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Best of 2021: Potential Birth Defects with Hydroxychloroquine

d Jack Cush, MD

HCQ is one of the safest meds used in rheumatology, but new claims data suggests a small increase in the risk of malformations associated with first-trimester HCQ use. The March 2021 issue of the American Journal of Obstetrics and Gynecology studied the risk of major congenital malformations during the first trimester of pregnancy in women with rheumatic disease taking HCQ.

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Indications Awaiting (12.17.21)

d Jack Cush, MD

There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

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Pain is the Focus of the 2021 Nobel Prize in Medicine

d Jack Cush, MD

The 2021 Nobel Prize in Medicine and Physiology was jointly awarded to Drs.

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DORIS - Defining Remission in Lupus

d Jack Cush, MD

Proponents of treat to target in systemic lupus erythematosus (SLE) have all agreed that "remission" should be the goal, but defining remission may be tricky in SLE.  A SLE Definitions Of Remission (DORIS)Task Force was convened in 2015 and first published their work in 2016.

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ICYMI: Uveitis and Prevalence of Psoriasis in axSpA: Dr. Robert Chao ( @doctorRBC) discusses the best SpA abstracts he saw at the #ACR21 annual meeting: abstracts #1324 and #1311. https://t.co/XEJMyvKDnx

Links:

Dr. John Cush RheumNow ( View Tweet)

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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)

d Jack Cush, MD

The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.

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Comparative risks of skin SCC and BCC with different DMARDs. Abatacept appeared worst, HR 2.18, but may be residual confounding due to burden disease/comorbidities. Abstr#1942 #ACR21 @RheumNow https://t.co/UzOwuKKFmX
Richard Conway RichardPAConway ( View Tweet)
Hospitalisation for heart failure ⬆️ in inflammatory diseases. RA>PsA>AS>PsO . HRs 1.1-1.6 compared to general population. Abstr#1925 #ACR21 @RheumNow https://t.co/kKlGQM5Tcg
Richard Conway RichardPAConway ( View Tweet)
*️⃣Abst#1800 observed that a changing pattern of purine, lipid, & amino acid metabolites occurred during transition from PsO to PsA. *️⃣Compared to pts w/ Pso that didn't progress to PsA, those that progressed had elevated levels of guanine! Potential biomarkers? #ACR21 @RheumNow https://t.co/iQh1ZapDMB
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Increased age at PSO diagnosis was significantly associated with shorter transition time between PSO and PsA diagnoses. No other variables, including BSA, were associated with time to transition @RheumNow #ACR21 Abst#1798 https://t.co/fLPBHKAMAc
Dr. Antoni Chan synovialjoints ( View Tweet)
Can we predict which PsO pts will develop PsA? Machine learning and phenotyping of blood immune cell subsets identified an immune profile to discriminate PsO from PsA. Abs#1774 #ACR21 @RheumNow https://t.co/PERx86jjkJ https://t.co/oEpbMZ0nnK

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Robert B Chao, MD doctorRBC ( View Tweet)
ACR Best

ACR21 Best Abstracts We Saw - Day 3 (Monday)

d Jack Cush, MD

The third day of ACR 2021 took a big leap in online content.  Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty. 

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Cush ACR learning computer online

Day 2 Report from ACR21

d Jack Cush, MD

This report highlights the VITAL trial; the ORAL Surveillance Study; and the Microbiome study of monozygotic psoriasis patients.

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Dr. Fujimoto provides a wonderful overview of skin findings in DM by antibody #ACR21 #ACRAmbassador https://t.co/KpOsgKPU7j
Veena Katikineni VeenaRheumMD ( View Tweet)
Knowledge Bowl at #ACR21 ⭐️This disease featuring purple-red papulosquamous eruptions, on the hands and elsewhere, can have preceding painless erosive symmetrical arthritis at the DIPs, and has a 30% malignancy risk. ➡️Multicentric Reticulohistiocytosis @RheumNow

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

SEC demonstrated significantly longer time to flare vs PBO w/ sustained improvement of ERA and JPsA signs and symptoms up to Wk 104. No new safety signals. Plenary Abs 1424 #ACR21 #RheumNow @RheumNow https://t.co/VF2HmJ3Ha9 https://t.co/ApYFusADHX

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Dr. Rachel Tate uptoTate ( View Tweet)
PsO pts not on biologics had a ⬆️ risk of PsA compared to those on biologics ⭐️HR 1.39 ⭐️retrospective cohort study w/ >1300 cases Abs#1355 #ACR21 #ACRBest @RheumNow https://t.co/tL37we3lwc https://t.co/SAexvn9HMb

Links:

Robert B Chao, MD doctorRBC ( View Tweet)
Psoriasis can be diagnosed at any time of axSpA follow up. Incidence of PsO ⬆️from 16.8% to 26.8% after 6 years Patients with PsO had more peripheral arthritis and higher BMI Abs#1311 @RheumNow https://t.co/IrvHiFqr2m https://t.co/lqCVcF81zA

Links:

Robert B Chao, MD doctorRBC ( View Tweet)
Prospective multicenter Screening for Axial Spondyloarthritis in Psoriasis, Iritis, and Colitis Study evaluated 240 patients with axSpA ⭐️Imaging of the SIJ and spine DOES NOT differ in Ps axSpA or axSpA associated with iritis or colitis Abst# 0902 #ACR21 #ACRBest @RheumNow https://t.co/Y2bRlysXI5
swethaann23 swethaann23 ( View Tweet)
Dr Manasson presents on microbiome differences between monozygotic twins discordant for psoriatic disease. Differences seen in gut (Ruminococcus virtually absent in psoriatic) and scalp non-lesional skin microbiomes Abstr#0944 #ACR21 @RheumNow https://t.co/8Ch0M4dwUH
Richard Conway RichardPAConway ( View Tweet)

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