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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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When to Stop Biologics in Systemic JIA?

Jack Cush, MD

Systemic onset juvenile idiopathic arthritis (sJIA) is a dramatic onset inflammatory condition marked by spiking fevers, intermittent rash, polyarthritis and a host of other hyperinflammatory manifestations.

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RheumNow Podcast - ACR 2021 Rehash (the good stuff..)

Jack Cush, MD

The ACR 2021 meeting has concluded. Dr. Jack Cush recounts a few more great abstracts from this past week’s virtual meeting.

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Emapalumab for the treatment of macrophage activation syndrome

Md Yuzaiful Md Yusof, MRCP(UK), PhD

Macrophage activation syndrome (MAS) is a term commonly used by rheumatologists to describe a potentially life-threatening complication of systemic inflammatory disorders, most commonly occurring in people with systemic juvenile idiopathic arthritis (sJIA) and systemic lupus erythematosus (SLE).

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ACR21 – Day 3 Report

Jack Cush, MD

Hitting the home stretch, day 3 presentations were big! Here are a few of my favorites: secukinumab efficacy in juvenile PsA; VEXAS - predicting poor outcomes; and the FDA Safety Update session.

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ACR Best

ACR21 Best Abstracts We Saw - Day 3 (Monday)

Jack Cush, MD

The third day of ACR 2021 took a big leap in online content.  Here is a compilation (with links) of presentations were the “ACRBest” as seen by our RheumNow faculty. 

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JAK Inhibitors in Refractory Adult and Childhood-Onset Still’s Disease

Bella Mehta, MBBS, MS

Still's disease is an autoinflammatory disease characterized by spiking fever, rash, polyarthralgia, sore throat and even life-threatening complications, such as macrophage activation syndrome. It was first described by George Still in the late 1800s.

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Watch Now: Can We Stop Medication in Systemic JIA? https://t.co/yRIb70YVME https://t.co/EJ2PmC6xKY

Links:

Dr. John Cush RheumNow ( View Tweet)
Pediatric Psoriatic Arthritis: Dr. Eric Ruderman ( @JointMD) discusses abstracts #1424 presented at the ACR21 annual meeting. https://t.co/aRCPAlBGev https://t.co/jsa261ZuYx

Links:

Dr. John Cush RheumNow ( View Tweet)
#ACR21 [Dr Pooni] #Telemedicine #Pediatrics providers felt PE was worsened BUT msk exam was the MOST reliable. @endocrine_witch @millennialpedia https://t.co/3FGCyBIxB2 https://t.co/fgwdk0WXKm

Links:

LiSa ◡̈︎ rheumarhyme ( View Tweet)
Handy overview of Jak/STAT pathways in rheumatic diseases and available inhibitors (Dr. Joost Swart). Happening now in the Pediatrics Hub (New Therapies & Biologic Safety in Pediatric Rheumatology​). #ACR21 #pedsrheum https://t.co/i4bYr4GKOP
Katie Poholek kpoho ( View Tweet)
#ACR21 #pedsrheum I say it counts! I mean, at the end of the day, these are all just pictures of food on the internet, right? #ACRBakeAnythingChallenge https://t.co/bVQuealWWX

Links:

Dr. Laura Lewandowski LauraLewMad11 ( View Tweet)

New dimensions in cellular immunology. Great session, some which I understood. Kids with #JIA have more cytolytic pathway missense - some leads to macrophage activation syndrome #MAS Low NK cells in Juvenile Dermatomyositis. 9T112 #ACR21 @RheumNow https://t.co/5lUkqr65UM
Janet Pope Janetbirdope ( View Tweet)
Can you stop monitoring eyes in + ANA and/or pauciarticular pt who becomes an adult if no uveitis ever, in last 5 yrs, etc. When can we stop looking? #AVR21 @RheumNow https://t.co/1Ml1BuJD7Y

Links:

Janet Pope Janetbirdope ( View Tweet)

#ACR21 #pedsrheum Risk factors for poor outcomes: delay to diagnosis, poor access to therapy, poor access to care https://t.co/SlFyav5KV6
Dr. Laura Lewandowski LauraLewMad11 ( View Tweet)
Please don’t miss MISC (pronounced Miss C)=multisystem inflammatory syndrome. Pediatric syndrome post #SARSCoV2 infection. May go w macrophage activation syndrome (MAS) w distinct proteomics signature. Potentially v poor outcomes. Need to dx and treat #ACR21 abst0961 @RheumNow https://t.co/uaBbUdg3lt
Janet Pope Janetbirdope ( 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)
CARRA STOP-JIA 400pts, Obs study w/ 3 treatments plans : -Step up -Early combination -Biologic first Which one do you think works best? I'd say none: overall 40-60% not achieving CDI off steroids at 24 months. Results: 42% for SU, 52% EC, and 44% BF #Abtr0960 #ACR21 @RheumNow

Aurelie Najm AurelieRheumo ( 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)
Nationwide study - low income - greater length of stay than highest income. Lowest income many be supported but those who do not have those resources may have an increased length of stay in children hospitalized with pediatric #lupus @dsoulsMD @rheumnow #ACR21 abst#0768 https://t.co/j7VDpVW7ND
Bella Mehta bella_mehta ( View Tweet)
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