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Teaching You How to Think… (8.15.2025)
Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and aphorisms to live by.
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Glossary for Giant Cell Arteritis
Dejaco and colleagues have published a glossary of terms often used in conjunction with giant cell arteritis. The glossary of definitions for 23 signs and symptoms of GCA was developed through a consensus process involving international experts.
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The Patient Journey with Rheumatic Disease
Oton and colleagues have reviewed the "patient journey" - from symptoms to specialty referral in those diagnosed with rheumatic and musculoskeletal diseases (RMDs).
Biologic Switching in Psoriasis
A systematic review and meta-analysis found that biologic switching was effective in a significant number of psoriasis patients; but there may be a price to pay.
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Wisdom of Medical Aphorisms
The American Journal of Medicine and Dr. Joseph S. Alpert have published a long list of smart, insightful and inspirational aphorisms from some of the greatest leaders in internal medicine. These aphorisms are timeless and should be passed from one generation of physicians to the next.
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Systematic review of 47 studies covering 1.5 million cases found that Dx of Crohns, SLE, Type I DM positively associated w/ incr risk of pancreatic, esophageal, colon, liver, and hepatobiliary cancers. MS assoc w/ lower risk of pancreatic, esophageal, rectal, & colorectal CA https://t.co/g0N5eHhJYj
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Rheums Speak: Changing Rheumatology Practices & Choices
RheumNow surveyed clinicians worldwide on how their rheumatology practice, treatment decisions, and career outlooks have changed over the past 20 years. 242 respondents (68% from the USA) shared their perspectives on the https://t.co/g714oow71a
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2025 ACR Guidance on Diagnosis and Management of VEXAS
The ACR has published a formal international consensus guidance on VEXAS as a resource for clinicians seeking to understand the disease and its management.
https://t.co/KoNjOiKdTq https://t.co/9bIZgvP8kD
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IBS in America
Despite advances, IBS remains a burden for many millions. A new AGA-sponsored survey conducted by The Harris Poll, a Stagwell (STGW) agency, reveals that IBS symptoms disrupt patients’ productivity and personal activities 19 days each month, impacting both https://t.co/lCV0ZKdq18
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Study of 94 children w/ Enthesitis-related arthritis (ERA) - 45 Tunisian, 49 Turkish. While similar demographics, Turkish ERA had signif. more heel pain (61% vs 9%), enthesitis (69% v 40%), &biologics (50 vs 9%); but Tunisian ERA had more sacroiliitis (91% v 55%), Axial Dz (98% v https://t.co/AKNEYoO0C6
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Systematic review of Rx options for #PMR (24 pubs, 10 RCTs, & 13 prognostic studies) concludes IL6-R inhibitors effective GC sparing agents; RTX & Tofa are promising. Quality trials needed to refine Rx & establish prognostic markers for decision-making. Fast-track clinics https://t.co/c3rI6u1aI6
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Prospective study 1,237 pregnant women (APS excluded) - finding LA-RVVT, anti-β2GPI IgG, predicted preeclampsia & intrauterine fetal death (IUFDR) and were were in identifying obstetric antiphospholipid syndrome (APS) https://t.co/5zKpR9NTcw https://t.co/6HXID7gtwR
Links:
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945 consecutive severe psoriasis pts Rx TNFi or nbUVB phototherapy (2005-2010) w/ median F/U > 9 yrs. After propensity matching, incidence of future PsA was 1.18/100 w/ TNFi vs 2.48/100 w/ nbUVB (IRR 2.1; 1.37–2.98, P = 0.0002). TNFi lowered PsA risk (HR = 0.32). PsA predictors https://t.co/aBsXs6RpCY
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Nailfold videocapillaroscopy (NVC) in Dx of systemic sclerosis - study of 258 NVCs found giant capillaries (specificity 98%) & capillary density to be best at defining a scleroderma pattern (39%). Density ≤8 capillaries/mm best defined dropout (AUC 0.911); having both = 91% https://t.co/WQx6fbQiAB
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The world of rheumatoid arthritis treatment has changed dramatically. What do the experts say about the evolution of biologics and DMARDs over the last 20 years?
Join us for a live webinar, moderated by Dr. Jack Cush, where we'll unpack the results of a nationwide survey.
Tues, https://t.co/o2WqAaQ2mN
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PT in RA - Metanalysis of 17 RCTs, 1362 pts Rx w/ aerobic/resistance exercise, hydrotherapy, manual Rx, electrotherapy, multimodal Rx. 5 RCTs (n 307) signif reduced pain (SMD −0.347; interpreted as a small to medium effect favoring PT. https://t.co/UJGSGrgMV0 https://t.co/n4DzMSm9iJ
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Retrospective UK study of CPRD dataset (2012-2023) found 22 829 incident CTD Dx (81% F). Over time incidence SLE & Systemic Sclerosis fell, Sjogrens & MCTD stable, & IIM rose 3.23–4.31/100K. IIM had highest mortality (28/1000 py), followed by SSc, SLE, MCTD; lowest SjD (9.7)
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Venous thromboembolism (VTE) risk goes up w/ age, obesity, estrogens; BUT a UK primary care database shows VTE risk signif higher in RA (n 23K) vs matched controls (n 94K): adj HR 1.46. Absolute VTE risk higher w/ age & BMI, but VTE higher in younger v older; normal vs. Hi BMI: https://t.co/htI2YqiF0c
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Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh
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French OL trial of PCV13 vaccination in 248 early, DMARD Naive RA pts starting MTX @ same time or after 1 month delay. 1 mo delay in MTX resulted in significantly higher responses (46%, 65%) vs. pts vax while taking MTX. Signif responses seen 1 yr later. RA activity equal betw. https://t.co/AnqK89ZJtE
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