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Rheumatology: Believe It or Not (4/25/2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?
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Unmet Needs in Still’s disease
In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic pathways and possible biomarkers for diagnosis and response; (3) refractory disease and risk factors, and (4) treatment of SD and its complications.
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Osteoarthritis Risky Business (4.18.2025)
Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com. Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.
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Is High Dose Aspirin Needed in Kawasaki Disease?
Does aspirin add any advantage to intravenous immunoglobulin (IVIG) alone in children with Kawasaki disease (KD)?
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EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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Post-treatment Lyme Syndrome
Symptoms that persist long after Lyme disease is treated are not uncommon — a 2022 study found that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). https://t.co/mmwGCnARY8
Dr. John Cush RheumNow ( View Tweet)
Prevalence of ANCA Assoc Vasculitis (especially GPA) in Alaskan Natives (AN/AI) is high. GCA prevalence is lower than White populations, but higher than many others. AN/AI peoples w/ AAV & GCA may present at younger ages with more severe disease https://t.co/dhiu6sPGBk https://t.co/rNCo25HGcn
Dr. John Cush RheumNow ( View Tweet)
Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/29M0jePXHd
Dr. John Cush RheumNow ( View Tweet)
Castleman disease (CD) is a rare, non-clonal lymphoproliferative disorder w/ systemic sxs & maybe linked w/ herpesvirus 8, POEMS or TAFRO syndrome. Mimickers include lymphoma, sarcoma, IgG4-RD, Infections (EBV, HHV8, HIV, CMV, TB), Autoimmune Dz (RA, SLE, Stills) https://t.co/70sROoHusy
Dr. John Cush RheumNow ( View Tweet)
Just published, a review of Inflammasomopathies: mechanisms and disease signatures - these are Gain-of-function mutations in inflammasome receptors leading to chronic inflammatory conditions. https://t.co/kDebFdXlx9 https://t.co/NeJrgI9eRV
Dr. John Cush RheumNow ( View Tweet)
Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/Bgr5zoHyMG
Dr. John Cush RheumNow ( View Tweet)
Genetic Sequencing in Rheumatology
Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic
Dr. John Cush RheumNow ( View Tweet)
Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients
A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. https://t.co/Ltqf1yaaoy
Dr. John Cush RheumNow ( View Tweet)
Enzyme Porcupine inhibition of Wnt signaling is a promising treatment forsclerosteosis - rare Dz caused by SOST mutations & loss of functional sclerostin. Results in high bone mass & skeletal overgrowth (Sxs of facial paralysis, hearing loss, incr intracranial pressure https://t.co/9DYO82quiC
Dr. John Cush RheumNow ( View Tweet)
Phase 3 trial shows inebilizumab reduces flares in IgG4-related disease (10% vs 60% in placebo; HR 0.13, p<0.001) and boosts remission rates without background immunosuppressants. CD19+ B-cell depletion shows promise as a new treatment. #Rheum @RheumNow https://t.co/7iSyPfnMV0 https://t.co/M51b0dipMs
Links:
Natasha Salman, DO DrNatashaSalman ( View Tweet)
Prof Ian Giles will be covering a range of topics at this year's Rheumapreg Conference such as how immunologic changes and placental dysfunction cause adverse outcomes in rheumatic disease pregnancies.
View the full prgramme and learn more: https://t.co/tjiycjKJ8i https://t.co/FugHvtm8fY
BSR RheumatologyUK ( View Tweet)
Sjogrens is a hot area in drug development: “Sjogren’s Syndrome Pipeline Insight 2025” report provides comprehensive insights about 20+ companies and 22+ pipeline drugs, including:
nipocalimab
VAY736 (ianalumab)
HZN-1116
AMG 329
R-2487 https://t.co/sVbyPLi2Um https://t.co/IlvthM7qyG
Links:
Dr. John Cush RheumNow ( View Tweet)
Systemic sclerosis pts in the PRESS & STRIKE cohorts - High type I interferon (IFN) scores in diffuse SSc pts correlated w/ high disease activity & worse 12-month prognosis and overall survival. https://t.co/pdPjoVfQNH https://t.co/RB7li2ZIxX
Dr. John Cush RheumNow ( View Tweet)
Inebilizumab, an anti-CD19+ (B cell)mAb was tested in myasthenia gravis in phase 3, 238 pt trial and shows to signif. improv function and reduce disease severity in acetylcholine recpt Ab+ or muscle-specific kinase Ab+ myasthenia gravis pts. https://t.co/vBBjf8AUug https://t.co/cUbK4PJEvf
Dr. John Cush RheumNow ( View Tweet)
FDA announced approval of Inebilizumab (Uplizna; Amgen), 1st approved Rx for IgG4-related disease (targets CD19+ B cells). IG4-related Dz is estimated to affect 20,000 in the USA. List price is $140,248.50 per dose, After two initial loading doses it is given q 6 mos. https://t.co/aD9yBVJukQ
Dr. John Cush RheumNow ( View Tweet)
