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Autoantibody Associations in Systemic Sclerosis

Jack Cush, MD

Analysis of two large cohorts of systemic sclerosis (SSc) patients shows a signfiicant minority of patients to have autoantibodies typical of rheumatoid erosive arthrits, but their presence in SSc patients was associated with unique manifestations of SSc. 

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Lungs ILD

Best of 2021: Actemra FDA Approved for Systemic Sclerosis Interstitial Lung Disease

Jack Cush, MD

Genentech announced March 4th that the US Food and Drug Administration approved tocilizumab (Actemra) for the treatment of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD), specifically indicated for slowing the rate of decline in pulmonary function in adults S

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Indications Awaiting (12.17.21)

Jack Cush, MD

There's good news and bad news in rheumatology fellowship matching for 2022.  There's also new FDA approvals and indications, but a new serious safety warning has arisen from the CDC about the J&J COVID-19 vaccine. 

Dr. Jack Cush reviews the latest news, journal reports, regulatory approvals, plus 3 new cases from rheumatologists.

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Lab work

Infection or Disease Flare: What Tools Can Help Differentiate?

Olga Petryna, MD

Differentiation between a flare of disease and infection in patients with autoinflammatory (AI) conditions, where fever is the hallmark, can be extremely difficult. Few studies have evaluated potential differentiators; and having such tools would meet a huge unmet need. 

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ACR Best

ACR21 Best Abstracts - Day 1

Jack Cush, MD

The RheumNow faculty have been glued to their monitors all day, watching video, and running down abstract presentations to find the best – several of these stood out as #ACRBests. Here is a listing of “Best” they saw on Day 1.

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Blacks with Systemic Sclerosis May Have More Severe Disease

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that Black people living with systemic sclerosis may have more severe disease and worse prognosis than patients in other racial or ethnic groups, and these worrying disparities may be driven by several socioeconomic factors (Abstract #1854). This poster will be presented Tuesday morning,  November 9, 2021 in the Clinical Poster III (1836–1861) section on Systemic Sclerosis & Related Disorders.

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👌Superb review of #SSc ILD by @sclerodermaUM #ACR21 👉EARLY/SUBCLINICAL is NOT Mild ILD 👉MMF 1st 👉TCZ in combination for progressive phenotype/progression 👉Nintedanib:start slow, uptitrate for GI tolerability 👉Early HSCT referral (early dcSSc, FVC&DLCO 45-80%, Normal🫀) https://t.co/MUOhc3PakH
Ashima Makol MD AshimaMakol ( View Tweet)
Prof. Ami Shah: Patients with #scleroderma have an ⬆ risk of #cancer vs. general population 📌Data from 3 recent meta-analysis: Scleroderma pts have 1.4 to 1.8 fold increased risk of cancer @RheumNow #ACR21 https://t.co/4uQN6y3tIn
sheila RHEUMarampa ( View Tweet)
Dr. Ami Shah shares her approach to cancer screening in patients with #scleroderma👇 @RheumNow #ACR21 https://t.co/chmlGe4iyl
sheila RHEUMarampa ( View Tweet)
Who declines most with #scleroderma #ILD - early dcSSc, ⬆️CRP, ⬆️mRSS all w more ⤵️FVC. Results verified in SENSIS trial of SSc ILD where #nintedanib was superior to placebo abst#1846 #ACR21 @RheumNow https://t.co/eckUj0qwch
Janet Pope Janetbirdope ( View Tweet)
Dr Ami Shah - Scleroderma & Cancer: 🛑 ⬆️ risk of ca around the time of dx in SSc patients with RNA-pol-III (especially first 5 years after dx), anti-Th/To protective? 🛑Her approach for ca screening in newly diagnosed with SSc pts and red flags as below #ACR21 #ACRambassador https://t.co/2VcWn2UInm
Didem Saygin, MD didemsayginmd ( View Tweet)
What if a celebrity had #Scleroderma? Would that ⬆️attention & funding for this rare disease? See what Big Bird says @RheumNow #ACR21 ?affected #PetsofACR @RheumNow @scleroderma @SclerodermaCAN audio-13.m4a

Janet Pope Janetbirdope ( View Tweet)

#ACR21 Thieves: SLE and SSc with worsening cytopenia and hematuria despite treatment: Maria Powell - presents overlap case with PNH, responded to eculizumab @Rheumnow https://t.co/CGvHEMA3lI
Eric Dein ericdeinmd ( View Tweet)
Interesting thoughts from Dr. Distler re:nintedanib & MMF in SSc-ILD Agree we should look into MMF-nintedanib combo, but this graph makes me think MMF > NIN Why would that be? Unlike NIN, MMF pts were NOT randomized, which likely favors NIN for a few (speculative) reasons: https://t.co/ZHBD8x74PM
Mike Putman EBRheum ( View Tweet)
🔥Continued, More Clinically Meaningful data in #SSc #ILD from #Nintedanib in >52 wk SENSCIS & SENSCIS-ON(open-label ext)#ACR21 Dr Distler ✨MMF likely to stay 1st line, then Nintedanib ❓Is it time for MMF + Antifibrotic upfront?? Await SLS-III;Data so far seems supportive https://t.co/JWXMlsJgmc
Ashima Makol MD AshimaMakol ( View Tweet)
#ACR21 Abs#1367. Scleroderma pts with absent contractility (AC) associated with diffuse cutaneous disease, cardiac involvement, more severe Raynaud's. ⭐️14/67 AC pts died during study (21%), none without AC ⭐️15/16 Ro52+ pts had AC (p=0.06) https://t.co/GAuOiV5ScC @Rheumnow

Links:

Eric Dein ericdeinmd ( View Tweet)

#ACR21 #pedsrheum juvenile localized scleroderma Polypositive profile 3 or more autos correlated with more severe skin score, more activity https://t.co/vVXV4jjLvG
Dr. Laura Lewandowski LauraLewMad11 ( View Tweet)
✨Great Pearls when screening patients for clinically suspect #Scleroderma or #Juvenile #Dermatomyositis 📌 Don’t Stop Work Up at Negative ANA if strongly suspect SSc 📌 #Myositis Specific Antibodies have different phenotypes in kids than adults (MDA-5, TIF-1g, NXP-2) #ACR21 https://t.co/KrkkzA5bkV
Ashima Makol MD AshimaMakol ( View Tweet)
Clinical Pearl at #ACR21 by Dr. John Stone: ⭐️Patients w/ RNAPIII positive SSc do not always have puffy hands, Raynaud's phenomenon, or ANA positivity! #ACRBest @RheumNow @SChatterjee https://t.co/9J6OBibi4l
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
Nationwide 2 yr F/U study, 11 centers, 300 pts with early (1.2 yrs) systemic sclerosis shows, despite most (2/3) on immunosuppressives, 71% progressed to diffuse SSc, 21% worsen Skin, 23% worse FVC & 6.6% died (cardiac, GI, ILD) https://t.co/UfagmX2S16

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Dr. John Cush RheumNow ( View Tweet)

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