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Best of 2022: Approach to ILD in Myositis Syndromes

Jack Cush, MD Dec 19, 2022

Mehta et al have published a full read review of managing interstitial lung disease (ILD) in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk.

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CXCL5 Therapy in Lupus?

EurekAlert! Dec 14, 2022

A new study has shown that restoring the balance of a protein in blood may be a promising treatment option for systemic lupus erythematosus.

213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/rBNDHrb3sh #BestOf2022

https://bit.ly/3jd7GRO

Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/DlJzREdj0h https://t.co/peqZzpQrWk

https://bit.ly/3PC5f7m

Leflunomide versus azathioprine in lupus nephritis? Study of 215 bx proven LN given either LEF or AZA - Renal flares were equal (15.7% v 17.8%), as was time to flare (16 mo vs AZA 14 mo); 24-hr proteinuria, creatinine, C3 and C4 improved similarly. https://t.co/fbzhuFT3lh

https://bit.ly/3PDEsaQ

From the Hopkins Lupus cohort - Just one month of Prednisone 40 mg/d yields a FOUR fold increase in avascular necrosis risk #UTSWSLE2022 https://t.co/Kae2PMVgl7 https://t.co/XuhbkBwlCw

https://bit.ly/3hzhBRo

Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies Women of reproductive age comprise an overwhelming majority of patients with rheumatic and musculoskeletal disease. https://t.co/x44GTLRtnT https://t.co/YlLgqeDRgP

https://bit.ly/3Wp169g

73-87% of autoimmune (RA, SLE, UCTD, APL) pts used HCQ during pregnancy. HCQ significantly reduced pre-eclampsia (20% vs 9%), early-onset pre-eclampsia (8% vs 2.5%), 2nd/3rd trimester pregnancy loss (3% vs. 0.6%) https://t.co/CF5ivHeCmY https://t.co/CYqaCCuZJz

https://bit.ly/3hFU6pz

Review of the Rheumatic causes of Pericarditis and their management. Causes: SLE, RA, MCTD, Myositis, EGPA, GPA, IgG4-rel Dz, FMF, TRAPS, CAPS, AOSD, JIA, Sarcoidosis, Kawasakis, GCA, Takayasu's https://t.co/MQmkUe4Yey https://t.co/FSfrznoeBe

Lupus Research Alliance announced 2022 Distinguished Innovator Award recipients: - Hongbo Chi, PhD, Exploring Metabolism of Follicular Helper T Cells & Lupus Progression - Joseph Craft, MD: Processes Enabling T Cells to Be Destructive in Lupus Nephritis https://t.co/yI2NlCHaBi https://t.co/fevBTkaxCY

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https://bit.ly/3Wfk8yF

From a cohort of 689 SLE pts, prevalence of lupus pericarditis was 16.4% Pericarditis was signif assoc w/ renal dz (p 0.003), lymphopenia (p <.0001), thrombocytopenia (p 0.004), +APL Abs (p = 0.002) https://t.co/BndDu21aXF https://t.co/Umbq3rsF1y

https://bit.ly/3FHTWqZ

https://bit.ly/3BsYqiW

Study 119 SLE pts w/ SLEDAI-2K of 13.5 @Dx & 2.8 @ 1st birth. Half had 1+ flares at mean of 9 mos after birth. Pts in remission had less flares (37% vs 61%; p=0.008). SLE flares during pregnancy had more flares in F/U (76% vs 47%; p=0.019) https://t.co/3u3agu9wDj https://t.co/twj4YYclRz

https://bit.ly/3FiQy4E

Tight control of proteinuria in newly diagnosed lupus nephritis The last 3 years have been exciting times in the field of lupus nephritis (LN) with two new licensed therapies, belimumab (BAFF-inhibitor) and voclosporin (calcineurin-inhibitor). https://t.co/InkX6I7qUm https://t.co/U1M1DtF8Id

https://bit.ly/3V0Wzc5

Inadequate Dosing of Hydroxychloroquine Leads to Hospitalizations in SLE https://t.co/ZktIKo1eVl https://t.co/dtxVXZFXpk

https://bit.ly/3UNVvrL

Review of 120 pts w/ Catastrophic antiphospholipid syndrome showed that 54% had skin involvement & was 1st APS sx in 35%. Findings: livedo racemosa (45%), necrosis/ulcers (42%), splinter hemorrhages (29%), distal edema (23%), purpura (14%). https://t.co/HsVWlebfL2 https://t.co/dixoeHNkFQ

https://bit.ly/3Hk6fuW

SLE preg delivery hospitalizations (77560) was associated with increased risk of CV complications, including preeclampsia [aOR 2.12] , peripartum cardiomyopathy (4.42), CHF (4), arrhythmias (2.2), AKI (7.7), stroke (4.8), VTE (6.9) w/ incr hosp costs https://t.co/PF6P8oDWZB https://t.co/jA2pHcciB1

https://bit.ly/3Y80tSS

SLE: Variability in Racial Disparities in Pregnancy Outcomes Significant disparities exist in pregnancy outcomes in women with SLE, w/previous cohorts identifying Black women as having a higher risk of maternal mortality compared to White women w/SLE. https://t.co/1PrJYpMcHx https://t.co/YN7K0Gf5Jl

https://bit.ly/3HjoHDU

Lupus Linked With Greater Risk of Cardiovascular Complications of Childbirth Pregnant women with SLE were more prone to cardiovascular complications during delivery, and their risk seems to have increased over the past 15 years, according to data. https://t.co/mRUOVrKbt2 https://t.co/m18DWxSV20

https://bit.ly/3urUESV

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Best of 2022: Approach to ILD in Myositis Syndromes

CXCL5 Therapy in Lupus?

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