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How Does Your Garden Grow (9.26.2025)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA.
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What is IPAF?
Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD.
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Polypharmacy Impairs Rheumatoid Arthritis Outcomes
A French early rheumatoid arthritis (RA) study has shown that polypharmacy (PP) was associated with significant lower treatment responses and more serious adverse events (SAEs).
Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo.
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HLA-B27: still the most important genetic factor in axSpA susceptibility, but has lower frequency African American, South American & Middle Eastern pop. B27 discerns clinical subsets of SpA and PsA, particularly acute anterior uveitis or axSpA with psoriasis, https://t.co/S4s0NvuwNY
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High-Resolution CT in CTD-Interstitial Lung Disease
A systematic review and meta-analysis examined the role of high-resolution computed tomography (HRCT) in diagnosing and characterizing interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). https://t.co/9FmEe6BgN7
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Our final webinar in this month's Rheum to Breathe: ILD campaign brings together ILD experts to discuss best practices in diagnosis, screening, and monitoring, covering: tools, labs, and imaging; timing and frequency of screening; ILD screening in RA; and, referral strategies. https://t.co/Culzv9bSD4
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Scleroderma-associated Interstitial Lung Disease
Since the first placebo-controlled randomized trial published nearly 20 years ago for the treatment of patients with SSc-ILD, evaluating cyclophosphamide vs. placebo, there have been several other randomized studies to guide the https://t.co/n8S0N2wTqu
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Post hoc analyses of (FUTURE 5) 541 active PsA pts Rx w/ secukinumab shows NO radiographic progression through 2 years of SEC was assoc with achieving LDA at Week 104. https://t.co/IyCsJOm9PS https://t.co/PgDKanxaNU
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Report of 54 Sjögren dz pts w/ cutaneous vasculitis (CV); most had cryoglobulinemic vasculitis & hypergammaglob.vasculitis. Sjogrens w/ CV had higher risk of lymphoma. Type II cryoglob. vasculitis incr risk of mortality/lymphoma, renal dz, peripheral nerve involvement https://t.co/Yd1iu9ZJX0
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QD Clinic: ILD with Positive SSA and Rash
Dr. Elena Joerns, Rochester, Minnesota discusses a case of ILD with positive SSA and rash, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025.
https://t.co/Yuz8CuIN5H https://t.co/3M9emsIXVf
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ILD and ANCA: What to do?
Several cohort studies conducted in Asia, Europe and the Americas have evaluated the clinical significance of ANCA when detected in patients with ILD as well as the types of ILD encountered in patients with microscopic polyangiitis (MPA) and their https://t.co/nrToywCaKm
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Rheum to Breathe Journal Club
In this journal club, we will discuss two pivotal studies in ILD, the FIBRONEER study and the RECITAL study: Nerandomilast in Patients with Progressive Pulmonary Fibrosis, Maher, T.M. et al. NEJM. 2025 May 19.
https://t.co/L0gIsP5nAn https://t.co/026GbJdCvJ
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Screening for RA-ILD: metanalysis of 9 studies, 1380 RA pts - RA-ILD prevalence ranged from 6.7-42.7%; 18.9% via HRCT. None examined risk factors. Male sex & smoking were ~12% higher in RA-ILD & RA disease onset age was 7 years higher in RA-ILD pts. DAS didnt https://t.co/qA2oitwQg5
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CAR-T Product Shows Early Promise in Lupus
Five patients with systemic lupus erythematosus (SLE) in China have been treated with a potentially groundbreaking form of chimeric antigen receptor (CAR) T-cell therapy, researchers reported, with encouraging results after 3 months. https://t.co/eg37PZK6kn
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PPP syndrome = a rare triad
👉 Pancreatitis + Polyarthritis + Panniculitis
🔬 Pathogenesis: circulating pancreatic enzymes (esp. trypsin) → fat necrosis in subcutis & bone marrow.
📌 Clue: painful nodules + arthritis, often with minimal abdominal symptoms.
#Rheumatology https://t.co/3qniCmahgl
ILLIASUL IBAD IlliasulK ( View Tweet)
Inception SLE study of 674 pts (without LN), mean age 34 yrs - 154 (23%) developed new proteinuria (LN) after median of 3.6 yr. Cumulative antimalarial exposure did NOT lower risk of LN (HR 0.98; 0.94-1.02); same for those w/ serologically active SLE (HR 0.97) https://t.co/8OU3yJAvhN
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OL study of 60 pts w/ new idiopathic retroperitoneal fibrosis (GFR >30) Rx w/ low dose MTX+pred VS Pred only. @ 9 mos remission: 90% MTX+Pred vs 81% Pred (noninferior). Time-to-remission, RPF thickness & relapses were same; but pred use was lower w/ MTX+pred (p < 0.001) https://t.co/13cjnl4Ke4
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Turkish study of 799 psoriasis pts - 30% had concurrent onset PsO & PsA & in 70% there was a long transition time (~13 yrs) from PsO-to-PsA. Factors assoc w/ prolonged interval included Depression, fatigue, scalp PsO(OR 7), nail PsO (3.2), +Fhx & enthesitis ever (OR 2) https://t.co/wqtSbeQ2vz
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Canakinumab in VEXAS - 47 males Rx w/ anakinra (44), canakinumab (9), or both(6). Response @1 mos: ANAK 34% vs CANK 100%; 22% vs 78% @ 3 mos. Drug survival was 54 mos CANK 300/m; 7 mo CANK 150/m; 1 mo ANAK. More ISR (47% v 0) & infx w/ ANAK https://t.co/Y3iSfajTal https://t.co/qTNamGDwVI
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