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Best of 2024: Upside/Downside of Steroids in Lupus Nephritis
A systematic review of randomized clinical trials of patients with biopsy-proven lupus nephritis demonstrates both the benefits and harms to early glucocorticoid regimens on lupus outcomes.
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Best of 2024: Inadequate Zoster Vaccination in Immunocompromised Patients
A VA study of shows that recombinant zoster vaccine (RZV) vaccination in immunocompromised patients or those receiving immunosuppressive medications is insufficient, given these are high risk individuals.
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54K Peptic Ulcers Annually (12.13.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com
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Chikungunya marches on, at a cost
A recent article from BMC Global Health suggests that between 2011 and 2020, the mosquito-borne disease chikungunya, has disabled millions and likely amassed close to $50 billion in healthcare and disability-related costs in 110 countries.
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Don’t Buy Guitars (12.6.2024)
This year at ACR24, the RheumNow faculty and reporters were prolific, generating >800 Tweets, 56 written articles, 117 Videos and 28 podcasts – all in 4 days! You can best review and learn ACR24 by A) Rheumatology Roundup; b) Topic Panel videos; and c) Topic podcasts.
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Pan American Health Org announces that in 2024 saw largest dengue epidemic in the Americas, >12.6 million cases reported (3x record in 2023); 21,000 severe w/ 7,700 deaths; 90% from Argentina, Brazil, Colombia, Mexico. Most USA cases (FL, HI, TX, AZ, CA) seen in travelers… https://t.co/nhuJIP9Y8v https://t.co/QLju8uRKZ8
Dr. John Cush RheumNow ( View Tweet)
Steroids and Infection
https://t.co/J8OU6I9410 https://t.co/JwpSrS4ouI
Dr. John Cush RheumNow ( View Tweet)
In #RA, Higher levels of ESR and CRP, but not DAS28, joint counts or global assessments, were significantly associated with the risk of incident ILD in RA. German biologics (RABBIT) registry study compared 139 RA-ILD vs vs 686 controls. https://t.co/Ul4HZ1hzS0 https://t.co/GLKL7U4ASt
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 41 studies, & 5343 AAV pts showed 55% (2890) had infection; 36% w/ severe infxn. This included PJP, aspergillosis, candidiasis, HZ, CMV, etc. Pulmonary most common. Risk factors included older, ESRD, DM, smoking, Renal or lung involvement https://t.co/yHo5BNlbiL https://t.co/R2je32YYGy
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Dr. John Cush RheumNow ( View Tweet)
Biomarker Study of 171 synovial fluid samples (54 primary OA, 57 RA, 30 Crystal,30 septic arthritis) examined the cartilage oligomeric matrix protein (COMP) to IL-8 ratio and found it can differentiate primary OA and inflamm arthritis w/ sensitivity 87% and specificity 89%… https://t.co/UH77DFgAlJ https://t.co/MfXQcl0BhW
Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 41 studies, & 5343 AAV pts showed 55% (2890) had infection; 36% w/ severe infxn. This included PJP, aspergillosis, candidiasis, HZ, CMV, etc. Pulmonary most common. Risk factors included older, ESRD, DM, smoking, Renal or lung involvement https://t.co/4TtnP5wGc4 https://t.co/RatBXPUk7a
Links:
Dr. John Cush RheumNow ( View Tweet)
Dengue fever, a mosquitoborne viral illness, is increasing worldwide; during 2024, approximately 13 million cases have been reported in the Americas. 2010–2024, a total of 15,077 (38.6%) patients were hospitalized But the fatality rate is unchanged. 2023 DENV-3 recent outbreak in… https://t.co/BKrEmN4F6G https://t.co/WIXaPeex8Z
Dr. John Cush RheumNow ( View Tweet)
Chikungunya marches on, at a cost
A recent article from BMC Global Health suggests that between 2011 and 2020, the mosquito-borne disease chikungunya, has disabled millions and likely amassed close to $50 billion in healthcare and disability-related costs in 110 countries.… https://t.co/TnDObv1obT https://t.co/yjMeBODuFv
Dr. John Cush RheumNow ( View Tweet)
In US, peptic ulcer disease affects 1% of population w/ ~ 54 000admitted to hospital annually w/ bleeding peptic ulcers. But only 10% of PUD pts present w/ upper abdominal pain. Prime causes are Helicobacter pylori infection (42%) & NSAID use (36%) https://t.co/0VvA7lI0MQ https://t.co/YWv4SDNVLC
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Dr. John Cush RheumNow ( View Tweet)
Lacaille et al. Long term harms of previous steroids in RA. CV/infection mortality increase 7% every year/use. Takes 3.5 and 10 years to return to normal after 1 and 2 years use. Never returns to normal if >2 years use @RheumNow #ACR24 Abstr#2673 #ACRbest https://t.co/qcp5mCHmeB https://t.co/keXw5Qg2ld
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Richard Conway RichardPAConway ( View Tweet)
Mortality Risk After Stopping Glucocorticosteroids (GC) in RA.
In a study of 28,078 RA patients:
Mortality risk from CVD ↑ 7.5%/year of GC use; ↓ 1.3%/year after stopping.
Mortality risk from infections ↑ 6.8%/year of GC use; ↓ 4.9%/year after stopping.
Risks normalize 1.5–10… https://t.co/i6cKet1EEV https://t.co/ClMjIly20E
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
PHOENYCS GO, RCT of dapirplizumab, novel CD40Li in SLE
Met primary endpoint (NNT~6 for BICLA) & numerical improvements in many other endpts
1 MI & 1 death from infection over 213 pts
Encouraging for sure! Second phase 3 being launched
#ACR24 @RheumNow Abstr#L16 #ACRbest https://t.co/QwDMKjhFvb
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Mike Putman EBRheum ( View Tweet)
Using longitudinal claims data, this study explores the safety of non-conventional combination targeted therapy in adults with psoriatic arthritis (PsA).
Key findings:
- 42,821 PsA patients analyzed; only 1.1% on combination therapy.
- Increased risk of serious infections:… https://t.co/Jghmz9lkLd https://t.co/YqwJlTKcEi
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Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Study revealing the Uterine-Joint Axis in female axial spondyloarthritis, highlighting dysbiosis and subclinical uterine inflammation as key factors in disease pathogenesis.
Key findings:
- Distinct microbiota profiles in AxSpA patients vs. healthy controls.
- Significant genital… https://t.co/Cl12ELdjI2
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
A retrospective analysis by Dr. ERayens et al showed that RA pts >/=50y given 2 RZV doses were less likely to develop HZ vs. unvaxxed grp
Incidence of PHN was also lower in the vaccinated group (0.2py vs.1.9py)
RZV is effective in preventing HZ & PhN
@Rheumnow #ACR25 abs0977 https://t.co/JhYBYnLmhl
sheila RHEUMarampa ( View Tweet)
