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Skin Biopsies to Predict Scleroderma Outcomes?

Jack Cush, MD

Researchers from the Hospital for Special Surgery and Weill Cornell Medicine have shown that skin biopsies in patients with systemic sclerosis (SSc) can define a fibroblast immunophenotype that may have prognostic and early treatment decision impact.

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High-Resolution CT in CTD-Interstitial Lung Disease

Jack Cush, MD

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).

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Scleroderma-associated Interstitial Lung Disease

Marcy B. Bolster, MD

While we know there are certain clinical features serving as predictors that patients with SSc may develop ILD, including diffuse skin disease and serologies such as anti-Scl-70 and Th/To antibodies, it is imperative that clinicians consider that any patient, particularly early in their disease course (5 years of disease since the first non-Raynaud phenomenon symptom) could develop ILD. 

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What you need to know about scleroderma-related lung fibrosis

Dinesh Khanna, MD, MSc

What do you need to know about scleroderma-related lung fibrosis as a practicing rheumatologist? Here are takeaways from these guidelines and my practice.

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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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How to assess ILD in your patients?

Janet Pope, MD, MPH, FRCPC

Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis.

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PAH diagnosis and management in the context of CTD ILD

Aurelie Najm, MD, PhD

Pulmonary arterial hypertension (PAH) is a serious complication of connective tissue disorders. Approximately 25% of patients with PAH have an underlying CTD, making CTD-PAH the second most common cause of PAH. During the session on Management of Lung Complications in CTD at APLAR 2025, Prof. Dinesh Khanna and Masataka Kuwana provided an excellent overview of PAH diagnosis and management strategies the context of CTD-ILD.

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ERS/EULAR guidelines for CTD-related interstitial lung disease

Jack Cush, MD

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in the European Respiratory Journal and Annals of Rheumatic Diseases.

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September to Remember (9.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.

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Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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Detection, Monitoring & Management of Autoimmune ILD The American Journal of Managed Care has reviewed the approach to patients with ILD; a significant cause of morbidity and mortality in those with SARDs, including RA, SSc, and IIM. https://t.co/xtRfLNyZA6 https://t.co/S9JFlMd9CN

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Dr. John Cush RheumNow ( View Tweet)
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
Dr. John Cush RheumNow ( View Tweet)
How to assess ILD in your patients? Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis. All patients with CTD may develop ILD but it is more common (% of patients with https://t.co/UXdvPJCqDi
Dr. John Cush RheumNow ( View Tweet)
Why shall we screen all patients with SSc for ILD? Focusing screening strategy on patients « at risk » misses 25% of patients with ILD ILD being the main cause of mortality in SSc @RheumNow #APLAR25 https://t.co/djzCTdZoVb

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Aurelie Najm AurelieRheumo ( View Tweet)
Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Dr. John Cush RheumNow ( View Tweet)
ERS/EULAR guidelines for CTD-related interstitial lung disease The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have released clinical practice guidelines for evaluating and managing connective tissue diseases (CTD) https://t.co/2mmxsor4ND
Dr. John Cush RheumNow ( View Tweet)
SPRING-SIR Italian registry of systemic sclerosis: 1917 SSc pts, 56% had GI Sx, assoc w/ longer Dz duration, more severe Dz, diffuse SSc, ILD, digital ulcers, telangiectasias, & tobacco. In 211 very early SSc, 41% GI Sxs (most esophageal), w/ puffy fingers, & dyspnea. https://t.co/l2hStwavuu
Dr. John Cush RheumNow ( View Tweet)
SSc-ILD ABs & LESSONS: 30% of won't progress. Triple negatives (ATA, ACA, ARA) wont progress. Males & diffuse dz > predictive than Abs. Great read on if Abs are biomarkers to predict Rx effect. https://t.co/YcZt4aAvL0 https://t.co/wOknKRfRHf

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Dr. John Cush RheumNow ( View Tweet)
Study of 607 systemic sclerosis (SSc) pts finds Pulm arterial HTN (PAH) in 77 (12.7%). While early immunosuppression didnt reduce odds of PAH (OR 0.74, p=0.495), early mycophenolate was protective(OR 0.12; p=0.048). Only HCQ use signif. improved survival (HR 0.04; p= 0.004). https://t.co/DbsJVZ16Zd
Dr. John Cush RheumNow ( View Tweet)
MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/eu1IpaXGL8

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Dr. John Cush RheumNow ( View Tweet)
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