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MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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FMF #Recommendations
#Colchicine can be fatal
🔺️Beware of drug interactions
🔺️Mostly statins in adults
🔺️Macrolides in children
#EULAR2025
@RheumNow https://t.co/SYGLpAJXFu
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush RheumNow ( View Tweet)
"H Syndrome" review of 23 French pts. Autoinflammatory dz due to variants of SLC29A3 gene. Multisystem histiocytic lymphoproliferative disorder of young adults- skin 2/3, sensorineural hearing loss, fever w/ endo & autoimmune dz. Best responses w IL6 inhib. #EULAR2025 Abst https://t.co/F7NGI4TkJS
Dr. John Cush RheumNow ( View Tweet)
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic.
Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS
Several monogentic mutations in primary HLH- these panels can be available..
#EULAR2025 @RheumNow
Bella Mehta bella_mehta ( View Tweet)
Age of onset is really important when thinking about #MAS
Primary HLH more frequent in pediatric population. But can continue to adulthood.
#EULAR2025 @RheumNow https://t.co/J7xmTiQiwr
Bella Mehta bella_mehta ( View Tweet)
MAS can be triggered by infections in VEXAS syndrome. The threshold is reached leading to a hyperinflammatory state
Georgin-Lavialle S @rheumnow #EULAR2025 https://t.co/NKLL75rOgP
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Management of HLH/MAS and modes of action of advanced therapies
Jessica Manson @RheumNow #EULAR2025 https://t.co/Op3u53ZXeK
Links:
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
Stabilize the pts with HLH with steroids when still trying to figure out the diagnosis of #HLH/ #MAS
Many drugs can be used...but important to balance infection risk with immunosuppression
These are critical pts. Be vigilant..
#EULAR2025 @RheumNow https://t.co/id4ae3SWtj
Links:
Bella Mehta bella_mehta ( View Tweet)
Closing the care divide in #JIA treatment plenary session
Overall theme in #EULAR2025 is everyone talking about AI and digital health on day 1
Biologics have changed the game!
@RheumNow https://t.co/qDqbz8JApe
Bella Mehta bella_mehta ( View Tweet)
Treatment of MAS, or the bête noire in Still's disease, presented at the Plenary session by Peter Nigrovic
#Plenary room
#EULAR2025
@RheumNow https://t.co/S4SG2VflNg
Nelly ZIADE 🍀 Nellziade ( View Tweet)
Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/wYTNv50tqM
Dr. John Cush RheumNow ( View Tweet)
Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/IIJbJ7x2WB
Dr. John Cush RheumNow ( View Tweet)
A retrospective VEXAS cohort study of 59 pts receiving 71 targeted Rx - 98%male, mean 71 yrs & 46% had myelodysplastic syndr. Treatments included tocilizumab(19), anakinra (13), azacitidine(13), baricitinib (11), & pred only (10). Best responses w/ azacitidine & tocilizumab https://t.co/jqDmKinPDt
Dr. John Cush RheumNow ( View Tweet)
A retrospective VEXAS cohort study of 59 pts receiving 71 targeted Rx - 98%male, mean 71 yrs & 46% had myelodysplastic syndr. Treatments included tocilizumab(19), anakinra (13), azacitidine(13), baricitinib (11), & pred only (10). Best responses w/ azacitidine & tocilizumab https://t.co/fBdfrrZt1M
Dr. John Cush RheumNow ( View Tweet)
Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/YbYPaJUEbz
Dr. John Cush RheumNow ( View Tweet)
Emerging therapies targeting the NLRP3-inflammasome (active in Autoinflammatory Dz, Gout, neurodegenerative Dz/Alzheimers). Currently no FDA approved drugs, but many in trials. eg, Oxidized DNA (DAMP) activates NLRP3 & may be blocked by repurposed glycosylase inhibitors to reduce https://t.co/CJv50LVKhy
Dr. John Cush RheumNow ( View Tweet)
A brief history of familial Mediterranean fever - FMF is most common periodic fever syndr. an inherited polyserositis mainly affects Arabs, Armenians, Jews, & Turks. Hx may date back to 1802 & Heberden. Osler described 11 cases in 1895. 1st clear report 1945 by Siegal 10 pts. https://t.co/m20uO3bOoj
Dr. John Cush RheumNow ( View Tweet)
A brief history of familial Mediterranean fever - FMF is most common periodic fever syndr. an inherited polyserositis mainly affects Arabs, Armenians, Jews, & Turks. Hx may date back to 1802 & Heberden. Osler described 11 cases in 1895. 1st clear report 1945 by Siegal 10 pts. https://t.co/61WOxt9fPy
Dr. John Cush RheumNow ( View Tweet)
