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Osteoarthritis Risky Business (4.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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DNA,genetics,sequencing

Genetic Sequencing in Rheumatology

Jack Cush, MD

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 sequencing in the field of rheumatology. 

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AI,genes

Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients

Jack Cush, MD

A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. 

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Genomics and Future Drug Targets for Osteoarthritis

EurekAlert!

A Nature article details the results of an osteoarthritis, genome-wide association study meta-analyses across up to 489,975 cases and 1,472,094 controls, establishing 962 independent associations, 513 of which have not been previously reported.

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Distinguishing Septic and Gouty Arthritis

Jack Cush, MD

A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 cells/mm3.

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Predictors of Developing RA

Jack Cush, MD

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 rheumatoid arthritis (RA).

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EMR Messaging Woes (4.11.2025)

Jack Cush, MD

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

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Immunophenotyping, JCI

RA Prevention through Deep Immunophenotyping

Jack Cush, MD

Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA).

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Lab work

Consensus on Bone Turnover Biomarkers in Osteoporosis

EurekAlert!

A new consensus paper, published by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), the International Osteoporosis Foundation (IOF), and the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC),

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Cancer Survival with TNF Inhibitors (3.28.2025)

Jack Cush, MD

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

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Genetic Analysis of Asymptomatic Antinuclear Antibody Positive Patients A large scale genomic population study found antinuclear antibodies (ANA) in up to 14% of the population; most with ANA are asymptomatic, and ANA production is not associated with significant genetic risk. https://t.co/Ltqf1yaaoy
Dr. John Cush RheumNow ( View Tweet)
AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/u8abvqNtnX
Dr. John Cush RheumNow ( View Tweet)
Full read state of the art review of treatments for Axial Spondyloarthritis Concluding unmet needs: -Suboptimal Tx Response - Limited Drug Options - No Biomarkers - Extra-Axial Dz - Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/rkX2givwF8

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Dr. John Cush RheumNow ( View Tweet)
AutoAbs & protein signatures evolve as pts go from Preclinical to established RA. Pts vs controls distinguished w/in 5 yrs of Dx best by iCCP3, RFIgA, RFIgM; and 104 proteins differentially expressed & gene analyses showed 21 pathways enriched ≤5 years of Dx. https://t.co/EWwpvrduJz
Dr. John Cush RheumNow ( View Tweet)
Full read state of the art review of treatments for Axial Spondyloarthritis Concluding unmet needs: -Suboptimal Tx Response - Limited Drug Options - No Biomarkers - Extra-Axial Dz - Non-Inflammatory Pain https://t.co/K3oqRCgTCP https://t.co/IPn09jMFM2

Links:

Dr. John Cush RheumNow ( View Tweet)
RA Prevention through Deep Immunophenotyping Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for RA. They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to https://t.co/AEo0GOr7Kn
Dr. John Cush RheumNow ( View Tweet)
KORAIL (Korean RA-ILD) prospective cohort study of CT and biomarkers showed 35% ILD progressed over 3 yrs. Higher baseline KL-6 (HR 1.37) & hSP-D (1.51) levels assoc w/ progression. Increasing KL-6 at 1 yr showed the greatest progression (∆KL-6: HR 2.0) https://t.co/efowyCp1qu https://t.co/JVd7sRKzVF

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Dr. John Cush RheumNow ( View Tweet)
Systemic sclerosis pts in the PRESS & STRIKE cohorts - High type I interferon (IFN) scores in diffuse SSc pts correlated w/ high disease activity & worse 12-month prognosis and overall survival. https://t.co/pdPjoVfQNH https://t.co/RB7li2ZIxX

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Dr. John Cush RheumNow ( View Tweet)
Danish registry study of 1431 AAV pts ((median age: 69 yrs, 52M; F/U 4.8 yrs) shows AAV had more LVH (17% vs 12%), ST-T (10% vs 7%), aFib (9.6% vs 7.5%), QTc prolong (6% vs 3.6%). Only AAV w/ major ECG abnls had incr risk of CV mortality [HR 1.99; 1.49-2.65) https://t.co/OB8b9pC6kw
Dr. John Cush RheumNow ( View Tweet)
ACPA specificity and recognition motifs examined in 6,907 patients with RA from 5 Scandinavian cohorts. ACPA targeting non-glycine citrulline motifs assoc. more strongly w/ HLA-SE; ACPA to glycine citrulline motifs assoc. w/ smoking and IgA ACPA A&R https://t.co/PmKv3dZLc4 https://t.co/NdPG4Orfj4

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ACR_Journals ACR_Journals ( View Tweet)
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