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Rheumatologists looking for clues to whether their patients with certain inflammatory myopathies will improve on immunosuppressive drugs may find them in a new study appearing in Arthritis Care & Research.
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The European League against Rheumatism (EULAR) has developed recommendations for cardiovascular risk (CVR) management in rheumatic disease patients based on literature review and expert consensus.
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Interesting reports this week about dementia, who gets hand OA and a great list of women Heroes and Pillars of Rheumatology. Tune in as Dr. Jack Cush reviews the news and journal articles from this past week in RheumNow.com.
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The results of the VITAL study (presented at ACR 2021) are now published by BMJ, showing that vitamin D and omega 3 fatty acids reduce the overall risk of autoimmune disease (AID) in a population based intervention trial.
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Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. He discusses the GI side effects of IL-17 inhibitors, downstream revenues from rheumatology care and dietary prevention of gout.
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For adults aged ≥18 years who received 2 doses of an mRNA COVID-19 vaccine, a third dose increased vaccine effectiveness (prevention of hospitalization) among adults without (82% to 97%) and with immunocompromising conditions (69% to 88%), with near similar efficacy.
Dr. John Cush
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Study of 25/306 SLE patients (8.2%) who developed 29 episodes of Pulmonary Hemorrhage (PH). 1st manifestation . PH assoc w/ Renal dz, high SLE activity during PH; PH mortality w/ Renal failure & mech ventilation. https://t.co/ydJkgf5BFB
Dr. John Cush
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Challenges in Lupus:
-Mortality greatest in 1st yr
-Dx Delays 6.4 yrs
-Long-term complications increased 50 fold
-Steroids worsen long-term outcomes
-Health care costs increased 3 to 5 years prior to Dx
-Mean delay in drug starts after Dx =177 days https://t.co/QUbsIQtcRa https://t.co/zAMUp99ecg
Dr. John Cush
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Olumiant (baricitinib) studies in Lupus halted by Lilly due to mixed results in phase 3 trials. While the BRAVE-1 study showed 4-mg BARI meeting primary endpoint at 52 weeks; the Brave-II failed to do same & failed key secondary endpoints https://t.co/XBmo15UCYl
Dr. John Cush
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Lupus international cohort study of 1460 HCQ pts showed that SLE flares were increased with dose reduction (aHRs 1.20;CI 1.04 to 1.38) and HCQ discontinuation (aHR 1.56; 1.31 to 1.86), higher with low educational levels after HCQ D/C https://t.co/fO4fBtrFYo
Dr. John Cush
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Round up of last week's QD Clinics:
-Steroid Weaning
-Diagnosing Neuropsychiatric Lupus
- Not the Same Ol’ Lecture
- Your Next Follow-up Visit is When?
QD Clinic is sponsored by RheumNow Live
https://t.co/9U1wcbIMs4 https://t.co/HjyyGtbe4r
Dr. John Cush
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Among 10,205 admissions for psychosis, 19% were tested for ANA, 15% of those were ≥1:160; BUT ONLY 4 patients met 2019 ACR/EULAR criteria for SLE, & 2 met criteria for Neuropsychiatric SLE - NPSLE prevalence of 1.5% ANA+ psychosis pts https://t.co/r2sTSVKC66
Dr. John Cush
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Women Heroes in Rheum:
- Barbara Ansell - JIA
- Nanna Svartz - SSZ
- Gertrude Elion - Nobel Prize for allopurinol, AZA
- Tsai-Fan Yu - gout Rx
- Mary Betty Stevens - lupus & vasculitis
- Marian Ropes - 1st F ARA president
- Fionula Brennan - TNFi
& more
https://t.co/a9tKUyWBBu https://t.co/UsHDpzJ8ma
Dr. John Cush
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A prospective study of 124 pediatric SLE pts from UK - estimated Incidence 0.36/100 000. In 1st year 71% on systemic steroids, 98.2% on immunosuppressives, 20.4% accruing damage (mostly neuropsychiatric); most needing multiple speciality team care https://t.co/wdh52pn1Fd
Dr. John Cush
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Psychosis is rare in SLE; Retrospective cohort review finds 18/709 SLE or 2.5% developed lupus psychosis. Psychosis remitted in 12/18 w/ a combo of antipsyschotic (in 38.9%) and immunosuppressive (steroid 72%, CTX 56%, RTX 17%, etc) https://t.co/AnCPaPS8QE
Dr. John Cush
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The next generation of lupus therapies (esp in lupus nephritis) - belimumab, voclosporin , anifrolumab, obinutuzumab. Better trial designs, better organ endpoints, but yet these trials/results are limited by the high dose steroids in play.... https://t.co/48D9rI9EEH
Dr. John Cush
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van Vollenhoven et al strategies onT2T in SLE
1) Choose a Target; treat, monitor, adjust
2) LLDAS & DORIS remission are good targets
3) T2T trials needed w/ current Rx & new biologics & sm molecules
4) LLDAS & DORIS as outcomes in clinical trials
https://t.co/aTq398iaSD https://t.co/yWlp4vY7kh
Dr. John Cush
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ASK CUSH ANYTHING!
Have a Rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/LAC6XrYEyN https://t.co/POGHk7Ibq2
Dr. John Cush
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Lupus metanalysis of 41 studies, 17,270 pts shows that REMISSION was maintaned for 1 year in 42–88% of pts, and 5 yrs in 21–70%. Remission assoc w/ older age @dx, lower Dz activity, NO major organ involve. REM had less damage, better QOL https://t.co/1zPcITcYMo
Dr. John Cush
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Register for RheumNow Live, March 19-20, 2022.
You can attend RheumNow Live in person in Irving, Texas - or, the comfort of your own home or office.
You can also receive CME credit!
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