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Misdiagnosis of Dermatomyositis

d Jack Cush, MD

JAMA Dermatology reports a retrospective cohort study from Johns Hopkins reviewing mimic of dermatomyositis (DM), suggesting that DM and especially clinically amyopathic DM (CADM) are commonly and initially misdiagnosed as inflammatory skin disease (ISD).

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TNF Inhibitor Drug-Induced Lupus

d Jack Cush, MD

A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to common antiinflammatory biologic agents.

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Ankle Fusion or Total Replacement?

d Jack Cush, MD

In a large study of British patients needing surgical treatment for advanced arthritis in the ankle, fusion appeared to be a better option than total ankle replacement.

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Diagnoses via Immune ‘Fingerprints’

d Jack Cush, MD

Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors sequences from human blood, showing the ability to predict health status (healthy vs diseased) and discriminate between distinct autoimmune diseases or viral infections, and those who had received an influenza vaccine.

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Postoperative Weight Loss Improves Joint Replacement Survival

d Jack Cush, MD

A cohort study of shows that postoperative weight loss with antiobesity medications significantly reduced the risk of 5-year and 10-year revision among patients with obesity undergoing hip or knee replacement.

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Cross-trait study of >300K patients’ electronic health records at UCSF and Stanford. Autoimmune conditions associate with greater Alzheimer’s risk (ORs 1.4–1.7). Women with autoimmune disorders have higher risk than men with autoimmune disorders https://t.co/bwtGhyNBs6 https://t.co/FNUdRNozCw

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Cochrane review of TNF inhib. in #JIA shows TNFi efficacy, but uncertainty about LT safety, pain, function, & Dz control - esp compared to MTX. 9 studies, 678 JIApts, age 8-15 yrs (80% F), Dz duration 0.8-6.7 yrs. Withdrawls 1% v 3%; Serious AE 6% v 7% (PBO vs TNFi).… https://t.co/twmYfFg702 https://t.co/hG3j4sMPr9
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RNA-seq analysis of human chondrocytes (HTC) shows Osteoarthritis has more HTC-1 (w/ more cell apoptosis & PD-1 genes) & proliferate fibrochondrocytes (ProFC2) w/ heightened inflammatory response, & increased cytokine signalling https://t.co/FZ72CnWk20 https://t.co/sx4NB2C8h3

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Peking Univ long term F/U of Knee replacement (TKA) in 226 patients (246 knees) shows prosthesis survival rates of 93.6%, 92.4%, 89.8%, and 71.8% at 10, 15, 20, and 25 years post-TKA, respectively. 20yr function somewhat less than 10yr, but still much better than preop… https://t.co/gJbedIEr91 https://t.co/q799oV8TNm
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Do infections lead to Kawasaki Dz (KD)? Swedish registry study of 1774 KD vs 17 731 controls. +Hx of Infx incr risk of KD (OR 2.3; 2.0 to 2.5) - mostly Resp, skin, GU & GI Infx. Infxns usually clustered before KD Dx (OR 5.1 15–28d; OR 1.3 6-12 mos prior KD. More infx = more KD… https://t.co/V9zbcmJdKv https://t.co/Evl3rtCxUO
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Bubble Trouble - When Bullous Lupus Bursts onto the SLE Scene Presentation by Dr. Alana Haussmann at the Rheumatology Winter Clinical Symposia - Feb 2025 https://t.co/bkQSq51BEo https://t.co/DLBs3uIyH7

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Optimal Management of Rheumatoid Arthritis Patients and Liver Disease https://t.co/4JfUueF55o https://t.co/hBkgYU1Mye

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B Cell Depleters (2.21.2025) Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow. https://t.co/PRjy4a1BG9 https://t.co/3J4NSmn6Su

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Medicare study of 2.3 million shows high Telemedicine use was assoc w/ slight increase in visits (F2F & telemed), modestly lower use of 7 of 20 low-value screen tests for cervical CA, ECG, CMP, CBC, TFTs, & imaging for uncomplicated LBP (with less costs too)… https://t.co/lrG9NJ20B7 https://t.co/rLkGdBqWmr
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National Statistics analysis (2020-22)of 3.6 million US workers shows MDs & HCP had lower age/sex adjusted mortality rates vs non-HCPs. In nonHCPs, mortality is lower in females (HR 0.55), but in MD/HCP females its equal (HR 0.97; more CA +respt) & MD/HCP Black higher than whites… https://t.co/gmPJEN4xs0 https://t.co/7QpTZko8GP
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ACPA+ linked to nodule progression. 208 #RA pts w/ Chest CT studied. Lung nodules seen in 1/3; 10% before RA Dx (10.4 mos before). Positive ACPA (not RF) was assoc w/ nodule progression (OR 3.69). csDMARDs & b/ts-DMARDs NO affect on nodule progression. https://t.co/GO1wLRIl9j https://t.co/pfFGbPv2DG

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US nationwide claims data study of CV outcomes (MACE) in #RA based on b/tsDMARD (n=34375) exposures (71% TNFi, 10% JAKi, 8% ABA, 5% RTX, 5% IL-6i). Compared to TNFi, RTX (HR 1.5) & IL-6i (HR 1.3) had numerically higher, but not statistically significant, MACE risk.… https://t.co/GXunfMY3US https://t.co/XYZPt0kzGE
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Srudy of 558 #RA pts finds GERD symptoms were significantly w/ higher TJC28 and VAS scores and lower use of MTX (but not related to NSAID or steroid use). GERD Sxs may impact MTX dosing and Dz activity measures in RA https://t.co/2H8RUNywlG https://t.co/ZBSlTL1ZA3

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JAMA Case: A Woman With Painful Digital Ulcers - What would you order next? - chest CT w/ myositis-specific autoAb panel - dsDNA - SCL-70 & Centromere Abs - muscle biopsy https://t.co/9T8mNDdJTs https://t.co/pTphzcuZKF

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Seeing Beyond the Surface: Salivary Gland Ultrasound in IgG4 Related Disease Presentation by Dr. Amy Trang at the Rheumatology Winter Clinical Symposia - Feb 2025. https://t.co/DLXKCRz3fF https://t.co/lfobyjElFG

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