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Nintedinib’s Durable Efficacy in Systemic Sclerosis

MedPage Today

Patients with interstitial lung disease (ILD) related to systemic sclerosis continued to see less progression when treated with nintedanib (Ofev) in the pivotal 100-week SENSCIS trial, researchers said.

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mitochondrial,DNA

Mitochondria as Master Regulators of Inflammation

Jack Cush, MD

Mitochondrial constituents and metabolic products may give rise to immune activation; this is especially true for mitochondrial DNA, which can function as damage-associated molecular patterns (DAMPs) leading to inflammasome activation.

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2021,year

ICYMI: 2021 Rheumatology Year in Review

Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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Two Week Twitter (6.17.2022)

Jack Cush, MD

Dr. Jack Cush does a 2-week review of RheumNow Tweets on news and journal citations worth noting, along with some opinions on Telehealth, manpower, monkeypox and the price of drugs.

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Relevance of Raynaud’s in Systemic Sclerosis

Jack Cush, MD

Raynaud’s phenomenon (RP) is integral to the diagnosis and management of systemic sclerosis (SSc) patients; a recent analysis suggests that RP should be characterized based on color change and the presence of other symptoms to know whether RP portends more serious manifestations.

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Methotrexate Monitoring (5.13.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Bad news for digitial ulcers in Systemic sclerosis, Readmissions in Lupus and Thrombocytopenia in APL patients.

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Cochrane review of Stem cell transplantation in systemic sclerosis (3RCTs w/ 125 pts). Non‐myeloablative & myeloablative selective HSCT had moderate evidence for improved survival, skin thickness & function. But these had high Serious AE rates. https://t.co/qUOfMVSxGZ https://t.co/4icaRdC2EI

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Dr. John Cush RheumNow ( View Tweet)
Review of Clinical Trial measures in systemic sclerosis: -RCTs focus on skin dz, ILD or Pulm HTN using mod. Rodnan skin (MRSS), 6-min walk -FVC is surrogate measure for SSc-ILD - Composites: CRISS, the EUSTAR-AI -Future: Skin mRNA biomarkersTHBS1 and COMP https://t.co/KPLiNTSSZA https://t.co/YgvWuMiU4i

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Dr. John Cush RheumNow ( View Tweet)
Review of Clinical Trial measures in systemic sclerosis: -RCTs focus on skin dz, ILD or Pulm HTN using mod. Rodnan skin (MRSS), 6-min walk -FVC is surrogate measure for SSc-ILD - Composites: CRISS, the EUSTAR-AI -Future: Skin mRNA biomarkersTHBS1 and COMP https://t.co/2KD892VIUy https://t.co/9giddEl9I4

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Dr. John Cush RheumNow ( View Tweet)
Environmental articulate matter (PM2.5) levels can increase the odds of a systemic autoimmune rheumatic disease onset (OR 1.12; 1.08–1.15), , w/ no effect of ozone. Results not changed by controlling for smoking. https://t.co/7BGBh9h0lf https://t.co/LcUo4Lxzgx

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Dr. John Cush RheumNow ( View Tweet)
Baricitinib (JAK1/2 inhib) in 10 pts w/ systemic sclerosis showed improvement in modified Rodnan Skin Score ( −11.67 @wk 24; p=0.0008); 3/4 w/ digital ulcers healed at week 24. Similar findings seen in bleomycin induced animal model https://t.co/1G9CGjLK2N https://t.co/Gt35DcMyuz

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Dr. John Cush RheumNow ( View Tweet)
Sousa et al. Anti-Ku disease. Cluster analysis (Ku alone, Ku with other abs) asking is is a distinct entity. In isolated anti-Ku+ maybe so, characterised by Raynauds (41%), arthritis (26%), sicca (26%), myositis (15%), ILD (15%) @RheumNow #EULAR2022 POS0861 https://t.co/IboWzMYFMB
Richard Conway RichardPAConway ( View Tweet)
Beyond capillaroscopy, US vascular imaging dorsal/ventral fingers can improve detection of vasculopathy of SSc in patients with Rayanaud's (RP) by Nam et al. The % vascular areas in patient's with RP was significantly lower in SSc vs normal volunteers #EULAR2022 @RheumNow POS0127

Dr. Antoni Chan synovialjoints ( View Tweet)

CTD associated ILD 🫁: lncRNA ENST00000604692 detected in PBMCs is associated with CTD-ILD and can distinguish SSc- ILD and RA-ILD vs. non ILD patients with AUC 0.79. As many lncRNA, unknown if biomarker only or has a pathogenic role. @RheumNow OP0114 #EULAR2022 https://t.co/sR4GmaMkXD
Aurelie Najm AurelieRheumo ( View Tweet)
Burja et al. Dimethyl alpha-ketoglutarate has anti-inflammatory and anti-fibrotic effects on explanted systemic sclerosis skin. @RheumNow #EULAR2022 OP0095 https://t.co/PSbnVh6uta https://t.co/2ij9HgoU6Q

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Richard Conway RichardPAConway ( View Tweet)
✨Localized #Scleroderma Pearls✨ #EULAR2022 Eosinophilic Fasciitis 👉Contractures wrists/ankles, rarely fingers 👉Mimics- #Lipodermatosclerosis #Panniculitis 👉GCs+MTX 1st line (IV in refractory🧐),MMF 2nd line ✅I add IVIg+/-UVA1 (pending logistics and insurance coverage!) https://t.co/ZErfLxgdxd
Ashima Makol MD AshimaMakol ( View Tweet)
Retrospective pregnancy outcome study in 154 Rheumatic pts. Systemic sclerosis pts had higher risk of adverse preg outcomes (vs HC - 60.6% vs 10.0%; OR = 14; SSc had increase in 1st trimester miscarriage, preeclampsia, SGA & Preterm https://t.co/hfd6SsCRmr Conclusions

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Dr. John Cush RheumNow ( View Tweet)

Data from Scleroderma Lung Study (CTX vs MMF in PSS) shows that early progression of ILD by CXR scoring (≥ 2% at 12 or 24 months) experienced significantly worse long-term survival than those with stable Xrays (P = .014). https://t.co/hv2WNJ4Chr https://t.co/W5RIhoIGtT

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Dr. John Cush RheumNow ( View Tweet)
Relevance of Raynaud’s in Systemic Sclerosis A recent analysis suggests that RP should be characterized based on color change and the presence of other symptoms to know whether RP portends more serious manifestations. https://t.co/rLo6Ju5LV1 https://t.co/gAQAYxe9rL

Links:

Dr. John Cush RheumNow ( View Tweet)
Systemic Sclerosis patients with Digital Ulcers used significantly more healthcare resources per year. Study of 104 SSc pts; w/ DU's had more severe disease, more tests, More HCP/Rheum visits, etc (p˂0.05) https://t.co/wWvrOye92c https://t.co/HsZfSrf5CV

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Dr. John Cush RheumNow ( View Tweet)
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