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A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects agains cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).
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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.
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Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week.
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Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Location matters; Geo-rheumatology?
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A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance.
Dr. John Cush
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Study of 4370 RA pts (26534 PYs) saw 362 MACE (CV) events. RA activity & inflammatory markers assoc w/ MACE risk in bDMARD non-users (not those on bDMARDs). 515 bDMARD vs 3855 non-users (n=3855). Each DAS28-CRP unit incr MACE risk (HR 1.21)https://t.co/lRaHxTHzqe https://t.co/usEiJctVYk
Dr. John Cush
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Scleroderma skin findings in pts w/ skin of colour (SOC) - Raynauds was common but SOC pts had fewer hallmark Sxs: telangiectasias, calcinosis, digital swelling (complicating Dx). SOC had more severe pulmonary Dz & increased mortality, Atypical skin findings… https://t.co/8XkelxqvYE https://t.co/JOw8OSNjzw
Dr. John Cush
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Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M
Dr. John Cush
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Lipids and Inflammation in Rheumatoid Arthritis
In the realm of chronic inflammation, lipid abnormalities are well-recognized as pivotal contributors to the progression and clinical manifestations of atherosclerosis. Particularly in rheumatoid arthritis (RA), a systemic… https://t.co/zHKbBHlap8 https://t.co/KRIg1KYmcC
Dr. John Cush
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Metanalysis of 12 studies shows that being edentulous (or having < 20 teeth) was associated w/ higher risk (HR 1.66; 1.32–2.09) critical confounders also confirmed that tooth loss as a risk factor for Cardiovascular mortality (HR=1.52, 95% CI: 1.28–1.80) https://t.co/PStGlxmCC3 https://t.co/ZDzaytj9dY
Dr. John Cush
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Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease
A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD.
https://t.co/J9FCdkId8H https://t.co/uJylDP3IIp
Dr. John Cush
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Anti-Inflammatory Diet yields a lower risk of Dementia. UK Biobank study shows patients w/ type 2 diabetes, heart disease, or stroke who were on an anti-inflammatory diet had a 31% lower risk for dementia vs. a pro-inflammatory diet https://t.co/OjHq3BBOfd https://t.co/tG9vO59IEc
Dr. John Cush
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Less Mortality with GLP-1 Agonists in Rheumatic Patients
A recent study in PLOS ONE found that treating type 2 diabetes with GLP-1-RAs lowered the risk of mortality and cardiovascular events in patients with IMIDs and type 2 diabetes.
https://t.co/MzCG7WvrDS https://t.co/0RPIfOO0s7
Dr. John Cush
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Mass General Brigham Study 172 RA-ILD pts w/ 6.5 yrs F/U (age 62 yrs): noted (4%) lung transplants & 44 (26%) ILD-related deaths. FVC rapidly declining pts (14%) had aOR 19x lung transplant & aOR 2.8 ILD-related death. Slow decline in 54%, no decline 32% https://t.co/fKDnJIu9a7 https://t.co/ondzN4WZ1F
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Lit review of ILD in anti-synthetase syndrome finds no conclusive evidence of effective treatment. 10 studies, 514 pts (68% female); Hi Res CT positive in 87% w/ 49% having NSIP pattern. 48% Jo-1+, 28% Ro52+. Low improvements w/ RTX (12%), CYC (17%). https://t.co/B7R0xQrUyw https://t.co/2hMzO8hyiV
Dr. John Cush
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EU study of 1052 systemic sclerosis pts failed to show early immunosuppressive use (vs late) lowered ILD risk. Early Rx (Dz Dur < 3yrs) group (n=547, 52%) more male, diffuse Dz, 60% Rx w/ MTX (1.7% biologics); ILD in 47% after3.6yrs (HR 1.13;0.93–1.38) https://t.co/PtQlgyX0TE https://t.co/R7X3zvPvIg
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The adipokine Resistin - predicts disease severity and survival in patients with pulmonary arterial hypertension. High resistin levels (>4.5ng/mL) in PAH assoc w/ older age, shorter 6-min walk, decr CV performance, incr death (HR 2.6) https://t.co/TUR4KnVsR9 https://t.co/rc6IMNWH4w
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Calif Cohort of 19340 rheumatic pts, finds Cardiovascular events (CVE) in 1.4% & antiphospholipid syndr in 5.5%. CVE increased risk of adverse pregnancy outcomes (>50%), including Sm for Gestational age (aRRs 1.2-1.5), Premature birth (aRR 1.6) https://t.co/9lxzrOVEks https://t.co/Jcm7tH61cv
Dr. John Cush
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Lit review of ILD in anti-synthetase syndrome finds no conclusive evidence of effective treatment. 10 studies, 514 pts (68% female); Hi Res CT positive in 87% w/ 49% having NSIP pattern. 48% Jo-1+, 28% Ro52+. Low improvements w/ RTX (12%), CYC (17%). https://t.co/oJ0EMAE7d0 https://t.co/bDiA1h9hO7
Dr. John Cush
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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
