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Opening Day Report

d Jack Cush, MD

The opening of ACR2 Convergence was a hit for all who signed up and viewed in. The day included the presidential address by outgoing president Dr. David Karp (UT Southwestern) and a keynote talk and interview with Dr. Seema Yasmin (Stanford).

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#ACR21 #Abstr0261 In stable Non sJIA, is it safe to taper or stop MTX? Of 375 pts in CARRA registry, 24% tapered and 14% stopped MTX. No diff in flare rates btw those continued vs tapered/stopped. Sustained remission was in ⬆️tapered vs stopped @RheumNow https://t.co/Mm1yfzRBQz https://t.co/rkHvXWj2oO

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Juvenile dermatomyositis, with Gottren's and diffuse hyperpigmentation Regional Winner of Europe & Central Asia Image Competition: Rheum Dz in Patients of Color #ACR21 @rheumnow https://t.co/vxayxgINa8
TheDaoIndex KDAO2011 ( View Tweet)
This 15-day-old boy developed this rash, which was diagnosed with neonatal lupus; anti-Ro and anti-La Abs were present, in both, mother and child. The mother never had had symptoms suggesting SLE or any autoimmune disease. The rash healed after 45 days; the boy is doing great😍 https://t.co/fYB0IzE7kY
Emilio Martin Mola emartinmola ( View Tweet)
Retrospective study hospitalized new-onset systemic JIA (2008-19):52 children’s hospitals & 534 sJiAshows 29% rx w/ biologics & 58% steroids. Over time Biologic use increased & MTX decreased. Biologic correlated w/ Hi hospital volume, ICU stay, later years https://t.co/blbOps9zVQ

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast – Quackademia (10.15.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the FDA approvals, news and the latest journal articles from the past week on RheumNow.com.

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Still’s Disease Following COVID-19 Vaccination

d Jack Cush, MD

Both systemic onset juvenile idiopathic arthritis (sJIA) and adult-onset Still’s disease are acquired autoinflammatory disorders of uncertain etiology. Yet recent reports of AOSD onset and flare following COVID-19 vaccinations may have important mechanistic implications.

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Costs of #JIA are substantial, total costs up to 44,832 USD annually. Direct costs up to $32,446 USD, accounting for 55-98 % of total. $$$ mostly related to meds; cost go up 3 fold after biologic initiation. (JIA Indirect costs are underrepresented) https://t.co/rukJPWqD0y

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Dr. John Cush RheumNow ( View Tweet)

Most common reasons for starting canakinumab? Survey of 58 MDs (caring for 147 febrile pts) 1) perceived efficacy(81%), 2) lack of prior response (41%), 3) good safety (40%). Efficacy w/ HIDS/MKD (91%), no response w/ FMF (52%) https://t.co/JjxaUyBnyB

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Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

d Jack Cush, MD

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in this week's podcast. Let's begin.

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antisynthetase,myositis,nail,erythema

Clinical Associations with Myositis Antibodies

d Jack Cush, MD

While myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) may have prognostic value through their clinical associations, many patients will not have them and overall, they are poorly predictive of a malignancy risk. 

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Study of 52 pts with Juvenile Systemic Sclerosis (JSSc) -10% were without skin dz (SSc sine scleroderma). 7 pts reviewed, all had cardiac dz (86 vs 16%; 3 cardiomyopathy, 3PAH), longer Dx delay (20 vs 8 mos), worse outcomes, (42 v 6%) https://t.co/7wGuX8QVBO https://t.co/XdTK7AlPrs

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Dr. John Cush RheumNow ( View Tweet)
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Pathways to a Psoriatic Arthritis Diagnosis

d Jack Cush, MD

Ogdie and colleagues have retrospectively analyzed a longitudinal cohort of psoriatic arthritis (PsA) patients, showing that only two-thirds of PsA are diagnosed by rheumatologists, PCPs and dermatologists, with significant differences in what preemptive symptoms were noted by different subspecialties.

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exhaustion,depression

Lupus Frailty Index Predicts Organ Damage

d MedPage Today

Patients with longstanding systemic lupus erythematosus (SLE) who were considered frail were more likely to accrue disease damage over time, a secondary analysis of data from a Chicago lupus cohort found.

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RheumNow Podcast – Jack of All Subspecialties (10.1.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com

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Using EHR data from the UK, the frequency of children and young people with JIA in 2018 was studied. Age standardised incidence rate =5.61 per 100 000; prevalence rate=43.5 per 100 000. 5-yr incidence rates did not change over time. https://t.co/mwmf5nktkF

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Dr. John Cush RheumNow ( View Tweet)

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of JIA, although infections during fetal life or childhood did not increase risk of JIA. #RheumNow https://t.co/aXFOxoOyF1 https://t.co/Md0zBm5Txl

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Dr. John Cush RheumNow ( View Tweet)
drug,capsules,antibotic

Early Antibiotic Use Increases JIA Risk

d Jack Cush, MD

A population based Swedish study of birth records shows that antibiotic exposure in first three years of life to be associated with a future risk of juvenile idiopathic arthritis (JIA), although infections during fetal life or childhood did not increase risk of JIA.

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Retrosp. review of 10–24 yr olds w/ newly Dx #SLE shows 78% given steroid-sparing DMARDs by year 1; Most (69%) given HCQ & fewer (34%) given other immunosuppressants. Adults less likely to recv immDMARDs @1 yr https://t.co/aLi6FXlMd3

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Dr. John Cush RheumNow ( View Tweet)

Fever,temp,man,HA,thermometer

Canakinumab Use in Periodic Febrile Disorders

d Jack Cush, MD

A retrospective records review of patients with periodic fever syndromes (PFS)  receiving IL-1 inhibitor treatment with canakinumab (CAN), shows CAN to be effective and safe in a variety of PFS patients.

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