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Eating Crow (10.10.2025)
Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.
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Associations in Rheumatology (10.3.2025)
Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.
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#ACR25 Abstr#LB21 Are they novel somatic variants beyond #VEXAS in driving inflammation in undiagnosed SAID?Unbiased enrichment analysis in 265 UBA1-negative adults identified IDH1/2 hotspot mutations. Cd be used to screen esp those with cytopenia. Sorry pix not allowed @RheumNow
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
The Power of Gamma Delta T Cell for Autoimmunity https://t.co/wIMu5r7b3D
More on T Cell engagers , this time with gama delta T cell ( tiny but mighty ). Kate Roslin talks about advantages of this protocol. (No cytokines thus less toxicity).
@Yuz6Yusof
@RheumNow
#ACR25
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
How does DADA2 present?
Ten studies provided data on a total 225 patients
1) skin findings
2) fever
3) stroke
4) cytopenias
@RheumNow #ACR25 Abst 1615 https://t.co/xZuTk6YFdJ
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
When MAS is suspected. Soluble IL2 receptor alpha and CXCL9 may be useful (however t cell lymphomas and viral infections like hepatitis may also have them)
#ACR25 @RheumNow
Key takeaways below https://t.co/wJv1dvwU88
Bella Mehta bella_mehta ( View Tweet)
Soluble IL2 receptors help assess macrophages behavior. Ferritin also asses the same in Macrophage activation syndrome.
ADA2 is the newer biomarker for hemophagocytic syndromes.
#ACR25 @RheumNow
Interferon gamma also a newer important target in MAS https://t.co/7sWwninBTM
Bella Mehta bella_mehta ( View Tweet)
Simultaneous measurements if S100, Ferritin and IL-18 increase diagnostic utility of these biomarkers in Stills disease.
@RheumNow #Acr25 https://t.co/3wmijNcpVY
Bella Mehta bella_mehta ( View Tweet)
Low percentage of glycosylated Ferritin was more specific for Stills disease but not used frequently in clinical practice.
@RheumNow #ACR25 https://t.co/wTK1eIcSKX
Bella Mehta bella_mehta ( View Tweet)
Biomarkers in Stills disease and MAS. #ACR25 @RheumNow
IL 6 may not be helpful compared to CRP, and IL 1 beta is difficult to measure
IL-18 seems to be the best one. https://t.co/u3oBTd4eaP
Bella Mehta bella_mehta ( View Tweet)
IL- 18 go together sometimes with glycolytic enzymes such as aldolase
Also MAS may not be a switch on and off mechanism.
Lastly MAS with Stills may have increased IL18 levels but not in other disease like SLE
#ACR25 @RheumNow https://t.co/BW1fD7usBT
Bella Mehta bella_mehta ( View Tweet)
What do we know about IL-18
Normal levels less than 500
Non specific 500 to 15000
Stills (quiet) 2000 to 10000
Mas/glares 20000 and more
@RheumNow #ACR25 https://t.co/ZAltAD5Q8V
Links:
Bella Mehta bella_mehta ( View Tweet)
AOSD And sJIA aren't the same disease!!!. Another take on this by Scott Canna..because the clinical syndrome might have somethings distinct!!
#acr25 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
#0777 Big news for VEXAS! 🎯
The first validated disease activity index (VEXAS-DAI) has been developed via international Delphi consensus. A 12-domain, 40-point tool to standardise assessment & power trials in this complex syndrome. Validation underway! @RheumNow #ACR25 https://t.co/DSeHb7eNeV
Mrinalini Dey DrMiniDey ( View Tweet)
Why do pts with #Still’s #AOSD
Get hospitalized?
#Sepsis
1827 unweighted & 9135 Weighted #US #hospitalizations
Worse in
men
Black
Medicaid
But is it truly #infection or Still’s flare or both?
Abst#0163
ACR25 @RheumNow @rheumacr
#ACRBest as largest N ever! https://t.co/fLMNyQQNNj
Janet Pope Janetbirdope ( View Tweet)
From Eye on Cytokine Storm- Decoding MAS by Dr Grant Schulert : “IL-18 is highly elevated in SJIa and other autoinflammatory disorders…can amplify innate signaling as well as induce IFN-gamma”. @RheumNow #ACR2025 https://t.co/6e5yfeDepX
Gabriela Martinez Zayas, MD MartinezZayasMd ( View Tweet)
Retrospective study of 42 adult Still' pts Rx after 2010 w/ IL‐1 inhib if given < 6 mos (early) or > 6mos of Sxs. Early IL-1i had more inactive dz (CID)(67% vs 38%; P = 0.17) & steroid d/c w/in 6 mos. 10 major flares observed (62% after IL‐1i suspension or spacing) https://t.co/uD1meQuYvj
Dr. John Cush RheumNow ( View Tweet)
Systematic review of Still's Dz (240 articles, 95 sJIA, 134 AOSD, 23,136 pts); sJIA Dx by ILAR in 78% & AOSD used Yamaguchi criteria 98%. While clinical and lab findings were matched betw AOSD & sJIA, there was variability in MAS , outocmes & trajectory. Standarization needed
Dr. John Cush RheumNow ( View Tweet)
German survey of 124 AOSD pts - Dz duration 7 yrs (Dx delay 2 yrs), 2/3 on biologics, 84% responding, 81% inactive by CRP. MDs report 35% of pts Sx-free. More Patients report Persistent Sxs LBP (39.5%), fatigue/weakness (39%), & joint inflammation (27%). https://t.co/2FGUPrhB8H
Dr. John Cush RheumNow ( View Tweet)
Chronic urticaria (CU) may be a presenting feature of an autoinflammatory syndrome (monogenic or multifactorial) - disorders to consider: cryopyrin-associated periodic (CAPS), Schnitzler, Still's disease, & neutrophilic urticarial dermatosis https://t.co/GKYqFzX6A0 https://t.co/QEEaw9zNjH
Dr. John Cush RheumNow ( View Tweet)
