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Big Time Vasculitis (3.10.2023)

d Jack Cush, MD

Dr. Jack Cush Reviews the News and Journal articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers the question - does aggressive biologic treatment of psoriasis prevent future psoriatic arthritis?

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Long-Term Survival of Idiopathic Inflammatory Myopathies

d Jack Cush, MD

A single center cohort study analyzed the outcome and survival of idiopathic inflammatory myositis (IIM) patients and showed good 5 and 10 year survival but showed significant declined 15-25 years post-diagnosis.

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antibody (Keep)

Geo-epidemiology of Autoantibodies in Rheumatoid Arthritis

d Jack Cush, MD

A multinational study of rheumatoid arthritis (RA) patients shows a variety of post-translationally modified anti-modified protein antibodies (AMPA). While AMPA differed in different ethnic populations, their levels correlated with total serum IgG.

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Higher Rehospitalization Rates in Younger SLE Patients

d Jack Cush, MD

A Medicare study shows that young adults with systemic lupus erythematosus (SLE) exhibit very high 30-day rehospitalization rates (36%) that are significantly higher than older SLE patients and age matched non-SLE patients.

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alopecia,universalis

Does Methotrexate Work in Alopecia Universalis?

d Jack Cush, MD

Alopecia areata totalis (AT) and universalis (AU) are the most severe and difficult to treat forms of alopecia areata (AA).

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Does Methotrexate Work in Alopecia Universalis? Alopecia areata totalis (AT) and universalis (AU) are the most severe and difficult to treat forms of alopecia areata (AA). https://t.co/x8EjMekMBJ https://t.co/ntejSJcG5M

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CDC says EVERYONE should be tested for Hepatitis B al least once, w/ 3 lab - HBsAg, & Abs to hepatitis B surface Ag (anti-HBs), hep B core Ag (anti-HBc). At increased risk for HBV - persons in jail, +Hx of STDs, multiple sex partners or Hx of hepatitis C https://t.co/DRzAuhVJSJ https://t.co/9ma0I61xeD

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Population study from Japan shows that Aging is an independent contributor for seronegative RA in patients who are female, have a nonsmoking history, and a BMI < 25. https://t.co/WWRGczmc4K https://t.co/ZHRIHlxDIK

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1215 pts w/ refractory SJS/TEN (not responding to pulse steroids x 3d) compared subsequent plasmapheresis- vs IVIG treated patietns and shows similar mortality rates(18.3% vs 19.5%), but apheresis had more stays (45 vs 32 d) & cost ($34k vs $23k) https://t.co/QTnbPzf6Jd https://t.co/EgI2ueIhdz

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Registration is still open! Join us at RheumNow Live on 3/18 and 3/19. We have a great agenda lined up including a panel on Rheumatoid Arthritis: Revolutionary Advances in Therapy. https://t.co/duAfKSDi1O https://t.co/JkbHa6b2Fg

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NEJM Case: 44 yoF w/ 1wk hx of pustular rash, 1st on face, then legs. Also has ankle pain & odynophagia. PMHx oral ulcers. Exam: Aphthous ulcers & all labs were negative (ANA, ANCA, HIV, RPR, etc). Skin Bx= small-vessel vasculitis. What Dx? https://t.co/gxjXRaRKzq https://t.co/OYmC4om6hi

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Study of 21 Downs syndrome pts shows DS to be an autoimmunity-prone state, with a steady-state cytokinopathy, and evidence of hyperactivated CD4 T cells and ongoing activated B cells (CD11c+) - all contribute to a breach in immune tolerance. https://t.co/UUEByfBrqk https://t.co/ekq8AHYlxQ

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GCA patients with AORTITIS proven by CTA or FDG-PET/CT have higher rates of relapse. Among 82 GCA pts, 78% positive on both CTA & PET. Relapse was seen in 70% in the CTA+/PET+ group & 29% in the CTA-/PET+ (p = 0.019). https://t.co/psA6hywouL https://t.co/WORiBd9Qli

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New PMR Paradigm Lessons from the clinic, brought to you by RheumNow Live. Join us on March 18 &19, 2023 in Dallas, TX https://t.co/4umv0FvmsQ https://t.co/iFQGIHiIds

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Does Biologic Treatment in Psoriasis Reduce the Risk of PsA? Retrospective claims analysis shows that psoriasis patients treated with an IL-12/23 inhibitor or an IL-23 inhibitor had a lower risk of developing incident PsA. https://t.co/j73V7zMnkn https://t.co/EhGUXDNNlS

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My Bum Knee QD Clinic - Lessons from the clinic, brought to you by RhuemNow Live, March 18 &19, 2023 - Dallas, TX https://t.co/nqBiAZsYGY https://t.co/MxhCbrWm3p

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BRIDGE-PMR a proof-of-concept trial studied 1 dose of IV RTX in 47 PMR pts - at 1 yr, 52% RTX were in GC-free remission (compared to 21% given PBO). Eight (33%) patients in the placebo group and six (26%) in the rituximab group had adverse events https://t.co/yv8ezFN5BJ https://t.co/7FOOPbEIf3

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Bullous pemphigoid is an autoimmune blistering Dz that may be seen with other hematologic dz - hemophilia A, hypereosinophilic syndrome, autoimmune thrombocytopenia, aplastic anemia, Heme malignancy (MDS, CLL, etc) https://t.co/i8WdA28hYP https://t.co/RsJMt9RTNl

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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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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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