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IL-1 Inhibition in CPPD

Jack Cush, MD

Controlled clinical trials in patients with calcium Pyrophosphate Deposition Disease (CPPD) are scant. Now a metanalysis provides evidence that anakinra, an interleukin-1 inhibitor, is a promising alternative for patients with acute CPPD flares.

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ACR, guidance, guidelines

New ACR 2025 Guidelines for Non-Renal Lupus

MedPage Today

Written by Lisa Sammaritano, MD, of the Hospital for Special Surgery in New York City, and a committee of nearly 50 other experts, the new guideline also stipulates that corticosteroids are OK for gaining symptom control in newly diagnosed patients and when flares erupt, but the duration should be kept as short as possible.

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Deucravacitinib and Renal Function: Insights from the PAISLEY Trial

Akhil Sood, MD

In the phase 2 PAISLEY trial, deucravacitinib met its primary and secondary endpoints, demonstrating efficacy across multiple clinical and patient-reported outcomes. However, the impact on renal function has remained unclear. An abstract presented at ACR provides new insights.

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B CELL DEPLETION

Taking a closer look: B-Cell depletion beyond the blood

Akhil Sood, MD

Following the landmark case series by the Erlangen group, multiple cellular therapies have entered the race—each with unique targets, constructs, and mechanisms. Yet, a fundamental question remains: How deep is the B-cell depletion? In clinical practice, peripheral blood counts often serve as our surrogate for depletion. But these may only tell part of the story.

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Cush and Kavanaugh

ACR 2025 Rheumatology Round Up

Jack Cush, MD

Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.

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Mesothelin as a biomarker and potential therapeutic target in rheumatoid arthritis? Mesothelin is elevated in RA & animal models & promothes osteoclast differentiation & bony destruction. Blocking mesothelin has the potential to reduce bone destruction. https://t.co/WRXG91AqmJ https://t.co/hMgddPXhxG

Links:

Dr. John Cush RheumNow ( View Tweet)
NHANES study of 4,622 adults, including 296 w/ RA, shows volatile organic compounds (VOCs) & metabolites (mVOCs) exposures increases the risk of #RA (OR: 1.23 - 1.37), especially in females. https://t.co/pBNLTRkyLn https://t.co/L6nVbYlBhD

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Dr. John Cush RheumNow ( View Tweet)
The Decade Ahead: Predicting Long-Term Proteinuria Risk in SLE Lupus nephritis affects almost half of patients with SLE and conveys a mortality rate of up to 30% at 10 years, with at least 10-22% of patients developing end-stage kidney disease. Early detection and diagnosis are https://t.co/ggoA2KsqXg
Dr. John Cush RheumNow ( View Tweet)
Cellular Biomarkers of Rheumatoid Arthritis Dr. Jeffrey Sparks reports on four abstracts at #ACR25. https://t.co/ZO259DXIcW https://t.co/HOpgiXfYvM

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Dr. John Cush RheumNow ( View Tweet)
B Cell Depletion: Check the Lymph Node Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25. https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q

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Dr. John Cush RheumNow ( View Tweet)
This and other reports on palindromic rheumatism show that PR is a pre-clinical RA state, both having same predictive factors for progression to RA! https://t.co/jfpraGfe72

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Dr. John Cush RheumNow ( View Tweet)

@Janetbirdope’s #ACR25 pearls remind us: Order ANA only when clinical suspicion exists Never repeat a positive ANA ENA only if ANA+ ❌ Ignore dsDNA if ANA– (except anti-Ro52) Stop serial dsDNA/C3/C4 if stable Smart lab use saves patients anxiety and systems money. #SLE https://t.co/Mu3EefcIx0

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Romatolog Nurullah_Akkoc ( View Tweet)
#Urinary #biomarkers #lupus #nephritis #Tenascin C -suggests repair, fibrosis, progress of #LN #IL16, #CD163, & more for LN activity Sometime a biomarker may replace repeat #kidney #biopsies? #AMP group #Accelerated #Medicines #Program #ACR24 @ACRheum @RheumNow abst#851

Janet Pope Janetbirdope ( View Tweet)

Will #PAD4 levels predict pts w #CCP positive #arthralgia who will develop #RA? Leeds study - 79 at risk pts PAD4 levels may predicting #rheumatoid #arthritis development #ACR25 @RheumNow @ACRheum abst#832 https://t.co/dnAA6z3NJQ

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Janet Pope Janetbirdope ( View Tweet)
When should you order a renal bx in suspected #LN? Active urinary sediment Used to be #UPCR 500g/g or more Abst#772 looked at UPCR 250g/g to 499 71% + LN and half needed Rx esp if Low C3,C4 Black race Petri, Baltimore #lupus #cohort #ACR25 @ACRheum @RheumNow

Janet Pope Janetbirdope ( View Tweet)

Abstract 2694: Neutrophil:Lymphocyte ratio (NLR)- a practical step towards clinical monitoring of interferon? Log₂NLR significantly correlated with all three IFN signatures across patients with SLE, systemic sclerosis, rheumatoid arthritis, and myositis @RheumNow #ACR25 https://t.co/ujaOQGvAUV

Links:

Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

Sooner May Still Be Too Late: Kidney Biopsies in SLE #ACR25 kicked off with Plenary Session by Michelle Petri (Abstract 0772: Redefining When to Biopsy the Kidney in Patients with SLE. As part of a collaboration with the Accelerating Medicines Partnership, Petri and colleagues https://t.co/bU09vpcDew
Dr. John Cush RheumNow ( View Tweet)
Inflammation skews lipid levels in RA: the “lipid paradox” Using data from CERTAIN and VARA, inflammation (hsCRP)-adjusted TC & LDL better predicted ASCVD events than standard lipids. Are we missing RA pts who need statins? @RheumNow #ACR25 A#2681

Jiha Lee JihaRheum ( View Tweet)

#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

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