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Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.
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Juvenile dermatomyositis (JDM) is typically recognized for its striking skin rashes, vasculopathy, and muscle inflammation. Less visible, but equally significant, is lung involvement.
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Children with juvenile idiopathic inflammatory myositis (JIIM) are at risk of developing lung disease, notably interstitial lung disease (ILD).
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When I see patients with RA-associated ILD, I’m often asked: “Are the lungs and joints really connected?” The answer is yes, and the connection extends further back than some may realize. While RA is defined by inflammation of the joints, extra-articular complications of the lung are well recognized. ILD has often been viewed as a complication of longstanding RA, but it can also appear before joint disease in a subset of patients.
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Multimorbidity in SLE: metanalysis of 3 studies (1175 pts) saw Multimorbidity (by higher Charlson comorbidity index/CCI), is a strong independent predictor of mortality in SLE (OR 3.92). In SLE, the most freq comorbidities were DM, CVD, COPD, renal/lung/CNS Dz https://t.co/fuYUdfC6wE
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FDA has approved nerandomilast (PDE4b inhibitor) for treatment of adults with idiopathic pulmonary fibrosis (IPF). Approval is based on 2 RCTs, FIBRONEER-IPF & FIBRONEER-ILD, that show slowing of lung function decline IP & progressive pulmonary fibrosis (PPF) pts. https://t.co/pIQwyLUBoj
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ILD in Juvenile Dermatomyositis: Moving Toward Better Outcomes
JDM is typically recognized for its striking skin rashes, vasculopathy, and muscle inflammation. Less visible, but equally significant, is lung involvement. ILD is increasingly acknowledged as a critical driver of https://t.co/vNGWAB88Mc
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What is IPAF?
Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD.
https://t.co/ThU4pq27MU https://t.co/AOa5PALJst
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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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Challenges diagnosing lung disease and ILD in pediatric patients
Children with juvenile idiopathic inflammatory myositis (JIIM) are at risk of developing lung disease, notably interstitial lung disease (ILD).
https://t.co/SClva7aqKH https://t.co/hVX5zdju5V
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2019 National Health Survey of 87,678, 21% had chronic back pain (cLBP). cLBP had more Multimorbidity 62.1%, worse activity limitation. depression, and cardiovascular disease https://t.co/LFdWr0s6tg https://t.co/R5cZSWySUK
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Lung Involvement in Pre-RA
When I see patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD), I’m often asked: “Are the lungs and joints really connected?” The answer is yes, and the connection extends further back than some may realize. https://t.co/7Yl0flhJ3p
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Detection, Monitoring & Management of Autoimmune ILD
The American Journal of Managed Care has reviewed the approach to patients with ILD; a significant cause of morbidity and mortality in those with SARDs, including RA, SSc, and IIM.
https://t.co/xtRfLNyZA6 https://t.co/S9JFlMd9CN
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Study of 246 axSpA (nraxSpA 82, r-axSpA 164) w/ Sxduration 26 yrs. axSpA had more comorbid Dz (^CCI) esp for uveitis (28 vs 1%), IBD (10 v 1%), PsO (10 v 3%)], CVD (7 v 3%), FM (12 v 3%). BUT NO DIFF between r-axSp & nraxSpA for comorbidities https://t.co/0ERLt083yq https://t.co/65x02ZFKTb
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QD clinics on ILD - lessons from the Clinic #3
QD clinics on ILD - lessons from the Clinic; brought to during the "Rheum to Breathe" ILD campaign ILD QD Clinic #3 ILD QD Clinic: Application of the ACR CHEST Guidelines to Two Cases ILD QD Clinic: Progressive RA-ILD Management https://t.co/oYZf9KT9JF
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What is IPAF?
Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD.
https://t.co/ZEexaqoeLK https://t.co/p3Yfv2IkE2
Dr. John Cush
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Interstitial lung abnormalities (ILA) are found in 7% of Gen. population, most of whom are asymptomatic, but some will progress to ILD, IPF,and increased risk of lung cancer, etc. Finding incidental ILD appropriate screening monitoring, based on risk factors is indicated. https://t.co/kQbhxTAVTm
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Data from 2019 National Health Survey on 87,678 ppl -- 21.6% had chronic back pain. Chronic LBP assoc w/ multimorbidity in 62% (esp. CV dz, arthritis, & depression) https://t.co/LFdWr0s6tg https://t.co/Enj162VYJl
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High-Resolution CT in CTD-Interstitial Lung Disease
A systematic review and meta-analysis examined the role of high-resolution computed tomography (HRCT) in diagnosing and characterizing interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). https://t.co/9FmEe6BgN7
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Scleroderma-associated Interstitial Lung Disease
Since the first placebo-controlled randomized trial published nearly 20 years ago for the treatment of patients with SSc-ILD, evaluating cyclophosphamide vs. placebo, there have been several other randomized studies to guide the https://t.co/n8S0N2wTqu
