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Arthritis as a Harbinger of Pediatric Cancer

Jack Cush, MD

Lancet Rheumatology has published a cohort analysis showing that a small but significant subset of children presenting with arthralgia or arthritis may have a pediatric malignancy.

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2020 Year Review

ICYMI: 2020 Rheumatology Year in Review

Jack Cush, MD

2020 was historic, memorable and game-changing. Under the cloud of COVID-19, there were many significant and memorable advances and setbacks for the rheumatology world. In our accounting of most read articles for 2020, (not surprisingly) 17/20 were COVID-related.

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Neuropsychiatric Events Common in Lupus

Jack Cush, MD

Neuropsychiatric (NP-SLE) or CNS lupus events range from mild to severe; several recent studies have noted that NPS lupus is common and should be screened for.

A metanalysis of the literature finds 22 studies wherein the mean frequency of NPSLE ranged from 10.6% to 96.4%. When researchers with the Swiss SLE cohort study looked at their population, NPSLE was found in 28.1%. This included cerebrovascular insults, seizures and psychosis.

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Treatment of MIS-C COVID in Kids

Jack Cush, MD

The NEJM has published results of a real-world efficacty trial showing that COVID infected children with the multisystem inflammatory syndrome in children (MIS-C) respond better to initial IVIG plus glucocorticoids (than IVIG alone) which was associated with less subsequent cardiovascular co

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EULAR 2021 – Day 4 Report

Jack Cush, MD

It's been nearly two weeks since EULAR 21 ended. There were several presentations on the last day; notably, the late breaking abstracts and others. Here are a few of my favorites from Day 4, the final day of the meeting.

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RheumNow Podcast – Falling or Falling in Love?

Jack Cush, MD

Dr. Jack Cush reviews the best journal articles from the past week on RheumNow.com.

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Septic arthritis MIMICs (all presenting as acute monoarthritis) - consider: cellulitis, bursitis, abscess, osteonecrosis, gout, pseudogout, Lyme, Osteomyelitis, reactive arthritis, Lyme disease,, Rheumatoid arthritis, & Transient synovitis (kids) https://t.co/uNirAcoBds

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Dr. John Cush RheumNow ( View Tweet)

"Arthritis Mutilans" - worse outcome to chronic inflammatory arthritis is due to 5 disorders: 1) RA 2) Psoriatic arthritis 3) Tophaceous gout 4) polyarticular JIA 5) Multicentric reticulohistiocytosis (Ive never seen this!!) https://t.co/XYmBEW1F0R https://t.co/010QYkOO7E

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Dr. John Cush RheumNow ( View Tweet)
#EULAR2021 LB0004: Secukinumab for enthesitis-related JIA treatment-withdrawal study shows longer time to flare and decreased flares compared to PBO @Rheumnow https://t.co/LG3dDmH7we
Eric Dein ejdein1 ( View Tweet)
JUNIPERA - secukinumab in enthesitis related arthritis and juvenile PsA ⭐️achieved JIA ACR response compared to placebo ⭐️⬇️time to flare ⭐️75% with resolution of enthesitis ⭐️0 deaths, AE - minor infections, GI issues, headache Abs#LB0004 #EULAR2021 @RheumNow

Robert B Chao, MD doctorRBC ( View Tweet)

JUNIPERA trial: open label Secukinumab in ERA and JPsA: 90.4% JIA ACR 30 and 69.9% JIA ACR 70 W12 and > time to flare W104, 72% risk of flare reduction SEC vs PBO (HR: 0.28 95CI: 0.13–0.63 P<0.001). No particular safety signal. #LB0002 @Rheumnow #EULAR2021 https://t.co/PJ9NYi25UI
Aurelie Najm AurelieRheumo ( View Tweet)
Stop #smoking! Smoking is not good for you & others! 👉🏽Passive smoking exposures during childhood & adulthood associated with increased risk of #RheumatoidArthritis Could favour citrullination in genetically proned people By @YannNgyn OP0012 #EULAR2021 #rheumatoid https://t.co/ImDR0aLAXd
Dr Ai Lyn Tan DrAiLynTan ( View Tweet)

ERA & JPsA children & adolescents tx'ed w/ SEC, JUNIPERA 104wk data: longer time to flare vs PBO. NRI analysis: 87.2%, 83.7%, 67.4%, 38.4% and 24.4% achieved JIA ACR 30/50/70/90/100, respectively. No new safety signals. #EULAR2021 @RheumNow Abstract #LB004 https://t.co/reWawBWfqh https://t.co/9gzKKU1xrm

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Dr. Rachel Tate uptoTate ( View Tweet)
Using data of the E3N prospective observational study - including 98995 women - passive smoking in childhood or adulthood could be found as risk factor for #RA and potentially earlier onset #OP0012 #EULAR2021 @RheumNow https://t.co/58DJ8lZzfV
Paul Studenic Stiddyo ( View Tweet)
Data from E3N-EPIC cohort: passive tabagism in both childhood (HR 1.42 95CI [1.07 to 1.88]) and adulthood (HR 1.27 95CI [1.02 to 1.57]) associated with higher risk of RA in non smoking women (adjusted on age passive smoking educational level BMI) #EULAR2021 @RheumNow #OP0012

Aurelie Najm AurelieRheumo ( View Tweet)

We know smoking is ass w/ RA. How about passive 🚬? French E3N-EPIC cohort: OP0012. Prospective questionaries of 80,000F, 698 incident cases. ⬆️ risk in passive childhood and adult tobacco exposure. #EULAR2021 @RheumNow 🚭! https://t.co/1Rf0euz3VC
Eric Dein ejdein1 ( View Tweet)
Dr. G Robinson Abstr#OP0013 on sex link b/t autoimmune & CV risk 👉Hormones drive funx change in Treg transciptome 👉anti-inflamm Tregs⬆️in males 👉Tregs are more suppressive in males 👉Treg transciptome profile altered b/t males & females in autoimmunity #EULAR2021 @rheumnow https://t.co/p4Awfu2hiK
k dao KDAO2011 ( View Tweet)
Put out cigarettes around others! 👉passive smoking in childhood & adulthood⬆️RA risk 👉RA occurs earlier for passive smoking in childhood 👉passive smoking can cause citrullination in genetically proned subjects b/f 1st Sx's Dr. Y Nguyen Abstr#OP0012 #EULAR2021 @rheumnow https://t.co/ZoIumNQQAf
k dao KDAO2011 ( View Tweet)
New download available! Difficult RA Defined https://t.co/6WGMEiwiUk https://t.co/VTCm4cuyRe

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Dr. John Cush RheumNow ( View Tweet)
Cohort study of 4.4 million adolescents w/ 7.6 million fluoroquinolone Rxs found a 90 day LOW risk of tendon ruptures (0.47/1000 Pt yrs) or tendinitis (9.34 per 1000 person-years). These events were rare in kids and appear to be more common in adults. https://t.co/52uGZKAptc

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Dr. John Cush RheumNow ( View Tweet)

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