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Bad Actor Cofactor (10.17.2025)
Dr. Jack Cush reviews the news and journal reports, discusses pediatric reports, pregnancy data, diet and nutrition and more.
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SAIL-RA: Finding ILD in Early RA
Cohort study of early rheumatoid arthritis (RA) patients finds that interstitial lung disease (ILD) begins early in the course of RA, with certain factors enhancing this risk.
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Eating Crow (10.10.2025)
Dr. Jack Cush reviews the news, FDA approvals, and journal articles. In this episode: HMGCR Abs, FDA approvals and Cush eats crow.
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We need more biomarkers in GCA - what about fibrinogen?
Miller et al retrospectively compared CRP, ESR, and fibrinogen at different points in GCA dx
Fibrinogen (and ESR/CRP) only helpful prior to initiation GC with comparable performance
@RheumNow #ACR25 Abst #0750 https://t.co/q5gFxDMnTy
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Can tissue give us an underlying diagnosis in aortitis?
Dr. Kermani breaks down the autoimmune differential based on histopathology
@RheumNow #ACR25 https://t.co/twcH021dxS
Brian Jaros, MD Dr_Brian_MD ( 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
Links:
Janet Pope Janetbirdope ( View Tweet)
Phenotypes of GCA:
Pt dx by PET compared to TA biopsy were:
- younger
-longer disease before dx
-more frequent extremity claudication (still overall low)
-less cranial / TA sx
@RheumNow #ACR25 Abstract 0759 https://t.co/ilwa3eYmRq
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Miller et al. Fibrinogen for GCA diagnosis and flare identification. Similar to ESR/CRP in diagnosis. For flares, lower sensitivity (79%) but better specificity (96%) @RheumNow #ACR25 Abstr#750 https://t.co/SIkAkEeYh1
Richard Conway RichardPAConway ( View Tweet)
Observational study of fibrinogen for diagnosis of GCA
At a cutoff of 4.7, roughly similar diagnostic performance as compared to ESR/CRP
Kind of neat, but does not appear to have additive benefit
#ACR25 @RheumNow Abstr#0750 https://t.co/xy2qn4jHXP
Mike Putman EBRheum ( View Tweet)
ILD found in 30% of Sjögren’s pts w/ HRCT.
A new nomogram-based tool (AUC 0.8) predicts ILD risk using age, ESR, C3, hypergammaglobulinemia & anti-La/SSB.
Goal: guide HRCT referrals & catch ILD earlier.
@RheumNow #ACR25 Abstract #0510 https://t.co/FvAprq8eol
Jiha Lee JihaRheum ( View Tweet)
SLE & arthritis: Is there a difference?
Abstract #0629:
- Non-deforming (ND): 73% | Jaccoud’s: 19% | Rhupus: 8%
- Vs ND, Rhupus had lower odds of type I IFN signature
- Time to deformities: Jaccoud's ~2 yrs vs Rhupus ~5 yrs
- RNP+ predictive of Jaccoud’s
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Not just for salivary glands—lacrimal ultrasound helps too.
In early Sjögren’s, lacrimal + salivary US clearly distinguished SjD from sicca (AUC up to 0.97).
Noninvasive, reproducible, and highly diagnostic.
@RheumNow #ACR25 Abstract #0507
Jiha Lee JihaRheum ( View Tweet)
AI-enhanced MRI integrating STIR and T1-weighted MRI with BME data reflecting both inflammatory and structural changes, enabling the AI model to predict clinical diagnoses of axSpA with accuracy of 82%. Successfully identified axSpA patients who did not meet the ASAS criteria for https://t.co/dLlGj0ZFpj
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
High-resolution ultrasound detected subclinical enthesitis in 44% of psoriasis patients without arthritis and 12% had PD positivity. Supports a preclinical PsA phase and use of MSUS to detect entheseal inflammation in both symptomatic and asymptomatic PsO patients for timely
Antoni Chan MD (Prof) synovialjoints ( View Tweet)
12 yr study of 115 Systemic Sclerosis pts shows Finger-to-palm distance (tip 4th finger to distal palmar crease) may be a useful tool for predicting the progression of skin thickening and the development of digital ulcers in the early stages of severe SSc https://t.co/brCEz5Fqac https://t.co/kZMQ0UsimB
Dr. John Cush RheumNow ( View Tweet)
Casal Moura, M., Merkel, P.A., Jayne, D. et al.Challenges in the diagnosis, classification and prognosis of ANCA-associated vasculitis. Nat Rev Rheumatol (2025). https://t.co/fGUr2DnfwA
Good figure, citation above. Via
@AKronbichler and colleagues https://t.co/FGfPFiGgMv
Links:
Suleman Bhana, MD DrBhana ( View Tweet)
Whole Body MRI for Arthritis
Whole-body MRI (wbMRI) reviews have increasingly appeared in the medical literature, owing to better scanners, faster imaging times and reduced costs. Use of such non-oncologic musculoskeletal imaging provides high-contrast resolution images of the https://t.co/RQBPDhf1Vb
Dr. John Cush RheumNow ( View Tweet)
Skin Biopsies to Predict Scleroderma Outcomes?
Researchers from the Hospital for Special Surgery and Weill Cornell Medicine have shown that skin biopsies in patients with systemic sclerosis (SSc) can define a fibroblast immunophenotype that may have prognostic and early https://t.co/z3LykOgyHO
Dr. John Cush RheumNow ( View Tweet)
~1/3 non-IPF ILD progresses over time. KL-6, a new biomarker, retro study of 10 European centers, 303 pts - 37% progressed (⩾10% FVC decline) after 1yr. 5 predictors of progression: age, gender, BMI, FVC, KL-6. (superior to KL-6 alone) w/ 55% sensitivity, 73% specificity 67% https://t.co/i0Uc8DPHaM
Dr. John Cush RheumNow ( View Tweet)
Whole Body MRI for Arthritis
Whole-body MRI (wbMRI) reviews have increasingly appeared in the medical literature, owing to better scanners, faster imaging times and reduced costs. Use of such non-oncologic musculoskeletal imaging provides high-contrast resolution images of the https://t.co/6RIrDOwQx2
Dr. John Cush RheumNow ( View Tweet)
