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AOSD: Young vs. Elderly Onset

Bella Mehta, MBBS, MS

Adult onset still's disease (AOSD) is an autoinflammatory condition characterized by fevers, arthritis, and rash. It is considered an orphan disease because of its low prevalence - it is reported anywhere between 16 to 40 per ten million.

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AOSD: Young vs. Elderly Onset AOSDis an autoinflammatory condition characterized by fevers, arthritis, and rash. It is considered an orphan disease because of its low prevalence - it is reported anywhere between 16 to 40 per ten million. https://t.co/bB2mpul3j7 https://t.co/ic6mY04ddF

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Dr. John Cush RheumNow ( View Tweet)
AOSD: Young vs. Elderly Onset AOSDis an autoinflammatory condition characterized by fevers, arthritis, and rash. It is considered an orphan disease because of its low prevalence - it is reported anywhere between 16 to 40 per ten million. https://t.co/PPI1fvwLAf https://t.co/qMXMsbpwl3

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Dr. John Cush RheumNow ( View Tweet)
@eular_org recommendations session #EULAR2023 - and the first recommendation is one I’m so glad is up front: Adult Onset Still’s Disease (AOSD) and Systemic JIA (sJIA) are the same disease. If anything, it’s the really young sJIA (<18 months old) which is different @RheumNow https://t.co/OCDeeNtNoR
David Liew drdavidliew ( View Tweet)
@eular_org recommendation for AOSD/sJIA: An IL-1 or IL-6 inhibitor should be initiated as early as possible when the diagnosis is established #EULAR2023 @RheumNow https://t.co/xNUdpGDxb9
David Liew drdavidliew ( View Tweet)
Microvascular visualization in Behcet's disease by ultrasound. Maybe really useful in cases which are difficult to diagnose and may not need biopsies in some pts. #EULAR2023 @RheumNow https://t.co/PbC3tCe7v6
Bella Mehta bella_mehta ( View Tweet)
#EULAR2023 Clinical Highlights. Vasculitis: OP0061 - new US imaging showing vessel inflammation differentiating patients with Behcet’s vs No-BD. OP0304: cohort study showed Benralizumab (IL5 RA) given for eosinophilic asthma also improved BVAS. RCT for EGPA is ongoing @RheumNow https://t.co/7uohfjGk49
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Tune it at 1pm EST for RheumNow's daily #EULAR23 recaps. You can find us live on Twitter, YouTube and LinkedIn. https://t.co/t531csjXo8
Dr. John Cush RheumNow ( View Tweet)
Long term data on Canakinumab - IL-1B antibody in #AOSD @EULAR2023 25 pts with persistent disease activity, f/u 12 mths, remission in all but 2 pts. Improved parameters as below :- @rheumnow abst#OP0257 https://t.co/7jKTp87FlX
Bella Mehta bella_mehta ( View Tweet)
Obesity in #AOSD – predicted the development of a chronic disease course and biologic DMARD failure, 139 pts with AOSD- 19% Obese (BMI>30) observational study. abst#AB1503 #EULAR2023 @rheumnow

Bella Mehta bella_mehta ( View Tweet)

Pearls in AOSD – from #EULAR2023 Italian study of 64 patients – AOSD/sJIA pts who achieved drug-free remission more often had white blood cells count >15.000/uL at baseline, however those who were treated with cyclosporine likely failed drug free remission. Abst#AB1484 @rheumnow

Bella Mehta bella_mehta ( View Tweet)

An interesting biomarker in #sJIA- helps differentiate it from other diseases, including infections and other inflammatory diseases! - kids with fever! serum calprotectin (MRP8/14) particle enhanced immuno-turbidimeteic assay (sCAL Turbi). 650 pts @rheumnow #EULAR2023 abst#OP0034

Bella Mehta bella_mehta ( View Tweet)

Review of the etiology of Polyserositis (14 pts, 23 articles): most common - neoplasia (26.3%; Lung Lymphoma; ovarian; pancreatic), autoimmune (16.7% - SLE, AOSD) & infections (12.3%; coxackie, CMV, mTB). https://t.co/Bubd99ETgu https://t.co/VbiPB0y7pv

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Dr. John Cush RheumNow ( View Tweet)
Proposed AOSD criteria: 80 AOSD vs 60 autoimmune pts: \Nneed 7 points = AOSD dx (sensitivity 92%, specificity 93%, AUC 93%): - typical rash 3 pts - fever ≥ 39°C 3 pts - pharyngitis 2 pts - arthritis 2 pts - glycosylated ferritin≤ 20% 1 pt https://t.co/iLUryBVa7C https://t.co/HTWgAucBIm

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Dr. John Cush RheumNow ( View Tweet)
One in Ten has Autoimmune Disease A UK population-based study suggests that autoimmune diseases affect approximately one in ten individuals. https://t.co/a2VbAO0Fc6 https://t.co/69Yl9OTtKY

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Dr. John Cush RheumNow ( View Tweet)

Orphan drugs target rare dz <200k. New drugs (2008-2016) compared 5 yr sales 86 orphan Rx to 232 non-orphan = similar sales- Orphan ($719 mill) vs nonorphan ($812 mill). But orphan Rx lower volume offset by higher prices (7X higher) than nonorphan drugs https://t.co/I8kb4A0eyG https://t.co/gEQpssRVkg

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Dr. John Cush RheumNow ( View Tweet)
Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/0mC7PxF0DU https://t.co/klbnwjcPbM

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Dr. John Cush RheumNow ( View Tweet)
Join us 4/25 as we conclude our Women in Rheumatology campaign by focusing on what's next. Our panelists will recap the challenges addressed this month and discuss a strategy to suppot women in rheumatology. https://t.co/DP4S2hf5Tz @uptoTate @KDAO2011 @gwenesta_melton https://t.co/rcglaZxqoF

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Dr. John Cush RheumNow ( View Tweet)
Join us April 18 for: Private Practice & Academia In this session, our panelists will address the big questions of: "How do I choose between private practice and academia?" and "How do I advance in my career?". https://t.co/BrWG57mRRG https://t.co/A0pzEvJ3cu

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Dr. John Cush RheumNow ( View Tweet)

Anakinra Phase 2/3 study in severe hosp. COVID-19 pts (5/20-3/21) w/ pneumonia & hyperinflammation (incr levels IL-6, ferritin, CRP, LDH). 179 pt Rx w/ ANA or SOC - d15 need for Mech ventilation was 77% ANAK v 86% SoC (NS; RR 0.90; 0.77-1.04) https://t.co/CFcI1qTsU2 https://t.co/wAj4pHN5Dh

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Dr. John Cush RheumNow ( View Tweet)
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