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#ACR21 Thieves: SLE and SSc with worsening cytopenia and hematuria despite treatment: Maria Powell - presents overlap case with PNH, responded to eculizumab @Rheumnow https://t.co/CGvHEMA3lI
Eric Dein ericdeinmd ( View Tweet)
Lab work

Infection or Disease Flare: What Tools Can Help Differentiate?

d Olga Petryna, MD

Differentiation between a flare of disease and infection in patients with autoinflammatory (AI) conditions, where fever is the hallmark, can be extremely difficult. Few studies have evaluated potential differentiators; and having such tools would meet a huge unmet need. 

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Interesting thoughts from Dr. Distler re:nintedanib & MMF in SSc-ILD Agree we should look into MMF-nintedanib combo, but this graph makes me think MMF > NIN Why would that be? Unlike NIN, MMF pts were NOT randomized, which likely favors NIN for a few (speculative) reasons: https://t.co/ZHBD8x74PM
Mike Putman EBRheum ( View Tweet)
🔥Continued, More Clinically Meaningful data in #SSc #ILD from #Nintedanib in >52 wk SENSCIS & SENSCIS-ON(open-label ext)#ACR21 Dr Distler ✨MMF likely to stay 1st line, then Nintedanib ❓Is it time for MMF + Antifibrotic upfront?? Await SLS-III;Data so far seems supportive https://t.co/JWXMlsJgmc
Ashima Makol MD AshimaMakol ( View Tweet)
#ACR21 Abs#1367. Scleroderma pts with absent contractility (AC) associated with diffuse cutaneous disease, cardiac involvement, more severe Raynaud's. ⭐️14/67 AC pts died during study (21%), none without AC ⭐️15/16 Ro52+ pts had AC (p=0.06) https://t.co/GAuOiV5ScC @Rheumnow

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Eric Dein ericdeinmd ( View Tweet)

ACR Best

ACR21 Best Abstracts - Day 1

d Jack Cush, MD

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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#ACR21 #pedsrheum juvenile localized scleroderma Polypositive profile 3 or more autos correlated with more severe skin score, more activity https://t.co/vVXV4jjLvG
Dr. Laura Lewandowski LauraLewMad11 ( View Tweet)
✨Great Pearls when screening patients for clinically suspect #Scleroderma or #Juvenile #Dermatomyositis 📌 Don’t Stop Work Up at Negative ANA if strongly suspect SSc 📌 #Myositis Specific Antibodies have different phenotypes in kids than adults (MDA-5, TIF-1g, NXP-2) #ACR21 https://t.co/KrkkzA5bkV
Ashima Makol MD AshimaMakol ( View Tweet)
Clinical Pearl at #ACR21 by Dr. John Stone: ⭐️Patients w/ RNAPIII positive SSc do not always have puffy hands, Raynaud's phenomenon, or ANA positivity! #ACRBest @RheumNow @SChatterjee https://t.co/9J6OBibi4l
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
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Blacks with Systemic Sclerosis May Have More Severe Disease

d ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that Black people living with systemic sclerosis may have more severe disease and worse prognosis than patients in other racial or ethnic groups, and these worrying disparities may be driven by several socioeconomic factors (Abstract #1854). This poster will be presented Tuesday morning,  November 9, 2021 in the Clinical Poster III (1836–1861) section on Systemic Sclerosis & Related Disorders.

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Nationwide 2 yr F/U study, 11 centers, 300 pts with early (1.2 yrs) systemic sclerosis shows, despite most (2/3) on immunosuppressives, 71% progressed to diffuse SSc, 21% worsen Skin, 23% worse FVC & 6.6% died (cardiac, GI, ILD) https://t.co/UfagmX2S16

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Dr. John Cush RheumNow ( View Tweet)

Methotrexate is the most often-studied treatment and has best clinical outcomes in children and adults with localized scleroderma en coup de sabre. Metanalysis of 34 articles, only 4 RCTs, but 24 case reports. More research needed. https://t.co/fSEvDw2pge

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast square

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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Having both Cancer & Systemic sclerosis (SSc) is rare. Study of 1481 SSc pts saw cancer Dx w/in 2, (1.35), 3 (2.1%) & 5 yrs (3.5%;mostly breast, GYN, Heme CA). Higher 2 yr risk w/ topoisomerase I Ab (OR 3.43), U1-RNP (5.54), but not RNA polymerase III) https://t.co/dVuchv8Afv https://t.co/azGmJYifrj

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Dr. John Cush RheumNow ( View Tweet)
PSS.scleroderma.arthritis.contractures

IL-6 Inhibition in Refractory Systemic Sclerosis

d Jack Cush, MD

A small, single-center cohort analysis of difficult, refractory systemic sclerosis (SSc) patients showed that treatment with tocilizumab (TCZ), an interleukin-6 inhibitor, resulted in significant improvement in joint and skin involvement, regardless of SSc disease duration or subtype. 

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RheumNow Podcast – Do More DMARDs Mean More Switching? (9.17.2021)

d Jack Cush, MD

Smartphones and diet; COVID-19 and the numbers - reassuring or not, and what about masks?; and do more drugs mean more switching, less persistence, and patient adherence goes up...or down? All this and more news and journal reports in this week's episode.

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ICYMI: https://t.co/wM1iRxtHvk The interleukin-6 inhibitor, tocilizumab (TCZ), was studied in a cohort of difficult systemic sclerosis (SSc) and was shown to be effective in refractory joint and skin disease with good long-term retention rates and disease stabilization. https://t.co/A8dfCksp3b

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Dr. John Cush RheumNow ( View Tweet)
A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease. #RheumNow https://t.co/s5wSlndTrt https://t.co/KHz9LYZVAK

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Dr. John Cush RheumNow ( View Tweet)
pssfing.jpg

Risk Factors Associated with Systemic Sclerosis Hospitalization

d Jack Cush, MD

A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease.

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Cardiac coronary Ca score (CCS) in 20 asymptomatic systemic sclerosis (SSc) pts vs controls.CCS incr (& higher scores) in 45% SSc vs 10% controls. CCS values higher in Limited vs diffuse SSc. CCS > 100 assoc w/ age, dz duration obesity https://t.co/aDWpoePqXK

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Dr. John Cush RheumNow ( View Tweet)

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