All News
Immunosuppression Increasing (2.23.2024)
Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.
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No clear link between weather and MSK symptoms
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EurekAlert!
There is a longstanding belief that changes in weather conditions, such as impending rain or temperature, can trigger or worsen muscle and joint pain but Australian researchers have found no clear pattern between the two.
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CD19 CAR T-Cell Therapy in Autoimmune Disease
The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.
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Eating for Rheumatoid Arthritis
The majority of practicing rheumatologists at RheumNow Live were unaware of the new ACR guidelines issued in 2022 regarding dietary and lifestyle recommendations for patients with Rheumatoid Arthritis. Dr. Monica Guma reviewed these guidelines during her lecture on the impact of diet on disease activity and therapeutic response.
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Five Takeaways in PsA/SpA at RNL 2024
Continuing with the theme of clinical pearls, the PsA and SpA speakers also provided a wealth of information. Here are my five key takeaways and clinical pearls.
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MMPs play pathogenic role in RA-ILD. Multicenter VA study of 2,312 RA pts, 96 had prevalent ILD & Incident ILD developed in 130 (IR 7.5/1,000PY). High MMP-7 increased ILD (adj OR 3.78) & incident ILD (adj HR 2.33). Higher MMP-9 did same https://t.co/W8IuDJCH8e https://t.co/UdiyyUt7jJ
Dr. John Cush RheumNow ( View Tweet)
UK Clinical Practice Research Datalink matched cohort study compared Gout (152K) to controls (709K) - CV devlopment higher in gout (21% vs 15%; HR 2.58). Moreso in women (HR 1.88). Gout pt had more CKD, HTN, obesity dyslipidaemia, & NIDDM https://t.co/BXCawnuIfa https://t.co/ZMuK9Msesb
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2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA is 6.6% (4.4% immunosuppressive Dz; 3.9% immunosuppressive meds; 1.8% both); higher in women 7.9% ages 60-69 (9.5%) & Alaskan/Native indian (8.4%) https://t.co/phFPRqpCbJ https://t.co/non7zpQVOL
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FDA has issued new draft guidance on the "Use of Data Monitoring Committees in Clinical Trials", updating its 2006 guidance document. "..the DMC should have access to safety results as well as comparative efficacy results." https://t.co/F0vKOxCLq9 https://t.co/xBa4Q1ukqo https://t.co/KeBUsYIl6u
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Serial plasma samples assayed for 92 inflammation-related proteins, during and after gout attacks. 21 were differentially expressed. Gout flares assoc w/ increased IL-6, CSF-1, VEGF-A & tumour necrosis factor superfamily 14 (TNFSF14 was highest) https://t.co/mhIFaljKHv https://t.co/o45Zzn0g9A
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EMG fibrillation potentials (insertional activity) & positive sharp waves (Fib/PSW) are found in 95% study of 75 pts dx w/ idiopathic inflammatory myositis (44 PM, 17 DM, 7 ADM, 11 IBM); but also in 4 pts not meeting EULAR criteria https://t.co/VsrNjDMGnC https://t.co/OQYnUPJD5o
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False positive COVID tests (+Rapid Ag; neg PCR) are rare, 1.7% of 11,297 tests; Persistent false positives seen in 13/191 and usually in women, with autoimmune dz (6/13; RA, SLE etc) & using the Quidel QuickVue rapid antigen test https://t.co/Pqkk7uBVcO https://t.co/m6ylQz00Ih
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Join our experts, Drs Liebowitz and Mehta, as they provide insights on the differential diagnosis and management concepts in autoinflammatory diseases.
https://t.co/r5WjYIdmaT https://t.co/gGdhyDKqtC
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Dr. John Cush RheumNow ( View Tweet)
Week 52 outcomes of 180 lupus nephritis pts (IV, VI, III) from AMP academic centers (rx w/ standard of care) showed 22% complete resp, 22% partial resp, 42% non-responder& 14% undetermined. 8/180 (4.4%) had CR sustained Wk 12 to 52; 10% PR. An unmet need! https://t.co/UfYDKqHq1D https://t.co/zUIgvsZY6m
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Cochrane Review: How Good is Ultrasound Diagnosing GCA?
Is temporal artery ultrasound (US) equivalent or superior to the reference standard of temporal artery biopsy (TAB) when diagnosing giant cell arteritis (GCA)?
https://t.co/BWzP3K8dCo https://t.co/DMu19sPMQv
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Orismilast is a novel oral phosphodiesterase-4 (PDE4) B/D inhibitor studied in phase 2b RCT in 202 moderate-to-severe psoriasis pts vs PBO. At wk 16, Orismilast was better at PASI 75 (40%-49% vs PBO 16.5%; P <.05) and PASI90 (22%-28% vs 8%; P <.05) https://t.co/wSmiO2Hr5W https://t.co/gMiQUfT6EG
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Mayo study of 1643 #RA pts (Dzduration 7 yrs) found 4 clusters based on # of comorbidities (Cluster 1 [42%] few comorbidities & cluster 4 [7%] > 10). Cluster 1 w/ good prog/survival; but cluster 4 was older, less DMARDs/biologics https://t.co/NTJvuBujdp https://t.co/wZycwYDfFS
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Vasculitis Pearls
Once again RheumNow Live 2024 really delivered with high impact learning packed into short sessions. As someone with an interest in vasculitis it was fantastic to see four of my favorite speakers in the Vasculitis Mavens and STEP talks
https://t.co/RnaHa54F2T https://t.co/aRpAdz1o8y
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How do you manage enthesitis?
Enthesitis can be a challenge for clinicians to identify, evaluate, and manage in patients with psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA).
https://t.co/9SHM5aZAly https://t.co/KWYnhymsVr
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IV zoledronic acid (ZA) of PBO was given to 222 pts with symptomatic knee osteoarthritis (without severe joint space narrowing) and after 7 yrs of F/U, ZA had no effect on Knee OA progression w/ similar TKR Rates (39% vs 30%) https://t.co/P09EvRmApO https://t.co/s5fL1unM45
Dr. John Cush RheumNow ( View Tweet)