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SI,Sacroiliac,Erosion,MRI

Early MRI Sacroiliac Improvement with JAK Inhibition

d Jack Cush, MD

The TORTUGA trial tested filgotinib, a JAK1 inhibitor, in active ankylosing spondylitis (AS) patients and was shown to be both effective and capable of retarding sacroiliac (SI) joint erosions as early as 12 weeks.

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Lumbar.jpg

Lumbar Spine Decompression Alone is Superior to Decompression with Fusion

d Jack Cush, MD

The NEJM has published a multicenter study wherein patients with surgical lumbar spinal stenosis and degenerative spondylolisthesis were found to fair equally well (noninferior if treated with decompression surgery alone compared to decompression with instrumented fusion.

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Vertbral,Fracture,spine,compression

Fracture Risk with Low Dose Steroid

d Jack Cush, MD

A large RA cohort analysis shows that low-dose glucocorticoid therapy in rheumatoid arthritis (RA) patients may carry an increased risk of vertebral osteoporotic (OP) fractures. 

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ANCA, vasculitis, test

ACR/Vasculitis Foundation 2021 Guidelines for ANCA–Associated Vasculitis

d Jack Cush, MD

Chung et al have published the 2021 treatment guielines for the management of antineutrophil cytoplasmic antibody–associated vasculitis, including granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis. These guidelines are put forth by the ACR and the Vasculitis Foundation as benchmark guidance to assist health care professionals in managing AAV.  

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Hands-Down Rheumatology - Sarcoidosis usually presents as a monarthritis or oligoarthritis. Late sarcoid arthritis affects knees, ankles, fingers (dactylitis). Bony lesions show honeycomb trabecular pattern). https://t.co/lmXBbJz6ts https://t.co/oDYrBiPuIX

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Dr. John Cush RheumNow ( View Tweet)
RheumNow Podcast square

RheumNow Podcast – As Good As I Ever Was (7.2.2021)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.

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Retrospective study of 258 IBD patients, 17% had MRI sacroiliitis (73% w/ bone marrow edema. Sacroiliitis was significantly associated w/ Female gender, back pain, and later age of CD diagnosis. >two-thirds of these pts never seen a rheumatologist. https://t.co/HYhAU6aRIf

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Dr. John Cush RheumNow ( View Tweet)

artificial intelligence machine learning computer

Artificial intelligence brings clarity to early bony changes in inflammatory arthritis

d David Liew, FRACP

Subtle early bony changes in inflammatory arthritis can be hard even for experienced rheumatologists to interpret, even though they have traditionally been considered to become disease-defining as they progress.

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⭐️TORTUGA = PII trial that showed filgotinib (Jak1-i) signif improv SPARCC MRI scores (BM edema) in the spine + SIJ vs PBO in pts w/ active AS ⭐️OP0141 = post-hoc analysis that showed stat signif ⬇️ of CANDEN MRI scores (new bone format) w/ filgot at wk12 #EULAR2021 @Rheumnow https://t.co/RIpYIMcx1Q
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
MSK US before 1st clinic visit? Abs#POS0260 showed ⬇️ in time to diagnosis of inflammatory arthritis from 31 to 12 days and ⬇️clinical visits 2.8 to 2.1 How do you use MSK US in your clinic? #EULAR2021 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

#EULAR2021 and EULAR IQ Dr Jack Cush reviews highlight presentations from the first 3 days of EULAR 2021. https://t.co/BkHjhOUqNU https://t.co/4JS1yGiJHg

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Dr. John Cush RheumNow ( View Tweet)
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RheumNow Podcast - EULAR 2021 & EULAR-IQ (6.4.21)

d Jack Cush, MD

Dr Jack Cush reviews highlight presentations from the first 3 days of EULAR 2021.


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HOT🔥: thermography of hands in IA remotely collected via smartphone correlates w/ US features 0.48, p<0.01 and SJC 0.48, p<0.01), DAS28 (0.73, p<0.01), CDAI (0.84, p<0.01) and SDAI (0.82, p<0.01). A future tool for patients remote follow-up? #OP0300 @Rheumnow #EULAR2021 https://t.co/MJLpz6eqIy
Aurelie Najm AurelieRheumo ( View Tweet)
UPSTREAM results #OP0223 suggest that the newly developed and preliminary validated MSKUS PsA dz activity and damage scores could be used in observational and controlled trials. #EULAR2021 @RheumNow https://t.co/Tw7OWyMcgX https://t.co/WiT0yGwVqK

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Dr. Rachel Tate uptoTate ( View Tweet)
Don’t forget to use imaging that you already have! CT Abd/Pelvis (ordered for nonMSK) of 301 IBD pts shows underlying sacroilitis ⭐️60/301 had sacroilitis on CT ⭐️11/60 had AxSpA ⭐️3/60 previously undiagnosed axSpA Abs#POS0035 #EULAR2021 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

Bingo. It always had been rather odd to me that you would call someone nr-SpA when they had MR evidence of disease; xrays are not sensitive to pick up changes. While we're at it, can we just use the term "imaging" instead of "radiographs" with the availability of better tech? https://t.co/I6reoHyywf

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k dao KDAO2011 ( View Tweet)

In biologic-naïve PsA pts - 2 yr data, GUS improved skin & joint symptoms, physical function, & radiographic progression. Safety comparable to 6mo/1yr data, similar between Q4W & Q8W dosing, & consistent w/ PsO trials. Poster #POS1027 #EULAR2021 @RheumNow https://t.co/nlcjOX7cBq https://t.co/NWqDTwfb4u

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Dr. Rachel Tate uptoTate ( View Tweet)
So it comes down to the grand question: how on earth do we actually monitor disease activity?? "We still don't have a failsafe algorithm... relapse is both underdiagnosed & overdiagnosed" - @Sarah_L_Mackie The challenge lots of good people are working on! #EULAR2021 @RheumNow https://t.co/PUa6Ly1DQw
David Liew drdavidliew ( View Tweet)
#Eular2021: Do you start a bDMARD for nr-AxSpa without objective evidence of inflammation (elevated CRP, negative structural damage on MRI)? @RheumNow

Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

Some interesting abstracts at #EULAR2021 today on monitoring GCA with: - ultrasound OP0055 https://t.co/0fqLIK5IPV - PET/CT OP0069 https://t.co/WQl9VaHR9E OP0064 https://t.co/w7biFT6qy0 What do you believe is the most accurate measure of true disease activity in GCA? @RheumNow

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David Liew drdavidliew ( View Tweet)

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