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Drug Naming Games (2.7.2025)
Dr. Jack Cush reviews the news, regulatory and journal reports from the past week on RheumNow.com.
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Granzyme - a major driver of inflammatory & autoimmune diseases
EurekAlert!
Our immune system is armed with an array of defenses designed to detect and eliminate harmful threats. One of its most powerful defense mechanisms is the complement system—a group of proteins that patrols our body, ever vigilant for signs of infection or injury.
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Is Rheumatoid Arthritis Becoming Milder?
A 24 year, prospective study analyzing very early rheumatoid arthritis (RA) in three consecutive eras suggests that RA has evolved since 2005, demonstrating less seropositivity, inflammation, and erosions but is characterized by more comorbidity, smoking and corticosteroid use.
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#HOT #topic
Will #Rx of #PsO PREVENT onset of #PsA
Well, maybe 🤔
Alexis R Ogdie @RheumNow #RNL2025
70% of #psoriatic #arthritis is preceded by #psoriasis
Still a bit of a debate re prevention of PsA https://t.co/7bce8kcjdr
Janet Pope Janetbirdope ( View Tweet)
Great graph from @AlexisOgdie on the effect of biologic treatment on PsA development in psoriasis. Obvious front-loading in those who need systemic therapy. But over time those who don't appear to develop more PsA @RheumNow @RNL2025 https://t.co/UxUZyKb0NA
Richard Conway RichardPAConway ( View Tweet)
Michele Petri @RheumNow #RNL2025
1 mg of prednisone -> 3% increased risk of damage
Taper quickly, withdrawal slowly
Make sure background therapy is on - monitor therapy with HCQ levels, early use of additional Rx https://t.co/pjFNcg99ed
Eric Dein ericdeinmd ( View Tweet)
🏈Kick-off of @RheumNow w Jeff Curtis #RNL2025 🏈
AI in RA?
Can help with Rheum Boards Questions, though AI is not confident in answers
May not be better than paper charts for triage
Other roles: pt chatbot, AI scribe, research populations, generate DDx, consume guidelines https://t.co/X43DCmt0Ov
Links:
Eric Dein ericdeinmd ( View Tweet)
Some pearls from RA POD at #RNL2025
-What do rheumatologists want from AI: Right drug for right patient, improving documenting in less time and possibly include multimorbidity management?
-Utilize AI as enhancer not replacement of the physician. AI must be trained well in a… https://t.co/9YNmeVx4t6
Adela Castro AdelaCastro222 ( View Tweet)
OK this is ‘HOT’
App on phone for a
👇
#thermal #camera
Of hands 🙌
If #hot➡️ flare of #inflammatory #arthritis
And call for a #follow up apt
If not — then not a flare
#AI #artificial #intelligence
#rheumatoid #arthritis
@RheumNow #RNL25
Jeff Curtis AI in #rheum
Janet Pope Janetbirdope ( View Tweet)
How can AI be useful for RA pts and rheumatologists?
-AI models have the potential for improving diagnosis, management and outcomes in RA pts.
-Can also improve efficiency and clinic workflow.
-Not so perfect as it sounds (hallucinations, limited accuracy)
#RNL2025 @RheumNow https://t.co/44LUHQ1KPf
Adela Castro AdelaCastro222 ( View Tweet)
AI models require good Positive Predictive Value (PPV)
But: PPV decreases as prevalence decreases
- In choosing a successful biologic:
Harder to predict more challenging patients (multiple failures, co-morbidities, etc) - ACR50 non-response is higher
J Curtis
@RheumNow #RNL2025 https://t.co/SdJ0FHVuSC
Eric Dein ericdeinmd ( View Tweet)
#AI can help with Value Based Care…a year in remission for RA will save a lot of money. @RADoctor @rheumnow #RNL2025 https://t.co/rUpeMrDHZf
TheDaoIndex KDAO2011 ( View Tweet)
Late onset RA (LORA) aka RA diagnosed at an older age — pts have higher inflammatory markers, presents like PMR; they also have polypharmacy, comorbidities, frailty, etc that can complicate management
@UnaMakris #RNL2025 @RheumNow #GeriRheum https://t.co/zqEcyg2ejw
TheDaoIndex KDAO2011 ( View Tweet)
@UnaMakris #RNL25 @RheumNow
Older patients w RA
1/3 of pts onset >60-65
- More acute onset, more systemic, more PMR-like, larger jts
- Higher IL-6, lower TNF-a, less RF, higher ESR
-Co-morbidities, polypharmacy, cognition, depression
Age does not equal frailty, but does correlate https://t.co/5qb60WyKkP
Eric Dein ericdeinmd ( View Tweet)
Are your patients aging with RA, or are they diagnosed with Late Onset RA (LORA)?
-LORA pts tend to present acutely
-High inflammatory markers~PMR Like
-Seronegative/Decreased titers of RF/CCP
@UnaMakris
#RNL2025 @RheumNow https://t.co/aOCwb3lHef
Adela Castro AdelaCastro222 ( View Tweet)
Is Rheumatoid Arthritis Becoming Milder?
A 24 year, prospective study analyzing very early rheumatoid arthritis (RA) in three consecutive eras suggests that RA has evolved since 2005, demonstrating less seropositivity, inflammation, and erosions but is characterized by more… https://t.co/y50uCU79i9 https://t.co/crKytLY4WN
Dr. John Cush RheumNow ( View Tweet)
Pain Management in Rheumatoid Arthritis
BMC has published a full read literture review of pharmacological pain management in rheumatoid arthritis, pointing out that the best evidence for pain control comes from the use of DMARDs and treat-to-target strategies.… https://t.co/1rcTxpQxxT https://t.co/s20bg5FJqQ
Dr. John Cush RheumNow ( View Tweet)
QD Clinic - New Palmoplantar Psoriasis and PsA
New Onset Palmoplantar PsO and PsA - what are the options?
Features Dr. Jack Cush.
QD Clinics - lessons from the clinic, sponsored by RNL2025 in Dallas, TX; Feb 8 & 9, 2025
Register at https://t.co/2dcFVgu8z6… https://t.co/HZZuDvga58 https://t.co/wWKhnIECwB
Links:
Dr. John Cush RheumNow ( View Tweet)
Study of 702 pts who transitioned from PsO to PsA (median 9yrs) - no baseline differences in PsA pts who transitioned late (>9yrs); but on follow-up, the late group had lower Dz activity, less csDMARD use, but no difference in radiographic progression https://t.co/xUPXA79weS https://t.co/eUeemqovv8
Links:
Dr. John Cush RheumNow ( View Tweet)
Participation is Up! (1.31.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow. We also have two call-in cases on "Ask Cush Anything".
https://t.co/kxMkDW5X8c https://t.co/AjIuNzk7co
Dr. John Cush RheumNow ( View Tweet)
