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Hmmm Really? (7.11.2025)
Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?
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ICYMI: Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD
Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic options for patients with autoimmune ILDs.
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ICYMI: Secukinumab promise in PMR is real
Choice is not just good, it is often necessary, and secukinumab promises just that in both PMR and GCA.
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Don't Stop the DMARDS!!
Retrospective study of 91 JIA pts (all types; 36% oligo, 27%poly) all Rx w/ cycles of DMARD therapy. Consistently two-thirds relapsed and flared. Only one-third of JIA patients were able to remain off DMARDs. https://t.co/ifqnMKfhAe https://t.co/8JAbpO1IVe
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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/wC2dPvVR7x https://t.co/HCFSXBfVGM
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Rheums! Question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast.
https://t.co/HsqM9xLNtP https://t.co/voONsOLeSK
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Cancer Survival Outcomes in Autoimmune Skin Disease Patients
Patients with autoimmune skin diseases (ASDs) with cancer had significantly better cancer survival outcomes than those without ASD, suggesting coexistant autoimmune or inflammatory disease does not adversely affect a https://t.co/apnX4GGAdT
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Diffuse idiopathic skeletal hyperostosis (DISH)is a structural cause of dysphagia due to anterior cervical osteophytes. Retrospective study 208 dysphagia pts w/ head/neck CT. DISH was Dx in 39%; predicted by low serum albumin, COPD, & chronic pain https://t.co/zrn4dnCtLc https://t.co/svE6khmUEm
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Despite 2024 HHS proposal to reschedule CANNABIS to Schedule III, it remains Schedule I -having "no accepted medical use" and "high abuse potential".There's lots of use (legal in 24 states, DC, decriminalized in 7 states), but no evidence, research or guidelines. https://t.co/KumpvMHdhC
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Immunomodulators in the Treatment of Autoimmune Hepatitis
Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on https://t.co/KgzjNvrZ7v
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Referral of 304 suspected autoinflammatory Dz (SAID) to a UK national centre for primarily adult SAID in 2022, 121 (39.5%) were diagnosed with SAID, w/ half of these having monogenic Dz. Median Dx delay was 2 to 6 yrs, worse in late-onset SAID. https://t.co/x8VOFyjuVA https://t.co/3R2HdYUlSg
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Genicular nerve block (GNB) is effective intervention for Knee OA. Metanalysis of 6 RCTs & 420 KOA pts. GNB significantly reduced pain & improved function (p<0.003), w/ significant relief as early as 2wks and function by 12 weeks. https://t.co/NMtiQPICpw https://t.co/gVJ0TyuY01
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BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
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JAMA Patient Education Page on what is Interstitial Lung Disease https://t.co/BDbV6I53NH https://t.co/1OtTiJHkdt
Links:
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From 1990 to 2021, the global burden of OA from high BMI increased markedly. YLD (years lived w/ disability) rates of OA attributable to high BMI increased from 34 to 50.6 per 100,000 - higher in females, correlated w/ Socio-demographic Index levels https://t.co/RjTJFNEbYm https://t.co/tIqmn9eLQ6
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Japanese cohort study compared 12 pts w/ Stills Dz or intravascular lymphoma. Stills pt had significantly higher ferritin and IL-18 levels and IVL pts had significantly higher sIL-2R levels. https://t.co/Ecd6vNJTc4 https://t.co/KdEcpDeskA
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ICYMI: ACP: Best Practice Advice on Cannabis or Cannabinoids Use for Chronic Noncancer Pain
The American College of Physicians published a best practice advisory on cannabis or cannabinoids in the Annals of Internal Medicine.
https://t.co/mQI2g4W4hX https://t.co/BhfQtI792M
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In >228k CTD patients across France, ILD increased mortality risk across all CTDs. Proportion of incident CTD with ILD highest in IIM (37%). Up to 34% of CTD-ILD pts had progressive pulm fibrosis. Supports earlier ILD screening & vigilance in CTDs.
@RheumNow
#EULAR2025 #OP0033 https://t.co/nEiTWQEqsP
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POCUS of the lung can detect subclinical ILD and can be a useful, inexpensive, easy to perform screening tool for CTD-ILD.
#EULAR2025 @RheumNow https://t.co/HC0skwUKQG
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Foot and ankle #OA is often underrecognized..
1 in 6 people over 50 have foot OA!
#EULAR2025 @RheumNow https://t.co/4wGSzC8dvi
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