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RheumNow Live is Coming to Town (3.11.2022)

Jack Cush, MD

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

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COVID,hospital,ER,infusion

Tocilizumab Works Best in Non-Mechanical Ventilated COVID-19 Patients

Jack Cush, MD

JAMA has published a meta-analysis of 15 studies of hospitalized patients with COVID-19 treated with tocilizumab and corticosteroids, showing that a clinically meaningful mortality benefit from tocilizumab (and steroids) was best seen in those not requiring invasive mechanical ventilation (IMV).

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coronavirus,COVID,MISC,mask

ACR Updates Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With COVID

Jack Cush, MD

A Task Force from the ACR has provided an updated (version 3) guidance for the diagnosis and management of Multisystem Inflammatory Syndrome in Children (MIS-C), a COVID related condition characterized by fever, inflammation, and multiorgan dysfunction.

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The Overpricing of Drugs (1.14.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. This week we discuss amputations, a $57 billion RA market, an FDA approved drug for Cat arthritis and drug that works in Sjogren's.

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COVID,teen,young,man,mask

Clinical Practice Guidelines for Multisystem Inflammatory Syndrome in Children

Jack Cush, MD

Multisystem inflammatory syndrome in children (MIS-C) is new and serious complication of COVID-19 that preferentially affects adolescents. A review of proposed management guidelines is compiled in this report, suggesting a unified approach to therapeutic management of MIS-C.

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Single center study of individualized anakinra use in 47 autoinflammatory pts (32kids; 43% MAS; 40% systemic JIA). Off-label use in 38%, higher doses in 21 kids (5-29mg/kg); & 5 given IV anakinra; such doses were well tolerated without major AE. https://t.co/wQgw3YAPKX https://t.co/zL3HfdX4Ns

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New Download Available! Autoimmune Disease in the USA https://t.co/KvsgBUY7mL https://t.co/PSTF7ma6G6

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Korean study of 53 424 kids with Kawasaki disease (KD) showed that outbreaks of rhinovirus, respiratory syncytial virus and varicella were significantly correlated with KD at 1 to 3 months before KD outbreaks https://t.co/U8FXao1TWn

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ICYMI: Dr Artie Kavanaugh presents comparison of targeted therapies in different inflammatory disorders. #RWCS2022 @RWCSmtg https://t.co/P4SzIrWzYJ https://t.co/wnf3vnG4xc

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When to suspect an interferonopathy (when suspected you should offer an autoinflammatory panel from https://t.co/F9bat3YS1d) #RWCS2022 @RWCSmtg Dr. Susan Shenoi https://t.co/qUts9X8gwJ

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Dr Artie Kavanaugh presents comparison of targeted therapies in different inflammatory disorders. #RWCS2022 @RWCSmtg https://t.co/cX00RUOgAq
Dr. John Cush RheumNow ( View Tweet)
New 2021 JIA guidelines w 55 recommendations, 36 conditional and 19 strong. #RWCS2022 @RWCSmtg Dr Susan Shenoi https://t.co/CMETQeOdch
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds New and concerning: sJIA associated lung disease - rare and associated w/ pulmonary HTN, alveolar proteinosis, high mortality. Unique features: clubbing, eosinophilia, TCZ anaphylaxis, Trisomy 21. Most were Rx w/ IL-1 > IL-6 inhibition @UTSWRheum https://t.co/aJaPurDSmJ
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds Treating STill's (sJIA) - early early use of anakinra yields best results (in remission and off steroids) - 91% if Anakinra started within the first 3 mos @UTSWRheum https://t.co/neozpYhJtM
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds MAS occurs in 2-8% of Systemic JIA pts and has a high mortality (<40%); It is more frequent w/ onset in Years 1-4. Treatment - steroids, anakinra, etoposide or CsA & Rx infxn if present. Oh...dont stop the anakinra! @UTSWRheum https://t.co/09uQm3LURC
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds IL-18 levels are elevated in systemic JIA, MAS and AOSD @UTSWRheum https://t.co/pIYKf4pods
Dr. John Cush RheumNow ( View Tweet)
Dr. Peter Nigrovic asserts the division between pediatric and adult arthritis is senseless and has no firm biologic basis. Instead we should consider pts as sero- positive or negative, Systemci or Spondyloarthropathy. @UTSWRheum https://t.co/zx5oQmUQ6Y
Dr. John Cush RheumNow ( View Tweet)
UTSW Rheum Grand Rounds with Dr. Peter Nigrovic on systemic JIA in children and adults; yes, its the same disease with the same features. @UTSWRheum https://t.co/C7eBFjnDIi
Dr. John Cush RheumNow ( View Tweet)
Biomarker study of 21 systemic juvenile idiopathic arthritis (sJIA) shows you can differentiate between active & inactive disease. From 69 biomarkers, these were predictive: IL-6, MMP1, S100A12 (p < 0.0001), HMGB1; but IL-18 elevated in both groups! https://t.co/m2yXTITzwY

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Single center comparison of pts with MAS vs malignancy assoc. HLH (mHLH) - overall MAS had less hepatomegaly (0 v 25%), double platelet #s (50 v 29Kµ/L), but lower sIL-2R (6814 vs. 27,972.0) and less mortality (22 v 44%, p=0.18). https://t.co/NGIaPTU0yT

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