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Treating During Pregnancy (11.14.2025)
Dr. Jack Cush reviews the journal articles, news and guidelines from this past week on RheumNow.com
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Hospital Mortality in Dermatomyositis
A cohort study shows that hospitalized patients with dermatomyositis have higher in-hospital mortality in the presence of active rash, interstitial lung disease, and elevated neutrophil to lymphocyte ratio at admission.
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More on Methotrexate and ILD Risk
To assess the progression of the interstitial lung disease related to Methotrexate (MTX) exposure, and to evaluate the lung involvement in RA non-ILD patients with MTX exposure, a systematic review was performed to assess whether RA patients receiving methotrexate (MTX) are at greater risk f
ACR 2025 Rheumatology Round Up
Drs. Jack Cush & Arthur Kavanaugh, two of rheumatology’s most trusted voices, provide a breakdown of the latest breakthroughs and hottest topics in rheumatology from the 2025 ACR Convergence meeting in Chicago.
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25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/4nhACulIw0
Dr. John Cush RheumNow ( View Tweet)
Hospital Mortality in Dermatomyositis
A cohort study reveals that hospitalized patients with dermatomyositis have a higher in-hospital mortality rate in the presence of active rash, interstitial lung disease, and an elevated neutrophil-to-lymphocyte ratio at admission. https://t.co/6WIFVJT9w7
Dr. John Cush RheumNow ( View Tweet)
GLP-1 Receptor Agonists in PsA: Mortality and MACE
Dr. Antoni Chan reports on abstract 0849 (Mortality and Major Adverse Cardiac Events (MACE) with GLP-1 Receptor Agonists in Psoriatic Arthritis), presented at #ACR25.
https://t.co/XNyt3UIjgp https://t.co/RUnZCjXF9T
Dr. John Cush RheumNow ( View Tweet)
Western Australia study of 1854 SLE pts (median 40 yrs old). Interstitial lung disease was seen in in 3.8% of SLE, 26 fold more than controls. Risk factors for ILD included older age, smoking and serositis. SLE-ILD pts had higher mortality rates (MR 52.0, CI 37.0–71.1).
Dr. John Cush RheumNow ( View Tweet)
Nerandomilast for ILD
Dr. Mike Putman reports on abstract 1662 (Efficacy and Safety of Nerandomilast in Patients with Autoimmune Disease-Related Progressive Pulmonary Fibrosis: Subgroup Analysis of the FIBRONEER-ILD trial). #ACR25
https://t.co/J0e4SbVgFE https://t.co/dlOM700yVQ
Dr. John Cush RheumNow ( View Tweet)
GLP-1 Receptor Agonists: Impacts Beyond Metabolism?
Across multiple abstracts, investigators have used a large real-world dataset, the TriNetX network, to explore how GLP-1 receptor agonists (GLP-1RAs) might influence cardiovascular, renal and immune-mediated outcomes in our https://t.co/Xl6M3xSvlq
Dr. John Cush RheumNow ( View Tweet)
Upadacitinib is a Double Edged Vascular Sword in GCA
Dr. David Liew discusses abstracts O751, O738, and O734 presented at #ACR25.
https://t.co/eTmVehP2Cd https://t.co/vxehwRWM2D
Dr. John Cush RheumNow ( View Tweet)
#2662
Using Medicare data to emulate real-world RA-ILD trials, investigators compared RTX vs ABA, TOC, JAKi & TNFi
No sig differences in mortality, resp, hospitalisation or lung transplant across groups, suggesting other b/tsDMARDs may be as safe as RTX for RAILD
@RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#2661 In >5000 veterans with RA-ILD, 8 distinct FVC trajectories were identified. >1/2showed a progressive decline (≥0.7%/yr). These progressive patterns predicted higher mortality & respiratory hospitalisations, underscoring major disease heterogeneity. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Inflammation skews lipid levels in RA: the “lipid paradox”
Using data from CERTAIN and VARA, inflammation (hsCRP)-adjusted TC & LDL better predicted ASCVD events than standard lipids.
Are we missing RA pts who need statins?
@RheumNow #ACR25 A#2681
Jiha Lee JihaRheum ( View Tweet)
#2681 Tackling the “lipid paradox” in RA: inflammation-adjusted TC & LDL (using hsCRP correction) improved ASCVD risk prediction and flagged more high-risk patients than standard lipids. A smarter way to guide statin use in RA. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
Observational study from VCRC AAV patinet, >70% had pulm involvement at some point
As expected, nodules favor GPA (63% vs 12% MPA) & DAH favors MPA (61% vs 31%)
More ILD in MPA (11% vs 1%) & more endobronchial in GPA (12% vs 2%)
Helpful pearls!
@RheumNow #ACR25 Abstr#0721 https://t.co/Iu5MdiTABR
Mike Putman EBRheum ( View Tweet)
Not all RA meds are equal for the heart.
In >10K older adults w/ RA, advanced therapies lowered MACE risk (HR 0.63) vs csDMARDs, while GCs ↑ risk (HR 1.54) and undertreatment ↑ it 13-fold.
Control inflammation, protect the heart.
@RheumNow #ACR25 Abstract #2642
Jiha Lee JihaRheum ( View Tweet)
Sleep Apnea in Psoriatic Arthritis – A Wake Up Call
Fatigue is one of the most disabling symptoms in psoriatic arthritis (PsA), yet its causes are often underexplored. At #ACR25, Abstract #0549, a possible hidden contributor was studied: obstructive sleep apnea (OSA). In a https://t.co/E3cy1Uss73
Dr. John Cush RheumNow ( View Tweet)
Lung Disease in ANCA-associated Vasculitis
Dr. Mike Putman discusses abstract 0721, "Pulmonary Manifestations of Granulomatosis with Polyangiitis and Microscopic Polyangiitis", presented at #ACR25.
https://t.co/A5uKT4jG1I https://t.co/7E4k7QdiNK
Links:
Dr. John Cush RheumNow ( View Tweet)
Lung Ultrasound in CTD-ILD
Prospective cohort 146 pts CTD-ILD
30 preclinical ILD
76 limited ILD
40 extensive ILD
Median LUS scores higher if Extensive ILD
LUS scores correlation w/ fibrosis severity, DLCO & FCV
Agreement between LUS and HRCT severity 0.74
Excellent inter https://t.co/R9zGmCTT8Q
Aurelie Najm AurelieRheumo ( View Tweet)
