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MTX Fails Knee OA (6.6.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Autoimmunity Rising in Expectant Mothers

Jack Cush, MD

Lancet Rheumatology has published a UK study showing a significant increased in the number of expectant mothers beginning their pregnancies with autoimmune conditions.

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teen under covers looking anxious

How Living With Childhood-Onset Lupus Impacts Mental Health

Kaveh Ardalan, MD

Children, teens, and young adults living with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent serious organ damage. By the mid-2010’s, multiple studies were published that showed high rates of depression, anxiety, and suicidal thoughts among children and youth with cSLE. Importantly, young adults who were diagnosed with lupus in childhood were more likely than young adults with adult-onset lupus to experience major depression episodes, with a higher risk of recurrent episodes of depression well into adulthood.

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Why Childhood SLE is More Severe than Adult SLE

About 10 to 20% of all lupus patients are children, and the criteria to make the diagnosis of lupus are the same in pediatrics and adults. Why is pediatric lupus often more severe than adult-onset disease?

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Pope

Lessons Learned from a Lupus Registry: Two sides of one coin?

Janet Pope, MD, MPH, FRCPC

I want to talk about a large Canadian registry that sometimes doesn't get as much airtime. Our group is called CaNIOS: Canadian Network for Improved Outcomes in SLE. We've enrolled more than a thousand patients, seen at least annually and some for many years. These patients are incident or prevalent and they've consented to be in the database. So what have we learned looking at kid-onset versus adult-onset lupus?

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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

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Bella Mehta bella_mehta ( View Tweet)
🚨 Type I IFN in Pediatric SLE: Expanded Insights! •🩺 IFN-I Impact: Fuels pediatric SLE; drives T-cell autoreactivity, autoantibody production, proinflammatory cytokines. •📈 Key Pathways: Plasmacytoid dendritic cells overproduce IFN-I via cGAS-STING-TBK1, TLR4/TLR9; https://t.co/4i3MktOoVd

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Dr.Mukesh , MD , DM dr_immuno29 ( 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

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Bella Mehta bella_mehta ( View Tweet)
Young Patients’ AREA empowers teens/young adults w/ autoimmune disease to shape research. US-based, youth-led & grounded in empowerment, they co-design studies, train peers & advise researchers. A truly positive and meaningful initiative esp for PPIE @RheumNow #EULAR2025 #OP0008

Mrinalini Dey DrMiniDey ( View Tweet)

Muscle biopsies form 3 treatment-naïve juvenile dermatomyositis (JDM) finds transcriptomic evidence of mitochondrial dysfunction consistently in JDM muscle, independent of interferon-driven inflammation. Treating mitochondrial dysfunction may improve JDM outcomes https://t.co/u5tMhT23si
Dr. John Cush RheumNow ( 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

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Nelly ZIADE 🍀 Nellziade ( View Tweet)
Single-centre retrospec study of 39 Juvenile Dermatomyositis pts Rx w/ JAKi. Partial/complete Clin inactive Dz achieved in 32/39 w/in 6 months w/ steroid reduction and W/D of other DMARDs. Only TIF1γ) Ab (+) was assoc w/ nonresponse to JAKi (P < 0.001). 5 w/ H. Zoster

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)
Single-centre retrospec study of 39 Juvenile Dermatomyositis pts Rx w/ JAKi. Partial/complete Clin inactive Dz achieved in 32/39 w/in 6 months w/ steroid reduction and W/D of other DMARDs. Only TIF1γ) Ab (+) was assoc w/ nonresponse to JAKi (P < 0.001). 5 w/ H. Zoster

Dr. John Cush RheumNow ( View Tweet)

How Living With Childhood-Onset Lupus Impacts Mental Health Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush RheumNow ( View Tweet)
🍋 or ‘Lyme’ - is it Lyme disease? Dr Elizabeth Stringer discusses Eastern Canada 🇨🇦 Epidemic of #Lyme #arthritis Which mimics #pauciarticular #JIA When it is #chronic Work up of all oligoarthritis in endemic areas in kids Includes Validated Lyme test @ORAexec #ORA25 https://t.co/WxU1vaOa7z

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Janet Pope Janetbirdope ( View Tweet)
Do you routinely recommend SLE +Ro/La pregnant Pts to have routine screening for #congenital #heart #block #LUPUS2025 @RheumNow

Janet Pope Janetbirdope ( 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)
Retrospective study of 131 childhoold SLE pts found lymphopenia (in 53%) significantly correlated w/ higher anti-dsDNA and increased disease activity. (r = −0.63). Lymphopenia assoc w/ more nephritis (72%), HTN (24%), leukopenia (36%) & neuropsychiatric SLE https://t.co/ONUm84jThE
Dr. John Cush RheumNow ( View Tweet)
Single-centre retrospective study, 27 children with refractory juvenile dermatomyositis (jDM) Rx with baricitinib (F/U of 25 mos)-- 77% (21/27) improved skin rashes (62% complete resolution) & Dz activity improved (6 vs 0.8, p<0.01) 70% (19/27) achieved inactive disease https://t.co/rRlhoY9O4q
Dr. John Cush RheumNow ( View Tweet)
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