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NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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1 in 5 Patients are Unaware of their Arthritis Diagnosis
Current CDC numbers suggest that arthritis (any type) affects an estimated 67.1 million (27.9% ) adults in the USA. Interestingly, 1 in 5 do not know their arthritis subtype (21.6%, 14.4 million).
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Manifestations and Treatment in Relapsing Polychondritis
A large multicenter cohort study of Relapsing Polychondritis (RP) describes the clinical manifestations and treatment approaches to this rare, heterogeneous, multisystem disease.
Interstitial Lung Disease and Lung Cancer Risk
A large prospective cohort study found that interstitial lung disease (ILD) is associated with an increased risk of lung cancer.
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Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
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SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/rKDBovTOpl
Dr. John Cush RheumNow ( View Tweet)
Manifestations and Treatment in Relapsing Polychondritis
A large multicenter cohort study of Relapsing Polychondritis (RP) describes the clinical manifestations and treatment approaches to this rare, heterogeneous, multisystem disease.
https://t.co/Gz2qwtC4jZ https://t.co/ZLkjNQmbRC
Dr. John Cush RheumNow ( View Tweet)
SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/J3bMowsrUQ
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Dr. John Cush RheumNow ( View Tweet)
Interstitial Lung Disease and Lung Cancer Risk
A large prospective cohort study found that interstitial lung disease (ILD) is associated with an increased risk of lung cancer.
https://t.co/SdOT28qVfr https://t.co/6KhAijhfHw
Links:
Dr. John Cush RheumNow ( View Tweet)
Martinque, Afro-Caribbean population (n 354 800) study(2004-2022) of 33 AOSD pts (71%F; 79% systemic; 21% chr articular); 91% met Yamaguchi criteria; features as expected but more Pulmonary Dz(51%; 94% w/ a systemic pattern). Half Dx < age 35 yrs. Prevalence 7.6 /100 000 mean https://t.co/QWyfNuvhkl
Dr. John Cush RheumNow ( View Tweet)
Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
https://t.co/ZjuOO08sKx https://t.co/rNVBFxgjZY
Dr. John Cush RheumNow ( View Tweet)
Study of 74 systemic sclerosis pts shows nailfold videocapillaroscopy (capillary disorganization, late pattern changes) predicts ILD progression, worsening PFTs & mRSS in SSc over 2 yrs. KL-6 correlates w/ NVC findings & PFT decline. ILD incr from 38 to 51% in 2yrs https://t.co/A3LiG6Nn0m
Dr. John Cush RheumNow ( View Tweet)
Is the term polymyositis obsolete?.. now being replaced by dermatomyositis, necrotizing myopathy, inclusion body myositis, antisynthetase syndrome & overlap myositis. Full read overview of inflammatory myositis & new treatments from Joint Bone & Spine https://t.co/X46sptp1Ax https://t.co/smqCd8Rm2o
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Dr. John Cush RheumNow ( View Tweet)
EUSTAR Study of 893 SSc-ILD pts - 94 (10.5%) died (mean F/U 39 mos). Predictors of mortality: FVC deterioration >10% w/in 12 mos (HR 3.81) & >10% FVC decline or mRSS worsening (HR 2.82); but not changes in DLCO, mRSS or digital ulcer burden alone. https://t.co/28wSQc1dUS https://t.co/dourQ6WGDq
Dr. John Cush RheumNow ( View Tweet)
Is the term polymyositis obsolete?.. now being replaced by dermatomyositis, necrotizing myopathy, inclusion body myositis, antisynthetase syndrome & overlap myositis. Full read overview of inflammatory myositis & new treatments from Joint Bone & Spine https://t.co/X46sptp1Ax https://t.co/QqyMv6fkVS
Links:
Dr. John Cush RheumNow ( View Tweet)
Referral of 304 suspected autoinflammatory Dz (SAID) to a UK national centre for primarily adult SAID in 2022, 121 (39.5%) were diagnosed with SAID, w/ half of these having monogenic Dz. Median Dx delay was 2 to 6 yrs, worse in late-onset SAID. https://t.co/x8VOFyjuVA https://t.co/3R2HdYUlSg
Dr. John Cush RheumNow ( View Tweet)
BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study compared 12 pts w/ Stills Dz or intravascular lymphoma. Stills pt had significantly higher ferritin and IL-18 levels and IVL pts had significantly higher sIL-2R levels. https://t.co/Ecd6vNJTc4 https://t.co/KdEcpDeskA
Dr. John Cush RheumNow ( View Tweet)
First FcRn inhibitor in #IIM: In #ALKIVIA, SC efgartigimod PH20 improved TIS vs placebo at 24wks (50.45 vs 35.65, p=0.0004), with faster time to TIS≥20 (30 vs 71.5d) & TIS≥40 (113d vs NE). More major responders too (TIS>60: 34% vs 9.5%).
#EULAR2025 #OP0002 https://t.co/ulxtL1NX2Y
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FDA approves new drug for MAS in Still's disease. Gamifant (emapalumab-lzsg) is interferon gamma (IFNγ)–blocking Ab approved For HLH, now for use in adults & children w/ Still's Dz complicated by Macrophage Activation Syndrome. https://t.co/3div1fktWU https://t.co/VvSkuEoki5
Dr. John Cush RheumNow ( View Tweet)
