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Bad News Coronary Artery Calcium in Rheumatic Patients

Jack Cush, MD

A recent presentation at the 2024 Society of Cardiovascular Computed Tomography meeting by Brittany Weber MD, PhD (Brigham and Women’s Hospital) has shown that incidental findings of coronary artery calcium on chest CTs in patients with immune-mediated inflammatory diseases may be associated with poorer outcomes, even if they don’t have preexisting atherosclerotic cardiovascular disease.

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Systemic sclerosis sine scleroderma

Jack Cush, MD

Systemic sclerosis sine scleroderma (ssSSc), which accounts for nearly 10% of systemic sclerosis (SSc) patients and was first described in 1962, is a subset of SSc.

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Protective Benefits of SGLT2 Inhibitors and Lupus Nephritis

Jack Cush, MD

A multicenter cohort study of systemic lupus erythematosus patients with type 2 diabetes has shown the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors associated with a significantly reduced risk of lupus nephritis, dialysis, kidney transplant, heart failure, and all-cause mortality compared with no SGLT2i use.

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No Risk of Interstitial Lung Disease with Methotrexate Use

Jack Cush, MD

JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM).

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Damage in Childhood Lupus

EurekAlert!

Childhood lupus (cSLE) is a rare multisystem disorder with significant associated morbidity, but evidence-based guidelines are sparse, and as such management is often based on clinical expertise.

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New Treatments for Systemic Sclerosis

EurekAlert!

Autologous hematopoietic stem cell transplantation (aHSCT) for SSc has been proven the most effective treatment strategy with regard to overall and event free survival in selected patients.2 But a key limitation is its toxicity, and new treatment options are needed.

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EULAR 2024 – Day 4 Report

Jack Cush, MD

The final day of EULAR 2024 was rich in posters, Late-breaking oral presentations and EULAR updates and recommendations.  Below is a synopsis of the half-day's action.

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Bad News Coronary Artery Calcium in Rheumatic Patients In the 2024 SCCT meeting, Dr. Brittany Weber presented findings showing that incidentally discovered CAC in patients with IMID can lead to worse outcomes, even without prior ASCVD. https://t.co/aJhf0IL1WW https://t.co/uMl89rXjBK

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of myositis associated - ILD (and treatments), including: - Case examples - Antisynthetase Syndrome - Anti-MDA5 Amyopathic DM - Interstitial Lung Disease in Myositis https://t.co/PhfuuBHOYf https://t.co/OC1GmWkYyO

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of myositis associated - ILD (and treatments), including: - Case examples - Antisynthetase Syndrome - Anti-MDA5 Amyopathic DM - Interstitial Lung Disease in Myositis https://t.co/zQpfstnGy8 https://t.co/XogyyxuVMk

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Dr. John Cush RheumNow ( View Tweet)
ICYMI: Community-Acquired Pneumonia (CAP) https://t.co/geb8y2AK26 https://t.co/cB3y5vQoz1

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Dr. John Cush RheumNow ( View Tweet)
CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV https://t.co/VgFiCKfMqB

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Dr. John Cush RheumNow ( View Tweet)
CT angio in 75 pts w/ Takayasu arteritis (40 w/ cDMARDs, 35 biologics) showed reduced arterial thickness in 73% (31% w/ >25% decr in wall thickness). 1st immunosuppressives (p= 0.012) & bDMARDs(p= 0.026) reduced art. wall thickness (relative to cDMARDs) https://t.co/16eGmgVoWr https://t.co/AyNyT7FsYZ

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Dr. John Cush RheumNow ( View Tweet)
How do you manage new progressive ILD?

Dr. John Cush RheumNow ( View Tweet)

No Risk of Interstitial Lung Disease with Methotrexate Use JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM). https://t.co/qauRelAkG0 https://t.co/bhSLYrfzlv

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Dr. John Cush RheumNow ( View Tweet)
EUSTAr study of 4431 systemic sclerosis (SSc) pts - anti-SSA antibodies are detected in 15% of SSc-patients and represent an independent risk factor for the presence of lung fibrosis (OR 1.24) & more severe lung involvement. #EULA2024 OP0013 https://t.co/NcxReWk83n https://t.co/FSMx22XiNo

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Dr. John Cush RheumNow ( View Tweet)
TARGET compared triple DMARD to TNFi in 122 RA pts and association with CV risk. In a subanalysis they found no correlation between change in lipid measurements and change in vascular inflammation by FDG-PET. https://t.co/0HKogmdRGH https://t.co/cD7UVTgTQ3

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Dr. John Cush RheumNow ( View Tweet)
EUSTAr study of 4431 systemic sclerosis (SSc) pts - anti-SSA antibodies are detected in 15% of SSc-patients and represent an independent risk factor for the presence of lung fibrosis (OR 1.24) & more severe lung involvement. #EULA2024 OP0013 https://t.co/oW6NBjIG7E https://t.co/toyvHxJlr9

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Dr. John Cush RheumNow ( View Tweet)
Another proof (if needed) that controlling Dz Activity in RA is a very important preventive measure in RA! 179 pts ILD newly developed 9.5% progressed 12.3% no change 74.9% improved 4.5% 5.7% in the LDA group 28.0% non-LDA group (p=0.006) #EULAR2024 POS0408 @AurelieRheumo https://t.co/lKUY32KFiX
Dr. John Cush RheumNow ( View Tweet)
Matters of the heart: cardiovascular disease and mortality in RA Patients with RA have up to 2x higher risk of coronary artery disease, plus increased atrial fibrillation and stroke risk. https://t.co/wFs7ds3tF2 https://t.co/GWyXJbeyIn

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Dr. John Cush RheumNow ( View Tweet)
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