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D-Lay Trial: High-Dose Vitamin D Retards Multiple Sclerosis
A randomized clinical trial with oral high-dose cholecalciferol ( vitamin D3) was shown to prevent or delay the onset of clinically isolated syndrome (CIS), typical for multiple sclerosis (MS).
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Rheumatology: Believe It or Not (4/25/2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?
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EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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Unmet needs in #lupus are many
👇
Timely #diagnosis
Morbidity - CV, metabolic, OP, mental health
Premature mortality - CAD, active #SLE, infection
Issues w pregnancy
#steroid side effects
⬇️QoL
With partnerships we can ✅
Pts
HCPs
researchers
Pharma
Gov’t
#LUPUS2025
@RheumNow https://t.co/9T9rIrM1hV
Janet Pope Janetbirdope ( View Tweet)
Impt predictors of
#neuropsychiatric #SLE
#LUPUS2025 @RheumNow
No major predictors
But if explanation of other conditions ex
Past #cvA
#ischemic events
Doesn’t have to have
➡️Active systemic ##Lupus
➡️ ?ribosomalP
+Abs described in #CNS lupus
A real headache! https://t.co/iuWfB454EN
Janet Pope Janetbirdope ( View Tweet)
‘It’s #Lupus, it’s all in your head!’
➡️ Some patients with #SLE have heard this from others
At #LUPUS2025 in a packed session on #CNS lupus
#Dx is tricky
40% of #neuropsychiatric lupus have NEGATIVE #brain #MRI
👇r/o
infarct/bleed
Infection
Rx #steroids
@RheumNow https://t.co/yU1olg0uZU
Links:
Janet Pope Janetbirdope ( View Tweet)
Steroids prevention of #congenital #heart #block in +Ro
Mom
#DM #HTN #wt⬆️
Fetus
?no diff #cardiomyopathy
?learning &behavioural changes
Debate re screen #CHB
Most CHB are kids w CHB as mom is unknown to be +Ro
Angst w screening
High titre Ro Impt
@RheumNow #LUPUS2025
Janet Pope Janetbirdope ( View Tweet)
Assessing neuropsychiatric SLE by 3-T, 3D contrast-enhanced vessel wall imaging. 47 w/ NPSLE vs 42 without (just SLE) showed the NPSLE had 2 fold more 1ntracranial contrast-enhanced vessel wall imaging (CE-VWI) w/ AUC 0.78 for CE-VWLs, & sensitivity 60% , specificity 87%.
Dr. John Cush RheumNow ( View Tweet)
QOL survey of on 5222 lupus pts (94% F; 56% both CLE/SLE; 40% w/ SLE. QOL concerns on social activities (60%), mental health (38%). CLE had increased therapeutic hesitancy and less likely to believe in the efficacy of biologics than SLE or both. https://t.co/BOUXUSmmcM https://t.co/62Z1aFsbbv
Dr. John Cush RheumNow ( View Tweet)
National Inpatient Sample retrospective study of #RA pts using cannabis (n 42,415). Cannabis assoc w/ lower mortality (0.98% vs 2.71%; OR 0.50), depression (OR 0.47), chronic pain (OR 0.45), anxiety (OR 0.55); but more use of opioids (OR: 1.10), nicotine (OR: 1.35), & alcohol https://t.co/87SnCHVxkN
Dr. John Cush RheumNow ( View Tweet)
QOL survey of on 5222 lupus pts (94% F; 56% both CLE/SLE; 40% w/ SLE. QOL concerns on social activities (60%), mental health (38%). CLE had increased therapeutic hesitancy and less likely to believe in the efficacy of biologics than SLE or both. https://t.co/BOUXUSmmcM https://t.co/zrzEsDDqVn
Dr. John Cush RheumNow ( View Tweet)
Telemedicine and Lupus
https://t.co/RgfgnMGsZw https://t.co/uQEYLlrlB5
Dr. John Cush RheumNow ( View Tweet)
Full read review of Neuropsychiatric SLE. NPSLE criteria includes 12 central & 7 peripheral findings (psych, cognitive, Sz, CVA/TIA, neuropathy, MS-like). NPSLE AutoAbs are many: Abs against APL, LAC, RP, NMDA, NMO/AQP4, EC, SBSN, UCH-L1, TP1, GAPDH, MAP2, U1RNP https://t.co/1m7SXMA68Z
Dr. John Cush RheumNow ( View Tweet)
Full read review of Neuropsychiatric SLE. NPSLE criteria includes 12 central & 7 peripheral findings (psych, cognitive, Sz, CVA/TIA, neuropathy, MS-like). NPSLE AutoAbs are many: Abs against APL, LAC, RP, NMDA, NMO/AQP4, EC, SBSN, UCH-L1, TP1, GAPDH, MAP2, U1RNP https://t.co/HvDX8wSuoB
Dr. John Cush RheumNow ( View Tweet)
Retrospective study of 334 children with non-organic amplified MSK pain syndr(AMPS) plus back pain. Pts w/ localized AMPS were more likely to have a (+) straight leg raising test (P 0.01) & diffuse AMPS more likely to have allodynia & incongruent affect (reporting pain, but still https://t.co/unbub6VK0t
Dr. John Cush RheumNow ( View Tweet)
Systematic review shows PTSD is strongly assoc w/ an increased risk of developing SLE. 7 studies (5 prospect cohort) and 11614 SLE pts - 1,325 (11.4%) had comorbid PTSD, mostly females. All showed + association of PTSD & SLE, 3 showing 2fold incr risk of SLE. No genetic https://t.co/Xjya0QNznQ
Dr. John Cush RheumNow ( View Tweet)
MMWR: While PRE-overdose opioid prescribing is a risk marker for fatal overdose from opioids alone, stimulants alone, or both; PRE-overdose stimulant prescribing might not be a risk marker for fatal overdose attributable to stimulants. https://t.co/ReVbpligeT https://t.co/PnjeqaCySX
Dr. John Cush RheumNow ( View Tweet)
Mindfulness and CBT improve chronic low back pain
Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized https://t.co/e4jLNwNBy3
Dr. John Cush RheumNow ( View Tweet)
12-month community trial 770 adults w/ opioid-treated chronic low back pain (CLBP). Found that opioid dosage decreased with both mindfulness-based therapy & cognitive behavioral therapy (CBT) at 6 & 12 mos.(noninferior) - Why dont we use these? https://t.co/9VhqJEHlhc https://t.co/GWnL66nbvY
Dr. John Cush RheumNow ( View Tweet)
NIH Complimentary Medicine overview of Music Therapy - preliminary research suggests that music interventions may be helpful for anxiety, depression, pain control, dementia, multiple sclerosis, Parkinson’s disease, etc https://t.co/UGsfT7lITQ https://t.co/DrJm4JdEuY
Dr. John Cush RheumNow ( View Tweet)
