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MGUS,SPEP,Gamma

Review: Monoclonal Gammopathy of Undetermined Significance

Jack Cush, MD

NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those over age of 50 years.

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Multimorbidity predicts flares in rheumatoid arthritis

Jack Cush, MD

A study from Olmstead county and the Mayo Clinic shows that multimorbidity  and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.

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September to Remember (9.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.

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#ClinicalPearl Pts w #SpA ex #PsA May have 👇 #sicca #dry #eyes #dry mouth Inflamed gallbladder without calculi 👇 Can be associated w #autoimmune disease #POTS can be initial presentation of #SjD IgA vasculitis—May have #cancer #Secrets & #Pearls #ACR25 @RheumNow @ACRheum https://t.co/4SAqVYjnrD

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Janet Pope Janetbirdope ( View Tweet)
#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25

Mrinalini Dey DrMiniDey ( View Tweet)

Abstract 1718: Immune checkpoint inhibitors (ICI) in pre-existing #SLE Compared to non-SLE pts, those with SLE receiving ICIs had: 🔹 ↑ risk of thrombocytopenia & pancytopenia 🔹 No significant difference in all-cause mortality @RheumNow #ACR25 https://t.co/N1iOvxbsAZ

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Akhil Sood MD, MS AkhilSoodMD ( View Tweet)

#ACR25 Abstr#1532 “The more the merrier” or “Too many cooks..” Preliminary data of CTA313, dual CD19-BCMA CAR-T in 15 #SLE pts showed deep depletion & good response. Global study is planned. Will have to keep on eye on safety (G3 herpes zoster, pneumonia & neutropenia) @RheumNow https://t.co/0KQa9K6bYB

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)

#ACR25 Abstr#1537 Beyond T-cell malignancy, we should be vigilant re: Local immune effector cell-associated toxicity syndrome (LICATS) with CAR-T. - Mostly afect skin & kidneys - Med time of onset 10 days; duration 11 days -Most LICATS were mild & without sequelae @RheumNow https://t.co/EnAWL936oh

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Survival outcomes in patients with axial SpA and concomitant cancer are the same as those without. #abst1429 #ACR25 @RheumNow https://t.co/wicN3s9JrR

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Bella Mehta bella_mehta ( View Tweet)
Need better lymphoma biomarkers in Sjögren’s? APRIL joins BAFF as a promising candidate—high APRIL levels linked to ↑ B-cell activation, disease activity & future lymphoma. Easily measurable, potentially targetable. @RheumNow #ACR25 Abstract #1683

Jiha Lee JihaRheum ( View Tweet)

In Sjögren’s, cancer risk is real. >9yr multicenter cohort (n=314), overall cancer risk ↑ (SIR 1.68), NHL >15× expected Predictors: older age, smoking, LAD, splenomegaly, cryoglobulinemia (strongest for lymphoma). Malignancies = 24% of deaths @RheumNow #ACR25 Abstract #1681

Jiha Lee JihaRheum ( View Tweet)

#ACR25 Abstr#663 “Off-the-Shelf” iPSC-derived CAR-T is coming soon! Promising data on 8 #SLE patients in Phase 1. Advantages over autologous/allogenic: -No apheresis -No conditioning chemo -Shorter hospital stays ~3 days -Ability to redose in partial responder @RheumNow https://t.co/pbem7A5Iq5

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
A retrospective study from Spain assessed the relationship bet HPV infxn & biologic tx in SLE pts đź”… Prevalence of HPV 9.9% đź”… No significant assocs bet HPV infxn, biologic tx, SLE-related dse variables & HPV RF progression Still, emphasize HPV screening #ACR25 @RheumNow Abs0659 https://t.co/1YusM1nYPr

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sheila RHEUMarampa ( View Tweet)
#Cancers esp #hematologic & #lung are ⬆️in Pts w #inflammatory #rheum #diseases Odds ratios of hem malignancies are wide & risk stratification is imp Are we doing a good job? 🤔skin cancer screening ??- not as per general standards Abst#0172 #ACR25 @RheumNow @ACRheum https://t.co/Uve9knXD3o

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Janet Pope Janetbirdope ( View Tweet)
Review: Monoclonal Gammopathy of Undetermined Significance NEJM has reviewed the common hematologic/immunologic finding of "monoclonal gammopathy of undetermined significance" (MGUS) - a common premalignant plasma-cell proliferative disorder found in approximately 5% of those https://t.co/kleuYayTZW
Dr. John Cush RheumNow ( View Tweet)
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/ZEexaqoeLK https://t.co/p3Yfv2IkE2

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Dr. John Cush RheumNow ( View Tweet)
Interstitial lung abnormalities (ILA) are found in 7% of Gen. population, most of whom are asymptomatic, but some will progress to ILD, IPF,and increased risk of lung cancer, etc. Finding incidental ILD appropriate screening monitoring, based on risk factors is indicated. https://t.co/kQbhxTAVTm
Dr. John Cush RheumNow ( View Tweet)
CAR-T Product Shows Early Promise in Lupus Five patients with systemic lupus erythematosus (SLE) in China have been treated with a potentially groundbreaking form of chimeric antigen receptor (CAR) T-cell therapy, researchers reported, with encouraging results after 3 months. https://t.co/eg37PZK6kn
Dr. John Cush RheumNow ( View Tweet)
What are the Pros and Cons of autologous CAR T cell therapy? Summary slide from Georg Schett who also mentioned the exciting in vivo CAR approach using nanoparticules in myeloma, something to stay tuned for @RheumNow #APLAR25 https://t.co/kWjrx6N9Dv

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Aurelie Najm AurelieRheumo ( View Tweet)
Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/DPgDQsCWK9

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Dr. John Cush RheumNow ( View Tweet)
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