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Big Time Vasculitis (3.10.2023)

Jack Cush, MD

Dr. Jack Cush Reviews the News and Journal articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers the question - does aggressive biologic treatment of psoriasis prevent future psoriatic arthritis?

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Long-Term Survival of Idiopathic Inflammatory Myopathies

Jack Cush, MD

A single center cohort study analyzed the outcome and survival of idiopathic inflammatory myositis (IIM) patients and showed good 5 and 10 year survival but showed significant declined 15-25 years post-diagnosis.

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NSAIDs in Pregnancy (3.3.2023)

Jack Cush, MD

Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow.  This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.

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Burnout #10 (2.3.2023)

Jack Cush, MD

Dr. Jack Cush reviews the past week of news on RheumNow.com.

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Simon Says “Don’t Do This” (1.27.2022)

Jack Cush, MD

Dr. Jack Cush reviews this week’s journal articles, focuses on studies that should not have been done and responds to viewer questions in Ask Cush Anything.

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Lungs ILD

Best of 2022: Approach to ILD in Myositis Syndromes

Jack Cush, MD

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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RECITAL Trial: RTX vs. CTX in CTD-ILD

Jack Cush, MD

A UK study suggests the equivalent outcomes when patients with interstitial lung disease (ILD) associated with connective tissue disease (CTD) are treated with either intravenous rituximab (RTX) or cyclophosphamide (CTX), but with fewer adverse events with RTX. 

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Proposed Cancer Screening for Inflammatory Myositis Patients

Jack Cush, MD

Today's plenary session features a novel proposal on how and which patients with Idiopathic Inflammatory Myopathy (IIM) should be screened for cancer.  Abstract 0002 by Oldroyd et al, entitled "Cancer Screening Recommendations for Patients with Idiopathic Inflammatory Myopathy" took on this thorny practice issue. 

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NEJM Clinical image: 61-year-old woman presented with a 6-month history of periorbital swelling and shoulder weakness. The physical examination was notable for erythema of the upper and lower eyelids and substantial periorbital edema. Dermatomyositis. https://t.co/1Vu1Lh37Hd https://t.co/Bh7FXDgMRx

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Dr. John Cush RheumNow ( View Tweet)
Ccancer detection study in idiopathic inflammatory myositis: found w/in 3 yrs of onset 9/1011 (0.9%) CT chest & 12/657(1.8%) CT Dx cancer. Yield best w/ DM, TIF1γ pos. Yield very low age<40 yrs; high false(+) w/ antisynthetase synd & necrotizing myositis https://t.co/FCBwEYW1eT https://t.co/DAEj83xmam

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Dr. John Cush RheumNow ( View Tweet)
Drs Schett & Mackensen reported a case of refractory inflammatory myositis successfully treated with CD19 CAR T cells. 41yoM w/ +Jo-1, myositis, ILD, Raynauds, periorb edema, not responding to steroids, RTX, IVIG, tacrolimus, CTX https://t.co/DlKs3DGWNu https://t.co/M7qrcfcE2y

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Dr. John Cush RheumNow ( View Tweet)
Differential Dx of Granulomatous Myopathy: Sarcoidosis, inclusion-body myositis, myasthenia gravis, Crohns, GPA, TB, brucellosis, syphilis, PBC, RA, systemic sclerosis , lymphoma, checkpoint inhibitors, GVHD, natural killer/T-cell lymphoma https://t.co/5IUaC1ln7G https://t.co/guYtvyaaHU

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Dr. John Cush RheumNow ( View Tweet)
US population mortality rates compared dermatomyositis (DM) vs polymyositis (PM) in 1981 (12,249) & 2020 (23,608). Downward trend in DM/PM mortality (<7%); plus PM/DM was 2X more likely to be one of mult causes, instead of, sole cause of death. https://t.co/9KZKr8JxUE https://t.co/7acK0eHVku

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Dr. John Cush RheumNow ( View Tweet)
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/h6zpTOIuyu https://t.co/Gy3Eaqz8sM

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Dr. John Cush RheumNow ( View Tweet)
While myositis in the setting of SLE was found to be around 5% in Abs 1453, it was not associated with mortality. #ACR22 @RheumNow https://t.co/hLLuYoXsCv https://t.co/44XGhbPxzW

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Dr. Rachel Tate uptoTate ( View Tweet)
Very important point about statin induced myopathy by Dr. Christopher-Stine. If 1) history of statin exposure, 2) typical symptoms of myositis 3) HMGCR ab positive — do NOT need biopsy and can treat as statin associated necrotizing autoimmune myopathy! @RheumNow #ACR22 https://t.co/VHxPRkCWwj
Robert B Chao, MD doctorRBC ( View Tweet)
What if my #myositis patient gets pregnant? Abstract #0952 #ACR22 @RheumNow 🫁10 pregnancies ➡️ 1 miscarriage -2 preterm -3 low birth wght -1 HELLP -Mean gestational age 36w 🫁 Higher disease activity ➡️ more adverse pregnancy outcomes

Catherine Sims, MD DrCassySims ( View Tweet)

Key points in managing MDA5+ DM 1. Monitor lungs - HRCT/PFTs 2. Test muscle endurance (ref: IMACS site) not just strength 3. Close observation 4. MTX/MMF initial treatments 5. Repeat muscle biopsy if diagnosis unclear Meet the Expert Lundberg I, IMM session @RheumNow #ACR22 https://t.co/ZVFsYgDBx2
Dr. Antoni Chan synovialjoints ( View Tweet)
Dey @DrMiniDey @ElenaNikiUK @docrota @LatikaGupta_ et al. COVID vaccination in IIM+multimorbidity. Adverse events more common, but still infrequent. Both multimorbidity and active IIM increased risk of AEs. @rheumnow #ACR22 Abstr#0177 https://t.co/HA5NaRrPYL https://t.co/TKtagwa0gG

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Richard Conway RichardPAConway ( View Tweet)
Cancer screening in myositis: the path has always been unclear and inconsistent Workable consensus recommendations @Dr_Alex_Oldroyd risk stratification but still extensive investigation burden for most now need to look at effectiveness including cost ABST0002 #ACR22 @RheumNow https://t.co/322qnGjB9K
David Liew drdavidliew ( View Tweet)
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