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In 2023, the phase 2 TitAIN study showed that the effectiveness and safety of secukinumab in 52 patients with giant cell arteritis (GCA) who had an inadequate response to tocilizumab.
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A collaborative EULAR/ACR expert panel has established criteria for arthralgia patients at risk (clinically suspect arthralgia) to progress to chronic rheumatoid arthritis (RA).
Eric Topol
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The American Heart Association just published their alcohol recommendations today which line up with the report by the National Academies. Moderate EtOH intake, up to 7 drinks per week (1/day), is without risk (and may be beneficial for cardiovascular outcomes)
@American_Heart https://t.co/7c0IlmgZiv
Dr. John Cush
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Psoriatic Arthritis at Risk for Interstitial Lung Disease
A TriNetX EHR study shows that psoriatic arthritis (PsA), but not Psoriasis (PsO), patients are at increased risk for interstitial lung disease (ILD).
https://t.co/2zuxF1PY3Q. https://t.co/r28dY3T8nO
Dr. John Cush
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Extract of purple sweet potato ANTHOCYANINS (PSPA) studied in CIA animal model of #RA; Rats Rx w PBO or PSPA (10, 20, or 40 mg/kg) x14days. 40mg/kg dose reduced synovitis, altered gut microbiota (Akkermansia, Lactobacillus) decr RF & cytokines TNF-α, IL-1β, IL-6, IL-18) https://t.co/UjPFEuTU1S
Dr. John Cush
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Uncontrolled pilot trial of frequency specific microcurrent treatment given to 17 pts w/ Raynaud’s & systemic sclerosis. Microcurrent Rx given for 45-60 min over 1-2d; w/ average improvement of 40% in hand function & Raynauds improvement ~18% p .016)- RCT needed!! https://t.co/4OUeODuj8Q
Dr. John Cush
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Swiss Registry study of PsA outcomes when started on either TNFi (N 503) or IL-17i (n 341), latter w/ more severe PSO. IL-17i durability superior to TNFi (median 828 vs 445 d, P<.001), w/ less D/C in women (HR 0.57); but ACR 20 (14 v 33%) & ACR50 (7 v 24%) favored TNFi use https://t.co/R33bwSeB3E
Dr. John Cush
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52 wk Phase 3 DBRPCT of daily anakinra (100 mg sc) vs PBO in 30 giant cell arteritis pts. At wk 16 (17 ANK vs 13 PBO) there was no significant difference in relapse rates (12% vs 23%; p = 0.63). Same at wk 52 (53% vs 49% relapse). ANK didnt reduce relapses or GC exposure https://t.co/RFkkaUchsW
Dr. John Cush
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Global incidence of alopecia areata increased betw 1990 - 2021; from 20.43 million (19.77-21.09 million) in 1990 to 30.89 million in 2021 ( range of 29.95-31.82 million) - highest in USA 550/100,000. High in N.America, S.America, Southeast Asia, Australia. Lowestin Africa, Middle https://t.co/GxrZPY5NBc
Dr. John Cush
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Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/3RbDFVtJR5
Dr. John Cush
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CMAJ reminds us that w/ parvovirus B19 infection, Arthropathy seen in ~60% of adolescents & adults, but the classic “slapped cheek rash” is uncommon. Symmetric, polyarticular inflamm arthralgias/itis affects PIPs, MCPS mostly. Sxs resolve w/in 3 wks. ~20% can last mos-yrs https://t.co/WXnuViSLbe
Dr. John Cush
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Denosumab and Osteoporosis - A JAMA Review
An overview of denosumab use in osteoporosis (OP) by Bauer and Ensrud was published in JAMA
https://t.co/3d7Q61nVKM https://t.co/i3DjtcsuWo
Dr. John Cush
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Rules on Mycophenolate Use in SLE
Dr. Diane Kamen. a rheumatologist and lupologist from the Medical University of South Carolina in Charleston, South Carolina, discusses the use of mychophenolate in the management of systemic lupus.
https://t.co/ieiUNYQbsB https://t.co/KlC0dO06tc
Dr. John Cush
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Let the young know they will never find a more interesting, more instructive book than the patient himself." – Giorgio Baglivi
Dr. John Cush
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Do SGLT2 and GLP-1 therapies have a role in Lupus?
Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA), initially developed to lower glucose in Type 2 Diabetes, also provide cardiovascular and renal protection for patients https://t.co/JxnbgeqgOp
Dr. John Cush
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SLE Treatment Landscape: Abundance or Overload?
Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we https://t.co/xLgSU4ZLgP
Dr. John Cush
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Metanalysis of 12 trials, 12 902 adults hospitalized w/ COVID betw May, 2020 & March, 2022 (7 Bari, 3 Tofa, 2 Ruxo). Fewer deaths in those on JAKi (11·7% vs 13·2%; aOR 0·67 [95% CI 0·55–0·82]; high-certainty evidence); 39 fewer deaths/1000. JAKs had less mechanical ventilation https://t.co/QSMRo3RcRr
Dr. John Cush
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Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/lNFEX08Vn3
Dr. John Cush
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Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/wYTNv50tqM
Dr. John Cush
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IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/XsSFXgBxuD
