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STING/IFN Activation Promotes ANCA-Associated Vasculitis Progression
Research presented in the Journal of Experimental Medicine shows that ANCA-associated vasculitis (AAV) may be propagated by pathogenic mechanisms triggering cGAS/STING/IRF3-dependent IFN-I release.
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Autoimmune Disease Augments Cardiovascular Risk
A large UK database study suggests that young adults with autoimmune diseases have an associated increased risk for cardiovascular disease.
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Review of cGAS/STING - enzyme cyclic GMP-AMP synthase. self genomic & mitochondrial DNA stimulates cGAS-->dimerizes & binds to the endoplasmic reticulum protein stimulator of IFN genes (STING), unleashing an inflammatory response https://t.co/g04v1S4PYJ https://t.co/SHeneZq4sd
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Review of IL-1 inhibitors in recurrent idiopathic pericarditis. While Rilonacept is FDA approved (320 mg x1 then 160 mg sc/wk), anakinra (2 mg/kg/d or 100 mg/d), canakinumab and colchicine are used https://t.co/EQJV4qTFPj https://t.co/Rdkn4ljh0X
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USPSTF recommends clinicians prescribe Statins for the primary CVD prevention in adults (40-75 yrs) w/ 1 or more CVD risk factors (ie, dyslipidemia, DM, HTN, smoking) & 10-year CVD risk of 10% or greater. Inflammatory dz is considered a CV risk enhancer https://t.co/XEaXqcCEg1 https://t.co/vEqEFV1kYv
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Review of steroids & immunosuppressants on cancer outcomes in checkpoint inhibitor therapy
- Steroid use "for irAEs may not have a large deleterious effect on overall survival"
- DMARDs for irAE "a major drawback in the delay in the onset of response"
https://t.co/YciXN4fdZQ https://t.co/oNgszsYNB8
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MIRROR study lead to pegloticase (PEG) label change - adding MTX as Rx to reduced anti-PEG Abs. Based on 14 refractory gout pts given MTX 15mg/wk (w/ folate) and then PEG IV: 3 nonresponders, 1 dropped out, 10 responded/stayed on Rx x 52 wks w/ less ADAbs https://t.co/4Hew7zVu7J https://t.co/za9hQ8Plnl
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Prospective study of 124 adults hospitalized w/ acute MSK trauma saw good outcomes in 23% @6 mos & 61% @12 mos. Worse outcomes assoc w/ posttraumatic stress Sxs (OR 2.09), pain intensity (2.87), # fractures (2.79)& pain extent (4.67) https://t.co/ubuyWCBFgU https://t.co/ZfNGUQ1i0e
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Dr. John Cush RheumNow ( View Tweet)
Influenza Vaccination Recommendations
The CDC has published an update to the recommendations from the Advisory Committee on Immunization Practices (ACIP) on the use of seasonal influenza vaccines in the United States for the 2022-23 season.
https://t.co/6V21XZUsqX https://t.co/ln9bqta6UT
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Phase 2 RCTs are evaluating TLR 7 & TLR 8 blockade in SLE - BMS has afimetoran and Merck has enpatoran (both blocking TLR7/8) https://t.co/lSvnAkRvxB https://t.co/i7ZORYyKHP
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The prospective CARDIA cohort study studied 2110 adults (38 - 50 yrs) for 10+ yrs and showed those taking >7000 steps/day had a 50% to 70% lower risk of mortality (vs those taking <7000 steps/day). https://t.co/lE152z8vTw https://t.co/hjfnCN4bno
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Dr. John Cush RheumNow ( View Tweet)
ALL-HEART study presented in Barcelona at ESC Congress 2022 showed that allopurinol given to 5,721 older adults without gout, failed to reduce # nonfatal myocardial infarction, nonfatal stroke or cardiovascular death in ischaemic heart Dz pts https://t.co/I0dFXQa6Ao https://t.co/8IevQ4uwUY
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Bidirectional Association Between Depression and Rheumatoid Arthritis
A recent meta-analysis suggests a bidirectional association between RA and depression. Finding RA patients with depression yields an 80% increased mortality risk.
https://t.co/NUyZ2jAWzE
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Dr. John Cush RheumNow ( View Tweet)
Weight Loss Slows Knee OA Progression
Declines in body mass index (BMI) were linked with slower worsening of knee osteoarthritis (OA), according to data from three large longitudinal cohort studies.
https://t.co/jJlSTdBdXT https://t.co/9mPJiVT9nE
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Dr. John Cush RheumNow ( View Tweet)
Axial Psoriatic Arthritis and Ankylosing Spondylitis with Psoriasis
A cohort analysis from Toronto suggests that axial psoriatic arthritis (PsA) is distinctly different from axial ankylosing spondylitis (AS) with psoriasis.
https://t.co/8bAoqp79Mg https://t.co/K2Z1LwPTiS
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Dr. John Cush RheumNow ( View Tweet)
Cochrane review of Stem cell transplantation in systemic sclerosis (3RCTs w/ 125 pts). Non‐myeloablative & myeloablative selective HSCT had moderate evidence for improved survival, skin thickness & function. But these had high Serious AE rates. https://t.co/VKciXY0klN https://t.co/LdMu3RrlZK
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Learn how to manage lupus: 'The Lupus Encyclopedia: A Comprehensive Guide for Patients and Families' - on #BookBuzz - https://t.co/hvnoFRiabA
Donald Thomas, MD lupuscyclopedia ( View Tweet)
h/t @alhkim concluded. “Get Evusheld into your patients" - We add give aggressive out pt mgmnt for #Breakthrough
@CCalabreseDO
@philipcrobinson @drdavidliew
B-cell depleting therapies ‘biggest threat’ for reduced SARS-CoV-2 mRNA vaccine response https://t.co/VZRwg0Q6cw
Leonard Calabrese LCalabreseDO ( View Tweet)
Hyaluronic Acid Knee Injections Equivalent to Placebo
In the United States, where over $300 million is spent annually on intraarticular hyaluronic acid injections, yet another study shows such therapy to be no better than placebo.
https://t.co/NwJkyECfgM https://t.co/qGLQMWjQG4
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Dr. John Cush RheumNow ( View Tweet)
Charcot (neuropathic) arthropathy of elbow due to Syringomyelia - review of 50 pts. Median age 45 yrs, 2/3 isolated elbow arthritis; other joints: shoulder > wrist > MCPs/IPs. 2/3 had Chiari malformations, sensory/motor deficits, or ulnar neuropathy https://t.co/2hEArpbL8p https://t.co/MK4VTzSSRB
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Dr. John Cush RheumNow ( View Tweet)