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ANA Pollution (2.06.2026)
Dr. Jack Cush reviews the news, journal articles and regulatory news from this past week on RheumNow.com
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FDA vs. Amgen: At Odds Over Avacopan
MedPage Today
The FDA has requested that Amgen voluntarily withdraw avacopan (Tavneos), a treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis, but the company said it has no plans to pull the drug from the market.
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ACR Applauds Recent Government Funding
ACR
The American College of Rheumatology (ACR) today applauded the recent passage of the Congressional CY 26 funding package that includes several important provisions, including extending Medicare telehealth payment flexibilities, improving transparency in pharmacy benefit management (PBM) practices
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FDA has announced "Breakthrough Designation" for 3 drugs + 1 test being developed:
** Biogen: litifilimab (targets dendritic cells) for cutaneous lupus
** Novartis: Ianalumab (BAFF blockade) for Sjogrens
** J&J: Nipocaiimab (FcRn) for Sjogrens
** Encarta: pocket Lyme test https://t.co/RMKg14rejq
Dr. John Cush RheumNow ( View Tweet)
Air pollution ups ANA+: Ontariio Canadi study of 3548 serum samples (2010-13) corrlated particulate matter (PM2.5) w/ serologies. Highest vs lowest quartile PM2.5 showed higher risk of ANA ≥1:640 (OR 1.46) & ≥1:1280 (OR 1.54). Pollution has systemic immune effects! https://t.co/iyC68qh49R
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Study shows half of FL autonomous nurse practitioners practicing outside their scope of practice. FL law allows autonomous NPs in primary care w/ 3K practice hrs. 194/328 NPs working in non-primary care: cosmetics, antiaging, IV hydration, vitamin infusions, hormonal Rx, https://t.co/WMksEb0Uyc
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Always on exams, but I've never seen a case! JAMA Dermatology reviews Multicentric Reticulohistiocytosis - pt w/ multiple nodules on hands & pain in shoulders, elbows, MCPs, IPs. Erythema over face, chest, & back & bead like Perionychial papules. Rx w/ MTX + Pred https://t.co/QgS5VBOB51
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ALTO: Long-Term Abatacept Outcomes in At-Risk RA
Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 https://t.co/Lb8md9cYbG
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Giant Cell Arteritis Outcomes in Canada
A retrospective cohort study of patients with giant cell arteritis (GCA) demonstrates relapses are common and seen in nearly half of patients, were common after treatment is stopped and is not effectively averted by methotrexate (MTX). https://t.co/7hIpn6CJXg
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FDA sent a complete response letter to AstraZeneca on their application (BLA) for anifrolumabs (Saphnelo) subcutaneous use in SLE. Despite a positive TULIP-SC trial & EU approval of SC-anifrolumab, FDA & sponsor still have to work things out. CRL reasons are unknown https://t.co/3dNwEyolrj
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Congratulations to Anca Dinu Askanase, MD, MPH, who has been appointed Chair of the Department of Medicine and Chief of the Division of Rheumatology at Hospital for Special Surgery https://t.co/L5mbFloLpK https://t.co/gsZm9Is159
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Hiring, Onboarding and Training APPs
Tuesday Night Rheumatology: Hiring, Onboarding and Training APPs. Visit our Mission APP: Partners in Care site for more APP-focused articles and videos.
https://t.co/CGrXSCrp9n https://t.co/wYkb6C1IEW
Links:
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Which Fibromyalgia Drugs are Cost-Effective?
A cost-effectiveness analysis compared FDA approved fibromyalgia (FM) drugs (pregabalin, duloxetine, milnacipran) with amitriptyline and found duloxetine was the preferred strategy across perspectives.
https://t.co/5NZeYquGxs https://t.co/rhcwH2yLEm
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Take home points from his presentation. Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/kDFrGi7iXt
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NEXT STEPS: Karp and investigators are engaged in the MONA LISA study - Using smile Data and biospeciments – they intend to look for biomarkers that may better predict the future development of SLE Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/acZD1kmNhq
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The challenge may be that lupus has multiple endotypes with variable rates of progression/trajectories. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/BA4KRKebIv
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SMILE enrollment hampered by COVID - yet failed to show a protective effect for HCQ in preventing SLE. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/GImHpycbgO
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REcently published SMILE study looked at the potential of HCQ (vs PBO) to prevent SLE in at risk people. Had to be ANA+ and 1-2 SLICC criteria at entry. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/4FY0kOLdRT
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Factors that may augment future development of SLE - includes Vitamin D levels, poor sleep, EBV reactivation & social determinants of health. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/e3TKATcxXB
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Only a subset of incomplete lupus (ILE) will progress to SLE - betw 1 in 10 and 1 in 5. Can you Prevent SLE? Dr. David Karp lecturing at UTSW @drdavidkarp @utswrheum https://t.co/oo40Dumk4I
Dr. John Cush RheumNow ( View Tweet)
