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acne

Best of 2022: Acne with JAK Inhibitors

d Jack Cush, MD

JAK inhibitors have become enormously popular and while their side effect profile has been delineated and reviewed, little mention is made of acne – an adverse event that may affect up to one-quarter of patients taking JAK inhibitors (JAKi). Dermatologists often refer to this side effect as "JAKne".

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New Hope for Hand Osteoarthritis

d EurekAlert!

The drug talarozole – which increases retinoic acid – could be a promising new treatment for hand osteoarthritis.

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Best of 2022: Undifferentiated Arthritis Does Not Follow an RA Course

d Jack Cush, MD

Undifferentiated arthritis (UA) is common in medical practice and many advocate early use of DMARDs; yet a recent study shows that despite DMARD use, UA patients do not fair well with this approach.

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ANCA, vasculitis, test

Best of 2022: ACR/EULAR 2022 Classification Criteria for Granulomatosis with Polyangiitis

d Jack Cush, MD

The ACR/EULAR 2022 revised classification criteria for granulomatosis with polyangiitis (GPA) have been updated with performance characteristics and are validated for use in clinical research.

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213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/rBNDHrb3sh #BestOf2022

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Lit review of MDA5 antibody-positive clinically amyopathic dermatomyositis w/ ILD - shows limited data from 15 studies, 388 pts, 1 RCT: ? best survival with high-dose steroids + immunosuppressive (CTX or CyA/tacrolimus). Refractory dz Rx w/PLEX, Tofa, RTX https://t.co/8yE4B3SfRg

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Allopurinol Use Does Not Increase Mortality in Gout w/ Chronic Kidney Disease A trial has shown that allopurinol use dose escalation and achieving target uric acid levels, was not associated w/ increased mortality in patients with gout and concurrent CKD. https… https://t.co/IIBo3aOLio
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Lumbar spinal stenosis affects 103 million worldwide (11% of older adults in US). 1st line Rx is activity modification, analgesia, PT. Benefits of epidural steroids havent been established. Decompressive surgery only for selected pts w/ pain & limitation https://t.co/zye3p5j2Hn https://t.co/HzVGLT8Qgl

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Hyperuricemia as a biomarker of severe #PsA? Study of 242 PsA pts 30% had hyperuricemia & 6% had gout. Hyperuricemia was significantly associated with age, comorbidity, perph polyarthritis, Jt destruction, less response to treatment. https://t.co/6uUWYPyFKf https://t.co/9nVj0lYwMO

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Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/DlJzREdj0h https://t.co/peqZzpQrWk

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JAKi not yet safe in pregnancy - theyre fetotoxic at high doses (animals). JAKi do cross placenta. ACR Guidelines: no position due to no data. 47 tofa Rheum & 15 UC maternal exposures - no signif probs. Paternal use of JAKi is ok. https://t.co/o4zqwwHwU9 https://t.co/NfFu3rb3gD https://t.co/72bJgfC6zx

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Spanish SpA Registry (REGISPONSER) - 18.3% had psoriasis; w/ 3/4 of these (76%) having PSO before MSK Sxs. Pts w/ PSO before MSK Sxs had shorter dz duration, lower BMI, Less B27 & anterior uveitis, more dactylitis and ^risk PsA dx (78% vs 56%) https://t.co/Kc1n4RVe3v

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Nailfold Capillaroscopy doesnt have to be expensive: use handheld Carson Microbrite (~$10) 10x or 20 x handheld microscope (w/ KY gel) to evaluate #Raynauds #scleroderma https://t.co/aJ6K6JeVCp https://t.co/0aUBnqxhic https://t.co/54s66sWvyv #RWCS2022 #BestOf2022

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Leflunomide versus azathioprine in lupus nephritis? Study of 215 bx proven LN given either LEF or AZA - Renal flares were equal (15.7% v 17.8%), as was time to flare (16 mo vs AZA 14 mo); 24-hr proteinuria, creatinine, C3 and C4 improved similarly. https://t.co/fbzhuFT3lh

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From the Hopkins Lupus cohort - Just one month of Prednisone 40 mg/d yields a FOUR fold increase in avascular necrosis risk #UTSWSLE2022 https://t.co/Kae2PMVgl7 https://t.co/XuhbkBwlCw

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MTX side effects more prominent in PsA than RA pts. Study of 240 PsA & 86108 RA pts starting either MTX or TNFi. TNFi AE same betw PsA & RA, but MTX adverse greater in PsA (44.8% vs. 29.4%), especially N/V, abdominal pain, depression, tinnitus https://t.co/qpGYDguYBK https://t.co/KUNQrSBNO2

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Cancer Risk with Scleroderma Spanish Scleroderma Registry examined a large cohort of systemic sclerosis (SSc) patients showing an increased cancer risk, especially breast, lung, hematologic and colorectal cancer. https://t.co/S3EHajMF9q #BestOf2022 https://t.co/kV772Jef4V

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#BestOf2022 Metanalysis of 7 studies shows that oral anticoagulants need not be discontinued for joint injections or aspiration. Only pts w/ hemorrhage after 5427 procedures, over 32-yrs. INR values of 3 bleeding cases was 1.9, 2.3, and 3.4. https://t.co/8e1zIhDTJt https://t.co/L4vIkWf2OL

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#BestOf2022 Co-administration of MTX with Folic Acid on the same day did not reduce efficacy compared to FA application one day after MTX. (based on AIA was induced in female Lewis rats) https://t.co/uh78ZdsqgP https://t.co/j32q68DU0X

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COVID-19 Vaccine Responses in Rheumatic Disease Patients Nature Reviews Rheumatology features a review of three notable papers that address the impact of SARS-CoV-2 vaccination on people with inflammatory rheumatic disease. https://t.co/R9UM3amPRR. https://t.co/WmHyVKdsxw

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