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Clinical Associations with Anti-RNA Polymerase III Antibodies
A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome outcomes.
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NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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Immunomodulators in the Treatment of Autoimmune Hepatitis
EurekAlert!
Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology.
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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (compared with TNFis).
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New ICD-10 Diagnostic Code -- R76.81 -- for ’At-Risk RA’ (AKA Clinically suspect arthralgia or Pre-clinical RA); this applies to pts w/ abnormal RF or ACPA without having RA. Thanks to Dr. Kevin D. Deane for leading this effort. https://t.co/14I6RCZrXb https://t.co/YxTwPB0YDQ
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Dr. John Cush RheumNow ( View Tweet)
Retrospective review of 457 Autoimmune liver disease pts found 42.5% with Polyautoimmunity. Predictors included ANA positivity (78 vs 47%), ANA titers, dsDNA (12 vs 2%), RF+ (25 vs 9%), disease duration, low albumin, high ESRs. https://t.co/Socl6XWU9a https://t.co/8qomVBh3KP
Dr. John Cush RheumNow ( View Tweet)
La Paz study of 903 RA pts; 136 (14.5%) were D2T-RA, 96 for inefficacy. They define early vs Late D2T-RA=44.5 mos, & differed>> Early D2T-RA (1/3) pts more likely to have anxiety or depression (76% v 0), higher CRP @6mos, & time to develop D2TRA (35 vs 70 mos) https://t.co/KFG68y9Uq5
Dr. John Cush RheumNow ( View Tweet)
🧬 Myositis-Specific Autoantibodies (MSAs) – 2025 Update
MSAs aren’t just diagnostic—they predict phenotype, prognosis, & treatment response.
👇 Infographic #RheumTwitter #Myositis #MedEd @IhabFathiSulima @DrAkhilX https://t.co/91U5s88AdB
Aravind Palraj Rheumat_Aravind ( View Tweet)
SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/rKDBovTOpl
Dr. John Cush RheumNow ( View Tweet)
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/hp7sFR6kLa
Dr. John Cush RheumNow ( View Tweet)
SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/J3bMowsrUQ
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Dr. John Cush RheumNow ( View Tweet)
New download available on biomarkers
https://t.co/rFeApBnHav https://t.co/vwjog6ILJU
Links:
Dr. John Cush RheumNow ( View Tweet)
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/IDeEvitIrB
Dr. John Cush RheumNow ( View Tweet)
NHANES study (1999–2018) of 38,272 participants looked at the neutrophil-to-albumin ratio (NPAR), & elevated NPAR significantly assoc w/ an increased risk of RA (ORtertile3vs1 = 1.27), esp if NPAR > 13.6. NPAR superior to SI), SIRI, PLR, MLR, & NLR. https://t.co/asLc6ghz7w https://t.co/2dAhIvekGA
Dr. John Cush RheumNow ( View Tweet)
NHANES study (2007 to 2020) of 19,904 participants (≥ 20 years), including 1,477 RA pts. Prevalence of kidney stones was higher in RA (17% vs. 8%, p < 0.001) (OR = 1.77) https://t.co/0NZKQdQWR8 https://t.co/BRZ1RTNh5W
Dr. John Cush RheumNow ( View Tweet)
MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/PXkEC3LO6n
Dr. John Cush RheumNow ( View Tweet)
Can you predict disease from serum biomarkers? Comparison of 5 controls, 36 individuals at risk, 74, RA, & 97 PsA pts finds RA w/ higher levels of sICAM-1, MMP1, MMP3, PP, c-Peptide, CRP SAA. Also CRP, SAA, GLP-1, GIP-1, Leptin, PP precede disease onset https://t.co/zqWxsbTSlC https://t.co/Kgv2ZAuzIR
Dr. John Cush RheumNow ( View Tweet)
MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/hvxJRv1r0R
Dr. John Cush RheumNow ( View Tweet)
1,494 Ehrlangen RA pts - machine learning used baseline variables to predict remission at 6 mos. Best/most predictive results w/ AdaBoost modelingdemonstrated strongest accuracy of 85.71% (based on DAS28, Age, VAS and swollen joints. https://t.co/h9UgUKUFo4
Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study compared 12 pts w/ Stills Dz or intravascular lymphoma. Stills pt had significantly higher ferritin and IL-18 levels and IVL pts had significantly higher sIL-2R levels. https://t.co/Ecd6vNJTc4 https://t.co/KdEcpDeskA
Dr. John Cush RheumNow ( View Tweet)
