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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD? Ro52 makes a big entrance with all our ILD coverage this month.
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SMART study - Single vs. Split Dose Methotrexate in RA
Split dose weekly, oral methotrexate (MTX) was shown to be superior to single dose MTX in treating active rheumatoid arthritis (RA) patients.
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How to assess ILD in your patients?
Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis.
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SLE and Osteoporosis
In one of the SLE sessions at the APLAR 2025 Congress, Prof. Sandra Navarra discussed the assessment and management of osteoporosis in SLE patients, particularly glucocorticoid-induced osteoporosis (GIOP) and this article reviews the highlights and key takeaways from her talk.
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Key takeaways of trabecular bone screening:
📌Complements but doesnt replace BMD/FRAX in fracture risk assessment
📌Dont exclude any lumbar spine unless w/significant change like laminectomy
📌Can use in monitoring untreated pts since TBS declines
@RheumNow #APLAR25 https://t.co/bcN83IDDja
sheila RHEUMarampa ( View Tweet)
Remember! ☝️
Trabecular bone screening should not be routinely used in pre-menopausal women.
@RheumNow #APLAR25 #osteoporosis https://t.co/hGMExyDYUX
sheila RHEUMarampa ( View Tweet)
Cross-sectional study of 320 dermatomyositis (198 classic DM, 122 amyopathic DM/CADM) & compared myositis panels for ANA, MSA, MAA, etc. Comparing CDM vs CADM - ANA pos in 63% vs 49%, p<0.05; MSA+ 47% vs 40% (NS); MAA+ 29% vs 26%(NS); MSA&MAA neg 40% vs 48% (NS)
Dr. John Cush RheumNow ( View Tweet)
Japanese retrospective real world study shows antifibrotic use assoc w/ better survival in Pulm Fibrosis-ILD for 1st 3 yrs & improved survival in progressive pulm. fibrosis (PPF) “despite management” (PPF subset prev Rx non-antifibrotic therapy) https://t.co/caiIuhg7j8 https://t.co/N0ST73TMoR
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Dr. John Cush RheumNow ( View Tweet)
3 yr study of FDA Adverse Event Reporting on anifrolumab shows following AEs- URIs, herpes zoster, infusion reactions, and potential new risks like dyspnea and pyrexia, not in the label. https://t.co/vP2YWGT2vR https://t.co/BruGBtXEBu
Dr. John Cush RheumNow ( View Tweet)
Sjogren's Disease Interstitial Lung Disease
Dr. Nancy Carteron, a rheumatologist in northern California, discusses interstitial lung disease in Sjogren's disease, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025. https://t.co/lA1vrBiar4
Dr. John Cush RheumNow ( View Tweet)
Single center study of 47 RA-ILD pts (Dx Age 64.7 yrs; 30 mos F/U). Median 100 mos from RA Dx to RA-ILD. Nearly half (49%) recv Rx for RA-ILD; few w/ TCZ, nintedanib, pirfenidone. ~90% had RA-ILD stability/improve @ 6 & 12 mos. Progression assoc w/ tobacco use (P .025) @ 6 mos https://t.co/AK4zYgcxeK
Dr. John Cush RheumNow ( View Tweet)
Regional Disparities in DMARD Management for RA Treatment
Dr. Aurelie Najm, Glasgow, reports on a session on "Updates on DMARDs treatment: global standards and regional adaptations" from the APLAR 2025 Congress in Fukuoka, Japan.
https://t.co/zDo5NxKtbE https://t.co/kF9FxyWkIQ
Dr. John Cush RheumNow ( View Tweet)
Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Dr. John Cush RheumNow ( View Tweet)
ERS/EULAR guidelines for CTD-related interstitial lung disease
The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have released clinical practice guidelines for evaluating and managing connective tissue diseases (CTD) https://t.co/2mmxsor4ND
Dr. John Cush RheumNow ( View Tweet)
COLCHICORT Trial
The COLCHICORT trial in acute calcium pyrophosphate (CPP) crystal arthritis patients showed that colchicine was inferior to prednisone treatment and that responses were also influenced by other factors.
https://t.co/CC2yVRXbD5 https://t.co/ebLa3FUbGR
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Dr. John Cush RheumNow ( View Tweet)
A new player in AIRD
ThA age associated T helper cells
Displaying both Cytotoxic & APC functions
Correlation with disease activity in RA and SLE
More research is needed to better characterize function but could be a promising therapeutic target
@RheumNow #APLAR25 https://t.co/4SnY65tXpJ
Aurelie Najm AurelieRheumo ( View Tweet)
What to give next?
Bone sequencing therapy provides a novel perspective in #osteoporosis treatment.
Several sequential approaches exist.
Better treatment plan = better patient outcomes
#APLAR25 @RheumNow @rheumarhyme https://t.co/XvwnT9ZCU2
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sheila RHEUMarampa ( View Tweet)
This slide reflects the rheumatologist’s goals for treating #lupus
Prof. Mosca also highlights the fact that achieving targets is as important as maintaining these treatment targets.
@RheumNow #APLAR25 https://t.co/u8fw3fThXI
sheila RHEUMarampa ( View Tweet)
Prof. Eric Morand on the SLE T2T approach.
Ultimate goal is remission but we know that not all patients achieve this state.
Thru the T2T approach, low dse activity (LLDAS) is an acceptable target & a protective alternative goal
@RheumNow #APLAR25 #Lupus https://t.co/vz7E5prps0
sheila RHEUMarampa ( View Tweet)
Optimizing outcomes of pregnancy in #lupus:
📌 all patients should undergo preconception counselling
📌 close monitoring by a multidisciplinary team
- a ⬇️ cerebroplacental ratio reflects placental dysfunction
#APLAR25 @RheumNow @rheumarhyme https://t.co/RSyqgpRTG5
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sheila RHEUMarampa ( View Tweet)
