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JAMA: SLE Review
Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
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ICYMI: Co-management of Psoriatic Disease
It is a common clinical scenario to see someone with both severe psoriatic arthritis and skin psoriasis. In an ideal world this would involve a combined clinic with our local friendly dermatologist. For many of us, however, this is not practical for many reasons. The excellent Saturday morning session on choosing systemic therapies in psoriatic disease at RheumNow Live 2024 from dermatologist extraordinaire Dr. April Armstrong was therefore hugely insightful.
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Seasonal Pathogens and Henoch-Schönlein Purpura
Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers.
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1/600 Falls May Die (4.5.2024)
Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow- including problems w/ falls, pain and treatment of Dupuytren’s contractures.
https://t.co/37JSS1fbLi https://t.co/WEwjntAQEt
Dr. John Cush RheumNow ( View Tweet)
Serious Infections in Takayasu arteritis
The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.
https://t.co/qqtpCMYnZf https://t.co/ZlxATKVQIA
Dr. John Cush RheumNow ( View Tweet)
Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/tuIigaswDK https://t.co/DAh3lgRufA
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Dr. John Cush RheumNow ( View Tweet)
Primary care pop. study pts shows poor health literacy in gout pts assoc. w/ more gout flares. Study of 551pts; 30% w/ 2+ flares in 12 mos; 9.4% w/ poor health literacy. pts had more flares (OR 4.1) & hx of oligo/polyarticular flares (OR 1.93) https://t.co/tDiFqixbLV https://t.co/Kb75iJwTZE
Dr. John Cush RheumNow ( View Tweet)
#RNL2024 @RheumNow
@AlexisOgdie
Many therapies for SpA - but ONLY TNFi, IL17i, and JAKi for AxSpA
Check out https://t.co/3918uYvdFj to help guide treatment decisions: Prior therapies? enthesitis? concomitant IBD/uveitis? comorbidities? Pt preferences? https://t.co/6ugueBPMTy
Dr. John Cush RheumNow ( View Tweet)
TAPIR study shows that GPA patients treated with rituximab can be safely weaned off low dose prednisone. But. 20% risk of relapse in those treated with non-RTX regimens @VasculitisBCN24 #vasculitis https://t.co/jDy0lOQQIP
Catherine Hill CatherineL_Hill ( View Tweet)
Human touch. A systematic review that underscores the physical and mental health benefits. The essence of medicine that will not be provided by #AI
https://t.co/OvCDJYAsoS @NatureHumBehav @j_packheiser @helenahhartmann
@FredericMichon @GazzolaValeria @sbl_nin https://t.co/YuAiKtq87p https://t.co/Sxj1LfO5ZG
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Eric Topol EricTopol ( View Tweet)
Expert Review
Rheumatoid Arthritis: The Continuum of Disease and Strategies for Prediction, Early Intervention, and Prevention
📰 https://t.co/JfkO8WpELc
#rheumatoidarthritis #prediction #prevention https://t.co/3xqHalhjCV
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The Journal of Rheumatology jrheum ( View Tweet)
2018 ACR/National Psoarasis Foundation Guidelines for Treatment of PsA
- Created helpful definitions of Severe PsA and Severe PsO
#RNL2024 @RheumNow @AlexisOgdie https://t.co/mYOWNEevfW
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Dr. John Cush RheumNow ( View Tweet)
#RNL2024 @RheumNow
@_AprilArmstrong
Choosing a biologic in Psoriasis
TNF - great in PsA, pregnancy. Avoid in demyelinating, hep B
IL-17 - robust skin, PsA (axial too). Avoid in IBD
IL-23 - robust skin, PsA evidence, fewer injections https://t.co/42kUaIZxKs
Links:
Dr. John Cush RheumNow ( View Tweet)
vedolizumab-induced enthesitis
@lihi_eder #RNL2024 @RheumNow
11/90 (12.2%) of pts on VDZ for IBD w/ develop new-onset enthesitis
Is this true drug rxn or previously masked by prior meds (TNF)?
Usually unilateral +/- oligo, dactylitis
Most respond to NSAID or injxn, 27% change Rx
Dr. John Cush RheumNow ( View Tweet)
Staph. aureus bacteremia (SAB) is assoc w/ poor outcomes & Osteoarticular infection. Danish study of 18 274 SAB pt (367 w RA). 90d SAB risk in RA was 23% vs 12.5% in non-RA (HR 1.93). Higher w/ Jt implants (29%) & TNFi use (42%). 90d Mortality was 35% https://t.co/hjaPnTbE0E https://t.co/7t7omiUVYf
Dr. John Cush RheumNow ( View Tweet)
Polycyclic Aromatic Hydrocarbons Increase Lupus Risk
A case-controlled study shows environmental exposure to polycyclic aromatic hydrocarbons (PAH) may increase the risk of developing systemic lupus erythematosus (SLE).
https://t.co/04MPWwQlUr https://t.co/iTf6EmKLId
Dr. John Cush RheumNow ( View Tweet)
We're back on 4/9 with another Tuesday Night Rheumatology! We'll be focusing on PsA Hot Topics. Register to attend today!
https://t.co/Ay0uxyfYDk https://t.co/QxZSI9EzTg
Links:
Dr. John Cush RheumNow ( View Tweet)
10 SLE pts w/ ITP and thrombocytopenia were Rx w/ belimumab IV (age 34.3 ± 14 yrs). Overall response rate of thrombocytopenia was 90%, w/ improvement in platelets, lymphocyte count, Hgb, dsDNA, C3, C4 and SLEDAI https://t.co/5U7mHoY0fg https://t.co/oOqUJqUNgl
Dr. John Cush RheumNow ( View Tweet)
13 Risk Factors for RA-associated Interstitial Lung Disease (ILD)
ILD is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%.
https://t.co/x1YFv0ZlL9 https://t.co/XGeilz2tus
Dr. John Cush RheumNow ( View Tweet)
Pearl: Three "S" Rule (Smoking, Seropositivity, Sex/Male): if present the risk of RA-UIP (ILD) goes up nearly 13 fold (ACR23 Abstract 1269) https://t.co/2YFosInpGs https://t.co/rOVN79JJRz
Dr. John Cush RheumNow ( View Tweet)