SLE https://t.co/F1NALw86hu
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Lupus Unlocked: Journal Club https://t.co/z72E7gBZWp

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Full read review of Neuropsychiatric SLE. NPSLE criteria includes 12 central & 7 peripheral findings (psych, cognitive, Sz, CVA/TIA, neuropathy, MS-like). NPSLE AutoAbs are many: Abs against APL, LAC, RP, NMDA, NMO/AQP4, EC, SBSN, UCH-L1, TP1, GAPDH, MAP2, U1RNP https://t.co/HvDX8wSuoB
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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/C42QMd2zap
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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/h8trTxt5t1
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In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/uAfInA5MAq https://t.co/3AjMRQnmts

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