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Optimizing DMARD Therapy in Rheumatoid Arthritis

d Jack Cush, MD

A phase IV trial from Spain demonstrates that optimization of therapy by lessening biological DMARDs in rheumatoid arthritis (RA) may be feasible, with a low risk of flare.

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RA Hands Difficult deformity

Not all difficult-to-treat RA will have rapid radiographic progression

d Jack Cush, MD

A study of radiographic outcomes in difficult-to-treat rheumatoid arthritis (D2T RA) and poly-refractory RA (pr-RA) show a subset in whom damage is rapid and in need of more aggressive therapy.

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Sequencing DNA to find new lupus treatments

d EurekAlert!

Medical University of South Carolina geneticist Betty Tsao, Ph.D., will lead a five-year project to identify rare mutations associated with childhood-onset systemic lupus erythematosus (SLE), or lupus, with more than $3.5 million in funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Tsao holds the Richard M. Silver Endowed Chair for Inflammation Research in the Division of Rheumatology and Immunology at MUSC.

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Associations in Rheumatology (10.3.2025)

d Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and important associations in rheumatology from the past week on RheumNow.com.

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Activity Trackers Can Predict RA Flares

d MedPage Today

People with rheumatoid arthritis (RA) who experienced disease flares often showed changes in heart rate and physical activity captured by popular wearable devices 4 weeks before they became clinically apparent, a small study indicated.

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Systematic review of obesity management meds - 56 RCTs (60,307 pts). All OMMs were better at total weight loss than PBO (P < 0.0001), >10% semaglutide & tirzepatide (both effective at NIDDM CHF). Semaglutide effective reducing pain in knee osteoarthritis https://t.co/nbdZfBDukE
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ILD in Juvenile Dermatomyositis: Moving Toward Better Outcomes JDM is typically recognized for its striking skin rashes, vasculopathy, and muscle inflammation. Less visible, but equally significant, is lung involvement. ILD is increasingly acknowledged as a critical driver of https://t.co/vNGWAB88Mc
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FDA Approves Deuruxolitinib for use in adult patients with moderate to severe Alopecia Areata https://t.co/D6KXtDjfHL https://t.co/2WSIBWNexX

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Guselkumab FDA Approved for Pediatric Psoriasis and Psoriatic Arthritis FDA announced yesterday that guselkumab (Tremfya) is approved for use in pediatric patients moderate to severe plaque psoriasis (PsO) or active psoriatic arthritis (PsA) in children six years and older https://t.co/GHjCgqHaJC
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What is IPAF? Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD. https://t.co/ThU4pq27MU https://t.co/AOa5PALJst

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🆕 ILD (Part III): clinical practice focus 🔬 Diagnostic challenges 🧑⚕️ Case-based learning 📈 Evidence & outcomes 🌍 Global perspectives ⬇️ Download & learn more: https://t.co/WhpVzAfPDD Created by @MithuRheum | For our Rheum to Breathe: ILD Campaign https://t.co/4CL9mX9D6Y

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Post hoc analysis of Gout (CARES) trial (rx w/ ULT) showed remission @ 1yr increased from 37% to 63% at yr 6. In 6 yrs, 59% achieved remission 1+ times. Remission was signif assoc w/ age, race, Hi Dz severity, comorbidities, and febuxostat treatment https://t.co/uTOkch8VW6 https://t.co/Ykc7JV6m7r

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There is no consensus on flare definition in PSA. Review of 12 #PsA studies shows flare prevalence ranged 7% to 10%, w/ incidence was 22–23%. Over 12 mos, current patient-reported flare = 10%, physician-reported flare = 7% https://t.co/2LKlnaMSyv https://t.co/0TYXiZGsSc

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UK remission rates for early RA have been stablebut there are variations. DAS study of 13 752 RA, 35% in remission - but 28% (London) to 40% (East England). Delays in referral since COVID-19. Less remission w/ youth, female, Black, hi DAS28, delayed DMARDs. longer Sxs duration https://t.co/57QlnEqBci
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Retrospective study of 259 SSc pts underwent cardiac MRI looking for primary heart involvement (pHI) - detected in 37 14%). Predictors included troponin T (OR 14.1), CRP [OR 11.2), ILD [OR 6.3), and arrhythmias https://t.co/8KTINQ5loi https://t.co/60wQAPCUJv

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Small 38 pt. RCT found that 16-wks of Mediterranean diet signif improved psoriasis PASI scores. Intervention grp had better PASI change at week 16 (−3.4 vs 0), PASI 75, and reducted hemoglobin A1c. Diet as adjunctive Rx in PsO!! https://t.co/oJnaAA8LMm https://t.co/AXxI8FWQqU

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Impact cumulative MTX on liver fibrosis? 1314 #PsA pts (age 44), 28% on MTX. Total of 44 (3%) had baseline liver fibrosis & 12% developed it over med/ 5.6 yrs. Cumulative MTX Did NOT assoc w/ liver fibrosis (OR 0.99), but high BMI & DM did (Metabolic factors) https://t.co/OSVZHskjB4
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Challenges diagnosing lung disease and ILD in pediatric patients Children with juvenile idiopathic inflammatory myositis (JIIM) are at risk of developing lung disease, notably interstitial lung disease (ILD). https://t.co/SClva7aqKH https://t.co/hVX5zdju5V

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2019 National Health Survey of 87,678, 21% had chronic back pain (cLBP). cLBP had more Multimorbidity 62.1%, worse activity limitation. depression, and cardiovascular disease https://t.co/LFdWr0s6tg https://t.co/R5cZSWySUK

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RheumNow is LIVE from #ACR25 Oct 24–29. KOL perspective videos, clinical-trial highlights, daily recaps & live streaming—all in one feed. https://t.co/fD2K4zW9Z7
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