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Keys to Mastery (5.2.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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Secondary Benefits to SGLT2 Inhibitor Use in SLE

Jack Cush, MD

An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 diabetes.

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Stills,continuum

Unmet Needs in Still’s disease

Jack Cush, MD

In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic pathways and possible biomarkers for diagnosis and response; (3) refractory disease and risk factors, and (4) treatment of SD and its complications.

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2025 BSR Guideline for Treatment of Axial Spondyloarthritis

Jack Cush, MD

The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD.

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Circulating miR-126-3p is a mechanistic biomarker for knee osteoarthritis. Study of 145 pts w/ #OA undergoing knee or hip arthroplasty or arthroscopy. miR-126-3p highest in subchondral bone, fat pad &synovium, not cartilage. IV or IA miR-126-3p given to mouse model of kneeOA https://t.co/DzudhYAK8E
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2023 report from US NHANES study says #Gout affects 12.1 million in the USA. Gout prevalence incr from 3.6% in 2011/12 to 5.1% in 2017/2018. Recent increases do to doubling in Asian Americans from 3.3% to 6.6%. https://t.co/IBa3fOt83c https://t.co/06Ltm0FycI

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Procalcitonin > 0.9 ng/mL can be a critical marker for identifying bacterial infection in #SLE. Single center study of 116 juv. SLE pts dx bacterial infx in 17%. Procalcitonin was signif better than others: NLR, PLR, ESR, CRP, LC4R, ferritin (cut offs need to be defined) https://t.co/NAM8xopNW5
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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/C42QMd2zap
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RHEUMATOLOGIST Survey: What are your contraindications tor renal Bx?

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RHEUMATOLOGIST SURVEY: Which Lupus patients should undergo renal Bx?

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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/h8trTxt5t1
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Study of 104 RA-ILD pts found that (31.7%) RA-ILD patients were ANCA positive (29/31 were p-ANCA+). compared to ANCA neg, ANCA+ RA-ILD had more respiratory Sxs, ANA positivity, worse PFTs, more acute exacerbations of ILD, more bronchietasis & honeycombing https://t.co/vZODUW9tSX https://t.co/zTrdtcc78O

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RHEUMATOLOGIST SURVEY: Which Lupus patients should undergo renal Bx?

Dr. John Cush RheumNow ( View Tweet)

RHEUMATOLOGIST SURVEY: Which Lupus patients should undergo renal Bx?

Dr. John Cush RheumNow ( View Tweet)

RHEUMATOLOGIST SURVEY: Which Lupus patients should undergo renal Bx?

Dr. John Cush RheumNow ( View Tweet)

Study of 104 RA-ILD pts found that (31.7%) RA-ILD patients were ANCA positive (29/31 were p-ANCA+). compared to ANCA neg, ANCA+ RA-ILD had more respiratory Sxs, ANA positivity, worse PFTs, more acute exacerbations of ILD, more bronchietasis & honeycombing https://t.co/vZODUW9tSX https://t.co/6WUbSoOyOm

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Incr. neutrophils in RA synovium correlates w/ higher Dz activity and poorer Rx responses. Study of 55 #RA pts, 1/3 (17) enriched for synovial PMNs - these correlated w/ DAS28--CRP, synovial inflammation, and CD3+/CD68+ cell counts https://t.co/zz59w8MMUU https://t.co/R7Ruyab0wj

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Ultrasound lesions of dactylitis associ w/short-term development of PsA. Study of 64 PsO +arthralgia pts. IUS PD synovitis & B mode enthesitis predicted PsA Dx (p < .001) w/ an accuracy of 89.1 %, a sensitivity of 86.7 % and a specificity of 89.8 %. https://t.co/KoXMmoxXhP https://t.co/tj2NxKDkqh

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Genetic Sequencing in Rheumatology Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic

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Predictors of Developing RA A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing RA. These studies underscore the influence of https://t.co/wpSHDfwCL7
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