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PCR: Prevalence, Cost, & Risk (6.27.2025)
Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com
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Remission in Axial Spondyloarthritis Unrelated to Gut Inflammation
Most patients with early, active axial spondyloarthritis (axSpA) who quickly received a tumor necrosis factor (TNF) inhibitor experienced remission, and it didn't matter whether or not they had intestinal https://t.co/Sa10k6neRP
Dr. John Cush RheumNow ( View Tweet)
FDA adds new warning for "myocarditis" to the Pfizer and Moderna COVID-19 vaccines (prev mainly assoc w/ Moderna) - risk is 8 per 1 million people for those on 2023-2024 COVID shots, most common in males ages 12 to 24. Generally good outcomes seen. https://t.co/QZbTRaKGH1 https://t.co/1cAUw73eqF
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Dr. John Cush RheumNow ( View Tweet)
UK study of 17472 newly Dx #RA pts (10997 MTX, 4,540 csDMARDs; 13680 steroids-CS) w/ 1307 Serious Infx (SI) (3/100PY) & 311 SI deaths. MTX signif decr. SI (adj HR 0.72) & CS no effect HR 0.99. SI assoc w/ age, smoker, comorbidity, seropositive, high DAS28. 1 DAS unit incr SI https://t.co/Zmsuaf7Rw3
Dr. John Cush RheumNow ( View Tweet)
Vector borne diseases that result in arthritis will rise with climate change/ flooding risk
- Chikungunya
- Dengue
- Zika
- West-Nile Virus
@RheumNow #EULAR2025 @bella_mehta https://t.co/CCOYqTjaXE
Dr. John Cush RheumNow ( View Tweet)
Steroids, Not JAKi, Are the Real Infection Risk
Dr. David Liew reporting at EULAR 2025 in Barcelona, Spain.
https://t.co/rLpyo1UNjd https://t.co/bDfdLTEM1N
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Dr. John Cush RheumNow ( View Tweet)
Safety of Recombinant Zoster Vaccine in Rheumatic Patients
New work presented at EULAR focuses on the RZV, which contains recombinant glycoprotein E – the major target of CD4+T-cells. The abstract describes the tolerability and safety of RZV in patients with inflammatory https://t.co/NS3h9CdGIU
Dr. John Cush RheumNow ( View Tweet)
Management of AAV:
1.High dose GC f/b reduced dose taper ‼️caution in pts w/severe renal dz and RTX induction.
2. RTX effective for induction and maintenance, best for relapses.
3.PLEX: in RPGN pts if accesible ⚠️ risk for infection.
4.Avacopan: for faster GC weaning. No https://t.co/kfZ4gM38KG
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Adela Castro AdelaCastro222 ( View Tweet)
#ClinicalPearls
For
#cartilage #swelling in #relapsing #polychrondritis
Ask for #pics
#Levamisole in #cocaine
#infection - uncommon - from piercing
Acute #bacterial v chronic
#lymphoma
#malignancy
#vasculitis
#Trauma
Hx, duration, fever can be helpful
#EULAR2025
@RheumNow https://t.co/X2b6VHYsYa
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Janet Pope Janetbirdope ( View Tweet)
Vector borne diseases that result in arthritis will rise with climate change/ flooding risk
- Chikungunya
- Dengue
- Zika
- West-Nile Virus
@RheumNow #EULAR2025 https://t.co/HtHyADsOSX
Bella Mehta bella_mehta ( View Tweet)
Climate Change Impacts #Rheumatology Care Taking
HEAT 🥵 causes:
🔺️⬆️ Hospitalisations
🔺️Renal failure ⚠️ NSAIDs
🔺️Flooding: no access to healthcare
🔺️New Infectious diseases mimics RMDs: Zika...
🔺️Insecurities for drug storage and transportation
#EULAR2025
@RheumNow https://t.co/V9RyxYX6Me
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Dual pandemic in Africa.
Increasing lifestyle diseases and obesity, along with infections and malnutrition.
These may be reflected in rheumatic diseases too (if they could be studied in detail)
#EULAR2025 @RheumNow https://t.co/6ulMRxX8az
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Bella Mehta bella_mehta ( View Tweet)
#Shingrix #vaccination is Impt in #SLE
HZ vaccination works in SLE, safe – 1yr still good humeral & cellular immunity
-attenuation over 1 yr re #immune #responses
No major flares
#shingles is ⬆️ in #lupus
👇
abnormal immune response
#pred, #MMF #IS
POS1005 #EULAR2025 @RheumNow https://t.co/o8lDXgOhE1
Janet Pope Janetbirdope ( View Tweet)
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush RheumNow ( View Tweet)
#EULAR2025 Abstr#POS0991 RCT showed Adjuvanted Herpes Zoster vaccination appeared safe in #SLE upto 1 year. However, humoral and cellular responses declined over time. Longer follow up needed to ascertain frequency of vaccine to be repeated @RheumNow https://t.co/FcUi1OfBLu
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#RITAZAREM: infection risk during RTX induction in AAV was ↑ w/ lung disease & nodules/cavities; ↓ w/ TMP-SMX prophylaxis. Early infections predicted later ones, but risk didn’t differ by RTX vs AZA. Pulmonary damage is a key red flag for infection
@RheumNow #EULAR2025 #OP0167
Mrinalini Dey DrMiniDey ( View Tweet)
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Clinical Pearl's for #MAS
Infections are still the most common cause.
Next is malignancy...
Then other causes like autoimmunity..
Ask a detailed history ! Sometimes check with the family when the pt can't give history..
#EULAR2025 @RheumNow https://t.co/fepercz5Af
Bella Mehta bella_mehta ( View Tweet)
MAS can be triggered by infections in VEXAS syndrome. The threshold is reached leading to a hyperinflammatory state
Georgin-Lavialle S @rheumnow #EULAR2025 https://t.co/NKLL75rOgP
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
#infections in #JAKi
@drdavidliew
#JAKi sl ⬆️ infection risk vs #TNFi
⬆️HZ w JAKi
JAKi same risk w #latent #TB #LTBI and new TB ⬇️in JAKi v bDMARDs
He didn’t discuss TYK2i
Reassuring - risk⬇️ over time for infection
@RheumNow #EULAR2025 @eular_org
JAKi & infection https://t.co/KVsY2gXVkQ
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Janet Pope Janetbirdope ( View Tweet)
