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DPGN, lupus, nephritis, GN, glomerulonephritis, biopsy, kidney

Increasing Risk of Lupus Nephritis

d Jack Cush, MD

Population based study from Minnesota shows that the incidence of lupus nephritis (LN) in the US has increased in the last four decades and that LN patients have poorer outcomes with high rates of ESRD and mortality rates six times that of the general population.

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2022 ASAS-EULAR Guidelines for Axial Spondyloarthritis

d Jack Cush, MD

Assessment of SpondyloArthritis international Society (ASAS) and EULAR have published their 2022 update and recommendations for the management of axial spondyloarthritis (axSpA).

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FDA Approves Upadacitinib for Non-Radiographic Axial Spondyloarthritis

d Jack Cush, MD

On Friday October 21st the U.S. Food and Drug Administration approved upadacitinib (Rinvoq) for the treatment of active non-radiographic axial spondyloarthritis in patients with objective signs of inflammation who have had an inadequate response or intolerance to tumor necrosis factor blocker therapy.

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ACR Award Winners (10.21.2022)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Highlighted discussion of implantable stimulators, urine proteomics and gut-immune responses to Prevotella in RA.

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Metanalyses have shown polypharmacy incr risk of dementia. New Wales study of 33,451 dx'd dementia pts. Freq of polypharmacy (3+ meds) grew over 20 yrs before DDx - from 5.5%, to 41%, to 70%, and 82% just before dx of Dementia. https://t.co/2sz38MYeCl https://t.co/WUdFMcmtTQ

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Hyperuricemia is assoc w/ adverse CV events in cardiac pts. ALL-HEART study Rx 5721 ischemic heart pts (no gout) w/ usual care of allopurinol. After 4·8 yrs F/U, there was no difference in cardiac outcomes. No allopurinol benefit in IHD https://t.co/1vS94pDs1B https://t.co/koAGpPrX7H

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Analysis of WHO Safety Vigibase found 625 cases of drug-induced SLE - mostly female (78%), 59 yrs old, w/ half suspecting only PPI. Most common was Omeprazole (30%). Another 800K French database ID 39 pts w/ PPI CLE, half SCLE, 5% DLE https://t.co/vfAArCfWW1 https://t.co/3xQc5NZhvQ

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Hydroxychloroquine Dosing and SLE Flares A cohort study examining HCQ dosing in patients with SLE suggests that HCQ doses of 5 mg/kg per day or less, was associated with a higher risk of lupus flares, including moderate or severe lupus flares. https://t.co/VCn4hOs1PY https://t.co/bbVeVlD1u0

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ACR Award Winners Dr. Cush reviews the news and journal reports from the past week on RheumNow. Highlighted discussion of implantable stimulators, urine proteomics and gut-immune responses to Prevotella in RA. https://t.co/tJTPtEPiyX https://t.co/w2DgjeGOtb

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Efficacy of Shingrix Vaccine lasts for 10 yrs. Shingrix was approved in 2017 based on 2 Lg RCTs showing 6 yr. protective efficacy of 97% (ages>50) * 91% (age >70). Long-term F/U shows 81.6% effectfor mean of 9.6 (±0.3) years post-vaccination https://t.co/qCHZ4fUm35 https://t.co/LfYROtN1xZ

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Spondyloenchondrodysplasia - Very rare genetic skeletal dysplasia w/ short stature, platyspondyly, short broad ilia and enchondromas in long bones or pelvis. Varied phenotype w/ CNS (spasticity, retardation) & autoimmune (ITP, SLE, AIHA, thyroiditis) https://t.co/4DHqohjb2Z https://t.co/Bafh1v0MOA

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NEJM: Dysphagia Due to Diffuse Idiopathic Skeletal Hyperostosis - 70yoM with 6-month history of dysphagia. Compression of the hypopharyx by large cervical osteophytes was seen in a videofluoroscopic swallowing study https://t.co/lp93QwiZlz https://t.co/jI070aQB2F

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Dr. Kent Kwoh and Researchers at the University of Arizona Arthritis Center have been awarded a $3.4 million grant from the National Institutes of Health to undertake a study that seeks to identify determinants of rapid knee deterioration in OA https://t.co/K9wxRzmVnw https://t.co/nM7ByxKikB

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Anakinra in Pericarditis: A Systematic Review (comprehensive, full read) -Options include steroids, colchicine, NSAIDs, pleuropericardial window, IL-1 inhibitors. ANAKINRA - 11 studies, 259 pts, all showing significant rapid resolution. https://t.co/mEkaa7Yjt1 https://t.co/BaMYHiG5Pb

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Highlights from the @ACRheum Kawasaki Disease Guidelines 🥇IVIG is mainstay therapy (2 g/kg) 👶🏼 Use ASA in acute KD 🗣Refractory cases may require steroids or additional immunosuppression 🫀Get echos on all patients to assess for coronary aneurysms

Catherine Sims, MD DrCassySims ( View Tweet)

Tawanese claims analysis of 10,857 RA pts shows lower CVA rates when taking Celebrex (5.95% vs 9.72% not taking) or Etoricoxib (2.69% vs 8.51% not taking). Both Celebrex/Etoricoxib significantly reduced stroke risk p < 0.001 https://t.co/6idrH9g0LJ https://t.co/d80bEtsP7k

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FDA has approves RINVOQ (upadacitinib) for the treatment of Active Non-Radiographic Axial Spondyloarthritis https://t.co/DMuQFjFdrf https://t.co/zLsniZ2zOg

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Dr. John Cush RheumNow ( View Tweet)
Health Canada has approved EVUSHELD to treat COVID-19 in immunocompromised patients (it was previously approved to prevent COVID) https://t.co/ePgd4DjTka https://t.co/whgSM3ce7Q

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Follow us for real time coverage #ACR2022 https://t.co/5CBdiKWdKM
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“If you torture the data long enough it will confess” -Ronald Coase (economist) https://t.co/ZGivhUWLZW

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