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Biomarker Predictors of Osteoarthritis

d Jack Cush, MD

Science Advances has reported that Duke University researchers have validated a biomarkers of osteoarthritis that may be identified 2 years before the appearance of radiographic OA.

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ARCTIC Rewind: Can You Taper DMARDs with Remission?

d Jack Cush, MD

In an open-label, randomized, non-inferiority trial, rheumatoid arthritis patients in remission were subject to tapering of disease-modifying antirheumatic drugs (DMARDs), and while maintenance of remission was seen in some, many DMARD tapering patients did flare and were unable to maintain flare-free survival compared to those on stable conventional synthetic DMARDs.

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TLR Antagonist in Lupus

d Medpage Today

An investigational Toll-like receptor (TLR) antagonist was effective in reducing biomarkers and clinical symptoms of systemic lupus erythematosus (SLE) in a pilot trial, evidence that the innate immune system may hold the key to lupus pathophysiology.

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ICYMI: What are the Early Stages of Lupus?

d Eric Dein, MD

Incomplete lupus? Undifferentiated connective tissue disease? Pre-clinical autoimmune disease? During the lupus pod at RheumNow Live 2024, Dr. David Karp discussed the spectrum of autoimmune disease and the confusing terminology that is used with the complex world of early autoimmune disease. He cautioned against the traditional use of phrases such as incomplete lupus or undifferentiated connective tissue disease, which are heterogeneous and poorly defined.

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Rheum Chapter Notes Dr. Jack Cush reviews this past week’s news and journal articles from https://t.co/V10S4oVFsv. https://t.co/m6pkmYeiAl https://t.co/3cr3KwV1CP

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Dr. John Cush RheumNow ( View Tweet)
UK Early Inflammatory Arthritis Audit of 20,060 RA pts (~12k on MTX; 5K csDMARD; ~2.5K no DMARD). Serious infections (SIE) hosp rate was 3.19/100PY, death 0.1/100PY. SIE risk incr w/ age, smoking, Hi DAS28 & HAQ. 1 unit DAS28, SI risk increased by 8% https://t.co/OrNh8oYE3y https://t.co/DqbeibNMbp

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Dr. John Cush RheumNow ( View Tweet)
Tuesday Night Rheumatology: Mastering SLE https://t.co/lhExjSsKNA

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Dr. John Cush RheumNow ( View Tweet)

FDA issued a drug safety warning linking thiopurine (AZA, 6MP) use in pregnancy & a rare risk of intrahepatic cholestasis of pregnancy (ICP). ICP has been reported in pts w/ CD, UC, or SLE; however thiopurines are not FDA approved for these Dx https://t.co/XKoUdy4sAR https://t.co/DSU9z0v7CZ

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Dr. John Cush RheumNow ( View Tweet)
British Society for Rheumatology (BSR) presented (at the 2024 annual BSR meeting) new guidelines for the management of Behçet's disease - how to manage skin lesions, mouth ulcers, genital ulcers, serious eye, CNS & vascular involvement https://t.co/d0bjKuubym https://t.co/lqoTeTGqZ7

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Dr. John Cush RheumNow ( View Tweet)
Spondyloarthritis Faculty Panel Q&A Spondyloarthritis Faculty Panel Q&A - featuring Drs. Eric Ruderman, Lihi Eder, and Lianne Gensler; moderated by Dr. Artie Kavanaugh https://t.co/6RFkyO72e1 https://t.co/CJ174sETFv

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Dr. John Cush RheumNow ( View Tweet)
Future Therapy of Axial Spondyloarthritis https://t.co/wjrlkuu0ds https://t.co/jQ12eTpT2l

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Dr. John Cush RheumNow ( View Tweet)
Predicting Infection in Lupus Nephritis Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN. https://t.co/BnV7jVfqj1 https://t.co/LYQd6w1DvD

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Dr. John Cush RheumNow ( View Tweet)
Our final TNR for the month of April will take place on 4/30 at 6:30pm ET. Mastering SLE Rethinking Pre-Clinical Disease in Lupus - David Karp, MD Biology and Rx of Lupus Flares - Michelle Kahlenberg, MD Current/Future Biomarkers in SLE - Andrea Fava, MD https://t.co/j05QmWg17f https://t.co/jDvP0iTS8T

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Dr. John Cush RheumNow ( View Tweet)
Predicting CKD Outcomes in Lupus Nephritis An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class. https://t.co/UHNqj6WTXn https://t.co/IOc0Gv21FM

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Dr. John Cush RheumNow ( View Tweet)
In biologic-naïve active PsA pts Rx w/ guselkumab & achieving enthesitis (ER) or dactylitis resolution (DR), had better PRO outcomes. GUS - ER or DR was assoc w/ minimal pain (p < 0.001), normalized HAQ-DI (p < 0.001), , better FACIT-Fatigue responses https://t.co/HymI7CBfXh https://t.co/dYk9qXdVpt

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Dr. John Cush RheumNow ( View Tweet)
In 530 #GCA pts, relapses seen in 46%; but severe relapse (ischemi/aortic events) in 3%. Severe GCA relapse pts more likely to be younger at Dx(P=0.02), w/ more limb claudication(< 0.0001), fewer GCA-related cranial Sxs (<0.0001); but not higher mortality https://t.co/qyUpepmryA https://t.co/MJ9kAKl62r

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Dr. John Cush RheumNow ( View Tweet)
With the FDA's approval of its 50th biosimilar - they have published "A Milestone in Facilitating the Development of Safe and Effective Biosimilars". Since biosimialrs were approved in 2015, they saved the health care system $23.6 billion. https://t.co/7GPJ5XLGnr https://t.co/6Qw7DttmjT

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Dr. John Cush RheumNow ( View Tweet)
Venous thromboembolic event Risk study in 1854 SLE pts vs controls (12,107) from 1985–2015 in W Australia. VTE affected 12.8% SLE pts; 6 fold higher than controls (RR 6.6). Risk factors: aPL(aHR 4.24), serositis (2.7), nephritis (1.75), low Plts (1.65) https://t.co/efUUQzTNzK https://t.co/XXXXTbQOCn

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Dr. John Cush RheumNow ( View Tweet)
JAMA review of ILD; that affects 650,000 in USA, leading to 25,000-30,000 deaths/YR. Types reviewed. Key Symptoms: dyspnea and cough, w/ chest CT being diagnostic tool. Antifibrotic & immunomodulatory may slow disease progression. https://t.co/tE7kHgUE02 https://t.co/V7Htoct3VP

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Dr. John Cush RheumNow ( View Tweet)
Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD https://t.co/ZkhpzaTjjI https://t.co/e3BO813b30

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Dr. John Cush RheumNow ( View Tweet)

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