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Kidneys small

Sooner May Still Be Too Late: Kidney Biopsies in SLE

Michael Putman, MD, MSCI

ACR Convergence 2025 will be kicking off with a Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE), which is a great place to kick off our coverage of the meeting. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues have given data to what many of us have long suspected: a biopsy threshold of 0.5g/d of proteinuria may be too high.

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Red puzzle piece

New pieces added to the Pre-RA puzzle

Aurelie Najm, MD, PhD

We know that pre-RA is a definition that stands under a large umbrella, ranging from asymptomatic individuals with ACPA positivity to individuals with symptomatic pre-clinical synovitis. How can we predict the transition from the at-risk state to clinical RA outside the realm of clinical, conventional serological (RF/anti-CCP) or imaging (US/MRI synovitis) biomarkers?

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steroid prednisone lab

Can Steroids Be Stopped in Lupus Nephritis?

MedPage Today

Patients with lupus nephritis were more likely to get off chronic corticosteroid treatment, and stay off, when certain factors were in place, researchers said.

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Clinical and Genetic Effects of Neuropsychiatric Lupus

Jack Cush, MD

The clinical features and genetic abnormalities of neuropsychiatric systemic lupus erythematosus shows that NPSLE often means more severe lupus and more organ involvement beyond the central nervous system.

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Bad Actor Cofactor (10.17.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports, discusses pediatric reports, pregnancy data, diet and nutrition and more.

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Telitacicept Effective in Systemic Lupus Erythematosus

Jack Cush, MD

The NEJM has published a report from van Vollenhoven et al showing a new dual B cell inhibitor, telitacicept, to be effective when given to active systemic lupus erythematosus (SLE) patients; but this comes with a few safety concerns.

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MGUS,SPEP,Gamma

Review: Monoclonal Gammopathy of Undetermined Significance

Jack Cush, MD

NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those over age of 50 years.

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Osteoporosis Screening in High-Risk Men

Jack Cush, MD

A Veterans Affairs (VA) Health Systems study of older male veterans found benefits of a remote model of screening that significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician acceptance.

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RA Hands Difficult deformity

Not all difficult-to-treat RA will have rapid radiographic progression

Jack Cush, MD

A study of radiographic outcomes in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) show a subset in whom damage is rapid and in need of more aggressive therapy.

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From Dr. Petri at Plenary - even small amounts of proteinuria are a PROBLEM. Reduction of microalbuminuria by even 10% improves mortality! #ACR25 @RheumNow https://t.co/hjmH26vXIb

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Brian Jaros, MD Dr_Brian_MD ( View Tweet)
5–10% of axSpA [ts jave comorbid IBD. Southern Swedish study 152 (r- & nr-) axSpA pts found elevated fecal calprotectin (≥ 50 mg/kg) & this was assoc. w/ more damage w/ higher mSASSS values for all axSpA (adj OR 2.2) & in r-axSpA (adj OR 2.9) https://t.co/Hi1lE4so1r https://t.co/YYCGYYasfL

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Dr. John Cush RheumNow ( View Tweet)
Study from Czech ATTRA registry of 8,543 RA pts 641 (7.5%) met criteria for D2T-RA & 1,825 achieved remission (21%). D2T-RA predicted by machine learning models (accuracy 0.606–0.747, AUC 0.656–0.832). Predictors included CDAI, DAS28-ESR, TJC, HAQ, CRP, steroids https://t.co/PqgKzKhM6h
Dr. John Cush RheumNow ( View Tweet)
SAIL-RA: Finding ILD in Early RA Cohort study of early rheumatoid arthritis (RA) patients finds that interstitial lung disease (ILD) begins early in the course of RA, with certain factors enhancing this risk. https://t.co/nI0YuYd3YS https://t.co/YR3Gg1kr59

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Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 423 seropositiv RA pts (SPRA) finds 21% with baseline ILD; over 10 yrs 31% had ILD. High monocyte counts signif higher in RA-ILD; whereas RF, CCP did not predict. Age & ILD predicted mortality - not monocytes, RF or CCP https://t.co/8H4wqZI3WQ https://t.co/dK9iHwj3cz

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Dr. John Cush RheumNow ( View Tweet)
Study of biopsy proven lupus nephritis pts (1970-2024) - a total of 324 LN pts followed for median 9.9 yrs -- 30 (9.3%) developed Venous Thromboembolic event (VTE); time from LN to 1st VTE 4.4 yrs. Predictors were SLEDAI-2K score (HR= 1.05) and proteinuria level (HR 1.26)

Dr. John Cush RheumNow ( View Tweet)

A high ANA titer (≥1:640) in individuals without an autoimmune disease was found to be strongly associated with liver-related disorders, including nonalcoholic and alcoholic liver disease Arthritis Care & Research https://t.co/tkMpPFPnhc https://t.co/Bk9JXWTsOU

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ACR_Journals ACR_Journals ( View Tweet)
~1/3 non-IPF ILD progresses over time. KL-6, a new biomarker, retro study of 10 European centers, 303 pts - 37% progressed (⩾10% FVC decline) after 1yr. 5 predictors of progression: age, gender, BMI, FVC, KL-6. (superior to KL-6 alone) w/ 55% sensitivity, 73% specificity 67% https://t.co/i0Uc8DPHaM
Dr. John Cush RheumNow ( View Tweet)
Activity Trackers Can Predict RA Flares People with rheumatoid arthritis (RA) who experienced disease flares often showed changes in heart rate and physical activity captured by popular wearable devices 4 weeks before they became clinically apparent, a small study indicated. https://t.co/LjE0LkJTrB
Dr. John Cush RheumNow ( View Tweet)
HMGCR Abs is assoc w/ necrotizing myopathy. Review of 78 pts w/ HMGCR IMNM. 31 had overlap w/ higher MMT-score, less muscle weakness, more ILD, arthralgia, wt loss & rash. 12 had musc. dystrophy like dz w/ earlier onset, longer duration, less myalgia & extramuscular Sxs https://t.co/RpzZI0zI7E
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 259 SSc pts underwent cardiac MRI looking for primary heart involvement (pHI) - detected in 37 14%). Predictors included troponin T (OR 14.1), CRP [OR 11.2), ILD [OR 6.3), and arrhythmias https://t.co/8KTINQ5loi https://t.co/60wQAPCUJv

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Dr. John Cush RheumNow ( View Tweet)
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