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Diagnosis and Management of Kawasaki Disease

EurekAlert! Nov 13, 2024

The journal Circulation has published a comprehensive overview called “Update on Diagnosis and Management of Kawasaki Disease,” summarizing data published since the 2017 American Heart Association Scientific Statement on Kawasaki Disease related to diagnostic criteria, risk scores and treatment options for children and adults with this condition.

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Blue Collar Arthritis (10.25.2024)

Jack Cush, MD Oct 25, 2024

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.

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Dot the "i", Cross the "t" (10.11.2024)

Jack Cush, MD Oct 11, 2024

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.

Major update in tx for GCA beyond Toci SELECT-GCA showed upadacitinib 15mg daily achieving higher rates of remission with SHORTER (26wk) steroid use compared to placebo (52wk) No significant adverse safety signal w JAKi including MACE/malignancy @RheumNow #ACR24 Abstract 0770 https://t.co/45D0Txed2N

Results from SELECT-GCA ➡️UPA 15mg + 26W GC taper demonstrates superior efficacy & reduced GC use vs PBO + 52W GC taper ➡️No new safety signals Is UPA the new kid on the block in #GCA? Ab0770 #ACRBest #ACR24 @RheumNow https://t.co/pHzozYiid5

https://x.com/DrMiniDey/status/1857796013395697830/photo/1

The TAPIR Trial on GPA shows higher (15.5%) relapse in the 0 mg prednisone arm vs. 4.2% in the 5 mg arm (OR 4.22), but does not impact PROs. Key finding: benefit of 5 mg/day seen only in non-rituximab regimens (20% vs. 2.6%, OR 9.50). Abstr#0774 Plenary 1 @RheumNow #ACR24… https://t.co/5DjW5Zwh0J https://t.co/UnsVPzJfs6

SELECT-GCA: Upa in GCA Merkel Upa 15 mg v 7.5 v PBO w slower GC taper 70% new onset, 30% relapse. Few prev on IL6 Primary endpt: sustained remission at w52- UPA 15 mg beats PBO (p=0.0019) 34% relapse in UPA vs 60% PBO Less steroids, longer time to flare @RheumNow #ACR24 #ACRBest https://t.co/1OV2889Ny0

Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/fr75XK21L1 https://t.co/Hhax7po7vV

EGPA: To RTX or not to RTX? French MAINRITSEG trial underway to determine utility of RTX vs. AZA maintenance therapy Huge anticipation for these results, hopefully next year! #ACR24 @RheumNow https://t.co/POelLpirrI

https://x.com/Dr_Brian_MD/status/1857484737084047833/photo/1

Year in review: The MANDARA trial showed benralizumab was non-inferior to mepolizumab for #EGPA @RheumNow #ACR24 @rheumarhyme @doktora_ging https://t.co/k5azGQOECB

Looking forward to this Plenary - upadacitinib vs plbo in GCA Similar to GiACTA, 26wk taper w/UPA better than 52wk taper w/PLBO. Too small for safety, but no new rsks Strong argument for DMARDs upfront in GCA... but doesn't help with which 😉 #ACR24 @RheumNow Abstr#0770 https://t.co/MZY4QUazhI

MANDARA Mepolizumab v benralizumab for EGPA BEN is non-inferior Secondary outcomes- less eosinophils and more pts completely off GCs Now approved for EGPA Year in Review #ACR24 Pillinger @RheumNow https://t.co/ThLziABvzu

https://x.com/ericdeinmd/status/1857773289474507223/photo/1

Abatacept for GPA? Tx with Abacept did NOT significantly reduce rates of treatment failure compared to GC + PBO (background DMARD allowed) in non-severe, relapsing GPA Continued need for tx options in non-severe relapsing dz @RheumNow #ACR24 Abstract #0823 https://t.co/7GfprUzoL7

https://x.com/Dr_Brian_MD/status/1857502436371607960/photo/1

Literature review of the treatment of IgA Vasculitis (Henoch–Schönlein Purpura) suggests: - Glucocorticoids are 1st -line therapy, esp if severe - For minor HSP: colchicine, dapsone, & methotrexate may be useful - Also studied cyclosporine A, tacrolimus, MMF… https://t.co/ZoZX3kyHvo https://t.co/dS82ekuEkv

Fasenra approved in the EU for eosinophilic granulomatosis with polyangiitis https://t.co/luhFvy3yjR https://t.co/52oiTYG3a4

Fasenra approved in the EU for eosinophilic granulomatosis with polyangiitis

Nailfold videocapillaroscopy (NVC) study of 65 Behcets pts found vascular abnl in 40-47% ( enlarged/tortuous capillaries, microhaemorrhages. Having ≥2 NVC abnormalities increase risk of Vascular events (VTE, superficial thrombophlebitis), but not ANA https://t.co/2Om0IIFVnG https://t.co/W7mbdPh9ee

Nailfold videocapillaroscopy abnormalities and vascular manifestations in Behçe…

Retrospective study compared IV methylprednisolone (IVMP) to oral glucocorticoids (GC) Rx in 419 #GCA pts (>90% vision Sx). 26% Rx w/ IVMP was not superior at survival or visual ac uity than GC, but IVMP was assoc w/ signif more diabetes @1 yr (OR 2.59) https://t.co/pRBA18Fzyw https://t.co/z6Sw5LTtGq

The use of intravenous methylprednisolone in giant cell arteritis: a population…

#VEXAS can present as atypical &/or refractory #ANCA-associated #vasculitis Consider possibility of VEXAS in cases of AAV ▶️Refractory to multiple treatment ▶️Atypical kidney biopsy 👉🏽https://t.co/1Vewb5n5vZ via @RheumJnl https://t.co/FLov5xaQAA

Genomic profiling of 34 ANCA-assoc vasculitis pts w/ glomerulonephritis suggests activity by cytokine-producing CD4+ & CD8+ T cells & potential for ustekinumab. 4 relapsing GN pts Rx w/ UST & CTX +steroids, w/ good responses, improved GFR and BVAS scores… https://t.co/ospA8CJ6JE https://t.co/HbRpXMec0f

Pneumocystis Jirovecii Pneumonia Complicating Systemic Vasculitis A retrospecitive analysis of 62 patients with systemic vasculitis complicated by Pneumocystis jirovecii pneumonia (PJP) showed those with MPA had a higher mortality risk, possibly due to a higher prevalence of… https://t.co/yWjWOXtMwR https://t.co/2aD3EIsi7z

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Diagnosis and Management of Kawasaki Disease

Blue Collar Arthritis (10.25.2024)

Dot the "i", Cross the "t" (10.11.2024)

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