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Hit Parade Review (8.12.2022)

Jack Cush, MD

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on popularity, measured by rheumatologist engagements on the website and social media.

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Cytomegalovirus Increases Thromboembolism Risk in ANCA-associated Vasculitis

Jack Cush, MD

Infection may play an important role in the genesis of vasculitis and ANCA seropositivity; this report suggests that past cytomegalovirus infection may be a risk in the occurrence of venous thromboembolism (VTE) in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis. 

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Increased Mortality in Giant Cell Arteritis

Jack Cush, MD

A population-based study from Ontario, Canada suggests an increased mortality risk in patients with giant cell arteritis (GCA), according to a recent report in Arthritis Care & Research.

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Rituximab Induction and Maintenance in Older ANCA–Associated Vasculitis Patients

Jack Cush, MD

A cohort study suggests that rituximab (RTX) use among patients 75 years and older with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is efficacious but also has a high risk of serious adverse events, likely related to associated steroid use and the advanced age of the po

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ICYMI: 2021 Rheumatology Year in Review

Jack Cush, MD

For 2022, let's look our top 10 list of advances, game-changers, worries and those better medical practices that evolved during 2021.

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What Happened to Kawasaki Disease During COVID-19?

Jack Cush, MD

During the COVID-19 pandemic, a new COVID-related syndrome in children, the "Multisystem inflammatory syndrome in children" (MIS), was described as being similar to but distinctly different than childhood Kawasaki's disease (KD). A new epidemiologic report shows that while MIS-C cases rose, KD cases fell and remained low during the period of masking and school closure.

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CMV Increases Thromboembolism Risk in ANCA-associated Vasculitis Infection may play an important role in the genesis of vasculitis and ANCA seropositivity; this report suggests that past CMV infection may be a risk. https://t.co/K8HzolqLJ9 https://t.co/2VUasoinnL

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Dr. John Cush RheumNow ( View Tweet)
Do not take antacids or PPI with mycophenolate. Magnesium & aluminium hydroxide antacids (Maalox) will lower MMF Cmax 33% & AUC 17% if given simultaneously. PPI also lowers AUC by ~33% https://t.co/IoWISgL3SY https://t.co/JV1Yv5Pg9d https://t.co/b8UoQ4zMUV https://t.co/VwNgVQ5End

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Dr. John Cush RheumNow ( View Tweet)
RTX Induction and Maintenance in Older ANCA–Associated Vasculitis Patients A cohort study suggests that RTX use among patients 75 years and older with ANCA–associated vasculitis (AAV) is efficacious but also has a high risk of serious adverse events. https://t.co/HF9hyQcHZV https://t.co/xpDSohFcRK

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Dr. John Cush RheumNow ( View Tweet)
#Bestinclass Recurrent #PMR RCT of #sarilumab v placebo. Nearly doubles sustained remission but maybe attenuating effect - flare difference over time? N=118. 🤷‍♀️ Dunno who I would use it in yet. LB0006 @RheumNow @eular_org #EULAR2022 @Janetbirdope

Dr. John Cush RheumNow ( View Tweet)

Getting Real on PMR Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022 https://t.co/DyVCxDVPE7 https://t.co/PF7zqxX7yk

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Dr. John Cush RheumNow ( View Tweet)
FDG-PET/CTscans were used in 58 for FUO evaluations. Dx was Rheumatic (44.5%), malignancy (34.5%), or infectious (10.3%). Most prevalent Rheum dx was vasculitis (17%), especially LG vessel vasculitis. FDG PET/CT is a useful FUO pts https://t.co/NEZDB20OXN https://t.co/4123Gh2v2Y

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Dr. John Cush RheumNow ( View Tweet)
Polymyalgia rheumatica immunological puzzle further illustrated Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research presented at #EULAR2022. https://t.co/oa619uNgnB https://t.co/gyNnsMDXGo

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Dr. John Cush RheumNow ( View Tweet)
Environmental articulate matter (PM2.5) levels can increase the odds of a systemic autoimmune rheumatic disease onset (OR 1.12; 1.08–1.15), , w/ no effect of ozone. Results not changed by controlling for smoking. https://t.co/7BGBh9h0lf https://t.co/LcUo4Lxzgx

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Dr. John Cush RheumNow ( View Tweet)
506 ANCA-Assoc vasculitis pt study - 72% were MPO-ANCA+ & 68% w/ renal Dz, & Rx w/ RTX (59%) or CTX (33%) - 16% died, 10% ESRD & 13% relapsed. ANCA negativity had less relapse (HR 0.55; 0.38, 0.81) but not less ESRD or death @ 5 yrs https://t.co/iCrxH9UArl https://t.co/6s3TmQqxVQ

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Dr. John Cush RheumNow ( View Tweet)
Watch: EULAR 2022 - Day 1 Faculty Recap Pane Drs. Jack Cush, Eric Dein and Kathryn Dao discuss highlights from day 1 at #EULAR2022 - Guidelines, Lupus, and more. https://t.co/WSOCQ8K38p https://t.co/0u28QHtxoJ

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Dr. John Cush RheumNow ( View Tweet)
Getting Real on PMR Dr. David Liew talks polymyalgia rheumatica and how our understanding has evolved over the years. #EULAR2022 https://t.co/j4LJPZFqzY https://t.co/ABAbm3axSG

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Dr. John Cush RheumNow ( View Tweet)
Polymyalgia rheumatica immunological puzzle further illustrated Infiltrating macrophages expressing IL-6 and GM-CSF may drive the subacromial bursitis often seen in polymyalgia rheumatica, according to new research presented at #EULAR2022. https://t.co/Miab1eiHZ6 https://t.co/n9IjPwqG2t

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Dr. John Cush RheumNow ( View Tweet)
Video: Vessels Glowing in the Dark - Does it Matter? https://t.co/ZM6kmqM9Ap https://t.co/ibqwrE3p1g

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Dr. John Cush RheumNow ( View Tweet)
FDG-PET/CTscans were used in 58 for FUO evaluations. Dx was Rheumatic (44.5%), malignancy (34.5%), or infectious (10.3%). Most prevalent Rheum dx was vasculitis (17%), especially LG vessel vasculitis. FDG PET/CT is a useful FUO pts https://t.co/AVQ7lRYoRw

Links:

Dr. John Cush RheumNow ( View Tweet)

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