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Dr. Cush reviews the news and journal articles from this past week on RheumNow.com; talking about lumbar belts, scholarships and misdiagnosis.
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Dr. Jack Cush reviews the news and recent journal reports on RheumNow.com.
Dr. John Cush
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e-cigarette use assoc w/ a 1.5-fold incr risk of RA & SLE. All of Us Research prg matched 15,909 e-cig users vs nonusers. 66 new RA or SLE among current e-cig (IR 1.43/1,000PYs) vs nonusers (0.93/1,000PYs; IRR 1.54); applies to past or current smokers https://t.co/xYRezwQFYC https://t.co/pnNANfui4Y
Dr. John Cush
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VA study of 4108 RA-ILD (2006-21). PRED use was 65-77%, A& 1st line Rx (MMF, AZA, RTX, CTX) incr after ILD, use was low (1.2-12%). MTX decr (47 to 30%), but LEF, TNFi, ABA incr. Predictors of ILD Rx: FVC, CCP+, ILD Dx after 2012. https://t.co/GT3Vwo11w1 https://t.co/KFDKsjkN0k
Dr. John Cush
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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc
Dr. John Cush
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Childhood vs Adult onset SLE? Retro Australian Lupus Registry study of 519 SLE pts (68/13% w/ cSLE) found childhood onset had signif more damage (SDI≥1 53 vs 40%; renal Dz 62 vs 37%), more Dz activity, less LLDAS-50 (36% vs 51%) https://t.co/ttBRtSVl5n https://t.co/hoN1t16Za3
Dr. John Cush
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Systematic review of targeted Rx for lupus nephritis during pregnancy (2000-25). HCQ & AZA are cornerstone good Rx. Acceptable: tacrolimus, ASA. MMF is TERATOGENIC-AVOID! Not Enuf data; Voclosporin, obinutuzumab, Anifrolumab https://t.co/otO9nMHHuO https://t.co/1hLysZLJnG
Dr. John Cush
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Rheum Survey >> What therapy do you most commonly use to treat Sjogrens disease? Answer here: https://t.co/XJEsqoSlbn
Dr. John Cush
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Multiple chronic conditions (MCCs; AKA multimorbidity) is highly prevalent in AIRDs; complicates Rx & increases adverse outcomes & all-cause mortality. MMCs 86% in RA, 81.5% in SLE, w/ a notable patterns of cardiopulmonary and mental health disorders https://t.co/AOWCsEodXR https://t.co/NyAR0TUQkE
Dr. John Cush
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SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG
Dr. John Cush
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Rheum Survey >> What therapy do you most commonly use to treat Sjogrens disease? Answer here: https://t.co/XJEsqoSlbn
Dr. John Cush
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3 SLE pts w/ Bx class III/IV LN had Lg proteinuria flares (4.6–13.4 g/d) despite MMF plus belimumab & were given voclosporin (+MMF) w/ rapid, sustained proteinuria reduced (≤0.7 g/day w/in 9–12 mos) & stable/improved eGFR, & GC tapering. Creat increases Rx w/ dose adjustments https://t.co/38lcD8DPgn
Dr. John Cush
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Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/s1VFhaOYgn
Dr. John Cush
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NHANES survey (2005-2018) studied prevalence of arthritis in adults w/ depression (PHQ-9 ≥10), From 15157 depressed pts, RA was most prevalent & increased 7.8 to 17.7%; OA unchanged 11.7 to 10.7% & PsA declined 7.2 to 1.7%. Depression assoc w/ higher risk for RA (OR 1.40) & PsA https://t.co/fcROEvsHDT
Dr. John Cush
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Biomarker substudy from SENSCIS trial of nintedanib in SSc-ILD shows higher baseline KL-6 levels >1000 U/mL was assoc w/ greater FVC worsening; & decrease in CA-125 was assoc. w/ nintedanib responses. Epithelial cells are primary source of CA-125 in the lung https://t.co/7VJ2UDOKin
Dr. John Cush
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CDC warns of an association betw severe CNS arboviral disease, w/ neurologic sequelae in pts receiving anti-CD20 mAbs (rituximab, ocrelizumab, ofatumumab, obinutuzumab, etc). West Nile virus was the most common arbovirus, but there are others; mortality up to 40%. Most arbovirus https://t.co/WWg41fsRgr
Dr. John Cush
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Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/MHz8mdqDqi
Dr. John Cush
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Arrhythmias in Autoimmune Rheumatic Disease
A new review in the Journal of Cardiovascular Development and Disease (Tamirisa et al) synthesizes how SLE, RA, and SSc have an increased risk of arrhythmias and SCD attributable to shared immune pathways. These facts substantiate the https://t.co/j9AW26LE66
Dr. John Cush
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In a Cohort of 410 #SLE pts, there were 37 MALES who demonstrated a high prevalence of renal (IV/V lupus nephritis 49%) and a notable incidence of Plaquenil-related retinal toxicity. 62% on HCQ, but 22% D/C HCQ due to retinal toxicity or drug intolerance. https://t.co/VISwHO1wcK https://t.co/6SoD6mD5tf
Dr. John Cush
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True or False: Neuropsychiatric SLE (NPSLE) was associated with a higher odds ratio for cerebral atrophy compared to age.
See if you got it right in this week's RheumIQ quiz at https://t.co/yQn8cIT5Cw. https://t.co/YjHwLFclv4
