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Happy Diwali (11.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Anxiety and Depression Rising in Rheumatoid Arthritis
A Mayo Clinic study shows that over three decades, anxiety and depression have become more common in individuals with rheumatoid arthritis (RA).
ANA+ consult (10.18.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Screening to Prevent Multimorbidity in Rheumatic Patients
A population based screening program of patients with chronic inflammatory rheumatic diseases (IRD) demonstrates that systematic screening IRD patients for multimorbidity increased preventive interventions and reduced hospital admissions.
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GI Abnormalities in Scleroderma
A prospective Scleroderma Cohort Study found that gastrointestinal tract (GIT) involvement was common and negatively impacted quality of life, physical function, and employment, but had no effect on mortality.
Study of at-risk & early RA Synovium suggests an early pathogenic myeloid signature (IL-1B+CCL20+ & SPP1+MT2A+ macrophage clusters) before disease onset. These display heightened CD40 expression, capable of shaping stromal cell responses https://t.co/CYmb1ro9g9 https://t.co/9pXbqHaQ2G
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Cross-sectional study of 176 CASPAR+ PsA patients correlated Dz activity (cDAPSA) w/ SAA, IL-8, IP10 (IFNg/CXCL10), M-CSF, SCGF-β, SDF-1α) (AUC 0.802- 0.835). The panel was significantly better than CRP (AUC = 0.727, p = 0.022). https://t.co/AZq81S6NH0 https://t.co/5eI241gLVj
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Hydroxychloroquine effects studied in 30pts (23 RA, 7SLE). Results did not support that HCQ may reduce CV risk - Arterial stiffness was not affected by HCQ, HCQ modestly lowered HbA1c & lipids - yet HCQ has been shown to reduced CV risk in observational studies… https://t.co/n283HwvRm4 https://t.co/lQN342uevy
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Psoriasis pts w/ Arthralgia referred for Rheum Eval - 1419 referred pts, 8.4% (119) met at risk for PsA criteria, and 29% (35) developed PsA w/in 1yr. Predictors included +FHx PsO, Ultrasound synovitis or enthesopathy findings, & low tender joint count. https://t.co/Fxgiu6D72j https://t.co/b8dMCOC18F
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How would you treat an anti-synthetase overlap pt w/ myositis, polysynovitis & rapid ILD (pt on steroids)?
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Surprise! Low-level proteinuria is more associated w/ proliferative LN and adverse long-term outcomes. Study of 249 SLE GN pts (median 33 yrs; proteinuria =2.2/D; 71% proliferative (PGN)
- 60% PGN w ≤1 g/d proteinuria (more renal recovery)
- 79% w/ 1-3g/d
- 71% w/ ≥3 g/d… https://t.co/t0aqWn3NDS https://t.co/zqJlJfHzqU
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Real-world study of 76 #PsA pts (Dz Duration Psoriasis 216 mos, PsA 120 mos. No correlatons seen between skin/PASI scores and PsA clinical variables, except the signif correlation betw PASI & enthesitis (ρ = 0.285; p = 0.013). https://t.co/K6FXjE5A4N https://t.co/NVlPiPVT0s
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Biomarkers in ILD: Small cohort study of 55 pts suggest potential biomakers: Cancer antigen 15-3, MMP-7, Surfactant protein D, MIP-1β, & chitinase 3-like protein-1 (YKL-40). https://t.co/S5bokc0SNi https://t.co/kLKjnyuK8p
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Nailfold videocapillaroscopy (NVC) study of 65 Behcets pts found vascular abnl in 40-47% ( enlarged/tortuous capillaries, microhaemorrhages. Having ≥2 NVC abnormalities increase risk of Vascular events (VTE, superficial thrombophlebitis), but not ANA https://t.co/2Om0IIFVnG https://t.co/W7mbdPh9ee
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Heritability of asymptomatic ANA positivity is 25%. Asymptomatic ANA positive individuals did not exhibit increased cumulative genetic risk for lupus compared to ANA negative individuals. Genetic study of 1,955 asymptomatic ANA+ v 3,634 asymptomatic ANAnegs.… https://t.co/P0MmFfG7NV https://t.co/KnlyNPKG4s
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Relapse of idiopathic inflammatory myopathies (IIMs) was seen 65/105 (62%) pts. Higher risk seen w/ ANA positivity (HR 1.13), w/ + histopathology on muscle Bx (HR 1.69), & immunosuppressants use before relapse (HR 0.50). https://t.co/tr0OdvOAPK https://t.co/H3t3u1mDtd
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Predictors of Adverse Pregnancy Outcomes in Lupus
A large metanalysis of systemic lupus erythematosus (SLE) patients and pregnancy outcomes suggests that adverse pregnancy outcomes are more likely in those with lupus nephritis, chronic hypertension, SLE disease activity before… https://t.co/31dqOyD3ZR https://t.co/L9LMn2CPYS
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Biomarker substudy of #SLE Rx w/ low dose IL-2 Rx in 342 pts (40% responders). SRI-4 predicted by rash, proteinuria, uRBC, %CD4 T cells, C3 (AUC 0.9330; however renal markers did not correlate with achieving LLDAS. https://t.co/pDgwegbU6t https://t.co/72w4gNAiWt
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Study of AutoAbs in 141 pts w/ systemic sclerosis overlap syndrome (SSc OS). Most common Abs: Ro-52, centromere (ACA) & anti-Scl-70. Scl-70 was assoc w/ ILD & SSc renal crisis (SRC); while ACA is protective factor of ILD. SRC & pulm HTN assoc w/ incr mortality… https://t.co/sqQhIlZjdB https://t.co/noyaFbd3Z8
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Cytokines/biomarkers from IL-23/IL-17 pathways are Increased in psoriasis. Subanalysis of phase 2 254 pt PsO trial revealed that 12 wks of deucravacitinib assoc w/ reduction in IL-17A, IL-17C, beta-defensin, PI3 - decreases correlated w/ PASI changes https://t.co/Ii381B2mZx https://t.co/vXDyLUsKPi
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