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Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and non-thrombotic (TMN) symptoms.
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JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with juvenile dermatomyositis (JDM).
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Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said.
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Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com
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A cohort study shows that hospitalized patients with dermatomyositis have higher in-hospital mortality in the presence of active rash, interstitial lung disease, and elevated neutrophil to lymphocyte ratio at admission.
Dr. John Cush
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25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/CYwVy7ls7y
Dr. John Cush
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual
Dr. John Cush
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Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
Dr. John Cush
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25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual
Dr. John Cush
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Review of neonatal Fc receptor (FcRn) blockers, being developed by J&J, argenx & UCB, showing utility in autoimmune dz as they reduce autoantibodies. FcRn inhibitor market may be worth USD 3.3 billion by 2035. Approved for myasthenia gravis & being developed in Sjögren’s, SLE, https://t.co/mBUla87dK5
Dr. John Cush
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Postmenopausal women on estrogen hormone therapy (HT) had a modest incr risk (HR 1.33; 1.32-1.35; P < .001). of a new autoimmune Dz over next 5-10 yrs (vs those not on HT) TriNetX study of 889,413 HT vs 2,6 mill (not HT) - 6.7% vs 5.3% developed autoimmune dz at 5 yrs. https://t.co/fsi32XIzLe
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+ANA's are common in pregnancy. Study of 2159 Chinese 1st trimester pregnant women found ANAs positivity in 14.7 % (1:100 most common titer; speckled most common pattern). ANA+ assoc w/ smoking, age 30-34 yrs, multiparity, thyroid Dz & hypertension https://t.co/mRQGajVe3g https://t.co/DqE1KC4Kgo
Dr. John Cush
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SLE Prospect. Observational Study of 826 SLE pts over 3 yr for outcomes& IFN signature (IFNGS). 71% were IFNGS-high. IFNGS-high pts were younger. on GC w/ Hi SLEDAI-2K. SLEDAI-2K decreased over time, regardless of IFNGS. By 36mos, 45% had ≥1 flare; higher in IFNGS. https://t.co/CT70CvnOQ9
Dr. John Cush
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Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/JfcycqHvhl
Dr. John Cush
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Beyond malignancy, look out for LICATS with CAR-T
CD19 chimeric antigen receptor (CAR) T cell therapy took the centre stage in 2022 where data pertaining to a successful case series of 5 patients with refractory SLE were published by Prof Schett’s group. Since then, this area https://t.co/JbTB033gti
Dr. John Cush
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Putting Steroid Tapering into Practice in SLE
Drs. Yuz Yusof and Ed Vital discuss abstract 1526 (Guidance For Corticosteroid Tapering In Patients With Systemic Lupus Erythematosus: Results From An International Delphi Consensus Project) presented at #ACR25. https://t.co/nqMyy3qNto
Dr. John Cush
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SLE Prospect. Observational Study of 826 SLE pts over 3 yr for outcomes& IFN signature (IFNGS). 71% were IFNGS-high. IFNGS-high pts were younger. on GC w/ Hi SLEDAI-2K. SLEDAI-2K decreased over time, regardless of IFNGS. By 36mos, 45% had ≥1 flare; higher in IFNGS. https://t.co/c3zHT2GfR5
Dr. John Cush
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Robinson et al has published that Epstein-Barr virus infects and reprograms autoreactive B cells to drive the systemic autoimmune response in SLE https://t.co/vjpvILrJOt https://t.co/HepyZrYW5L
