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Renal Involvement is Pivotal in ANCA-Associated Vasculitis

MedPage Today

Bearing in mind that renal impairment is among the worst complications of ANCA-associated vasculitis (AAV), researchers have identified four different trajectories of kidney function over time in AAV patients, with implications for personalized treatment, as well as future research.

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NSAIDs in Pregnancy (3.3.2023)

Jack Cush, MD

Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow.  This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.

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Target

Treat-to-Target Guidelines for GCA and PMR

Jack Cush, MD

The Annals of Rheumatic Disease has published updated multinational, treat-to-target (T2T) recommendations for the treatment of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR).

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Burnout #10 (2.3.2023)

Jack Cush, MD

Dr. Jack Cush reviews the past week of news on RheumNow.com.

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PsA Til Death Do Us Part (1.20.2023)

Jack Cush, MD

Dr. Jack Cush reviews the highlights from the past week on RheumNow.com.

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2022 Rheumatology Year in Review (1-6-2023)

Jack Cush, MD

Dr. Jack Cush reviews the best of 2022 in Rheumatology - highlights on new drug indications, breakthrough lupus therapies, new biosimilars and the multivitamin letdown.

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GCA,woman

In Giant Cell Arteritis, Hospital Admission Is Bad News

MedPage Today

One-third of patients admitted with giant cell arteritis (GCA) were rehospitalized within 6 months, largely because of complications potentially related to corticosteroid therapy, researchers found in a retrospective cohort study.

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Renal Involvement is Pivotal in ANCA-Associated Vasculitis Researchers have identified four different trajectories of kidney function over time in AAV patients, with implications for personalized treatment, as well as future research. https://t.co/O8EaW2MaBx https://t.co/VApYiH66yn

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Dr. John Cush RheumNow ( View Tweet)
ENT involvement studied in 320 ANCA associated vasculitis pts: 65% had ENT involvement w/ median age =52 yrs, & median BVAS3 = 12. Relapse seen in 29% despite immunosupp Rx. No diff in outcomes betw pts Rx w/ oral or IV CTX or RTX https://t.co/MwZSnVVd32 https://t.co/YbrHxnqDw9

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Dr. John Cush RheumNow ( View Tweet)
Study of 197 AAV pts in RAVE trial (RTX vs CTX; followed by AZA) showed most serious infections (82%) occurred in 6 mos (68% Resp infx) & assoc w/ lower#s CD19+ cells. TMP/SMX prophylaxis against P. jirovecii decreased SIE rates https://t.co/oz530OkGs8 https://t.co/YFW7PD6wrW

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Dr. John Cush RheumNow ( View Tweet)
Study of 78 pt suspected of #GCA undergoing Temp. artery Bx and US. Nearly half (35) Dx w/ GCA. Both had similar sensitivities(69% and 63%, respectively), but specificity higher w/ biopsy (100% vs 79%). Compression sign had best diagnostic performance https://t.co/wzVqrHvfqM https://t.co/HRmfb6g7aF

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Dr. John Cush RheumNow ( View Tweet)
Study of 78 pt suspected of #GCA undergoing Temp. artery Bx and US. Nearly half (35) Dx w/ GCA. Both had similar sensitivities(69% and 63%, respectively), but specificity higher w/ biopsy (100% vs 79%). Compression sign had best diagnostic performance https://t.co/ATPtN8WZin https://t.co/1MIrmp45AX

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Dr. John Cush RheumNow ( View Tweet)
Vision Loss with ANCA-Associated Vasculitis Shelley K. Dhillon, MD, presents her poster at RWCS 2023. https://t.co/e25SFDXk7O https://t.co/J1AsdE3b0Y

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Dr. John Cush RheumNow ( View Tweet)
PR3 autoreactive CD4+T cells found in affected kidneys of 72 pts with PR3+ ANCA assoc vasculitis. These cytotoxic GPR56+CD4+T cells were significantly greater in those with inactive (vs active GPA), suggesting they may be affected by immunosuppression https://t.co/dHFhgnB8yE https://t.co/ZxV6INeCrU

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Dr. John Cush RheumNow ( View Tweet)
Lg vessel US study compared 44 LV-GCA vs 42high-risk atherosclerosis pt.Intima-media thickness (IMT) was signif. higher w/ GCA. IMT ≥ 1 mmseen in 31/44 axillary, 30/44 subclavian in GCA; but only in 2/42 axillary & 3//42 subclavian in atherosclerosis grp.https://t.co/DGMOfflcVR https://t.co/QVBbdrcd3I

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Dr. John Cush RheumNow ( View Tweet)
197 ANCA assoc Vasculitis pts in RAVE - treated w/ RTX or CTX, thenAZA. 18/22 severe infections occurred within 6 months. Predictors of severe infx included higher baseline CD19+B cells & PJP prophylaxis w/ TMP/SMX (both groups Rx RTX or CYC/AZA) https://t.co/YhNDCdJuof https://t.co/Fg8AOLtYbI

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Dr. John Cush RheumNow ( View Tweet)
US study of 47 #GCA pts showed baseline US+ in 44/47 (72% TA, 72% LV). US was sensitivity to change over time w/ serial measures. TA-based US showed good correlation w/ Dz activity & discriminated remission vs, relapse https://t.co/2cDxac5oJw https://t.co/jH4rgvgELY

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Dr. John Cush RheumNow ( View Tweet)
International survey of 394 GPs & 937 rheumatologists shows most PMR pts are not referred to Rheum. GPs referred 25% suspected PMR for Dx & 50% were returned to GP. 39% of Rheums saw new PMR >2 weeks after referral, half already on Pred https://t.co/K56nYRckpz https://t.co/j6ukqPaQXd

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Dr. John Cush RheumNow ( View Tweet)
ACR GCA classification criteria tested in 676 patients suspected GCA (+US) - 276 dx w/ GCA; 400 not. Sensitivity was 87%, specificity 70%; 35 (13%) GCA pts did not meet criteria. & 119 non-GCA (30%) had ≥6 points (most PMR) https://t.co/bTrj83yM7l https://t.co/9iA8LbX6vB

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Dr. John Cush RheumNow ( View Tweet)
In GCA, Hospital Admission Is Bad News 1/3 of patients admitted w/ GCA were rehospitalized within 6 months, largely because of complications potentially related to corticosteroid therapy, researchers found in a retrospective cohort study. https://t.co/zaWZn7F9sl https://t.co/OfuyZxNbaa

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Dr. John Cush RheumNow ( View Tweet)
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