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Lungs ILD

Best of 2022: Approach to ILD in Myositis Syndromes

d Jack Cush, MD

Mehta et al have published a full read review of managing interstitial lung disease (ILD) in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk.

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Review of the Rheumatic causes of Pericarditis and their management. Causes: SLE, RA, MCTD, Myositis, EGPA, GPA, IgG4-rel Dz, FMF, TRAPS, CAPS, AOSD, JIA, Sarcoidosis, Kawasakis, GCA, Takayasu's https://t.co/h6zpTOIuyu https://t.co/Gy3Eaqz8sM

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Dr. John Cush RheumNow ( View Tweet)
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RECITAL Trial: RTX vs. CTX in CTD-ILD

d Jack Cush, MD

A UK study suggests the equivalent outcomes when patients with interstitial lung disease (ILD) associated with connective tissue disease (CTD) are treated with either intravenous rituximab (RTX) or cyclophosphamide (CTX), but with fewer adverse events with RTX. 

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While myositis in the setting of SLE was found to be around 5% in Abs 1453, it was not associated with mortality. #ACR22 @RheumNow https://t.co/hLLuYoXsCv https://t.co/44XGhbPxzW

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Dr. Rachel Tate uptoTate ( View Tweet)
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Proposed Cancer Screening for Inflammatory Myositis Patients

d Jack Cush, MD

Today's plenary session features a novel proposal on how and which patients with Idiopathic Inflammatory Myopathy (IIM) should be screened for cancer.  Abstract 0002 by Oldroyd et al, entitled "Cancer Screening Recommendations for Patients with Idiopathic Inflammatory Myopathy" took on this thorny practice issue. 

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Very important point about statin induced myopathy by Dr. Christopher-Stine. If 1) history of statin exposure, 2) typical symptoms of myositis 3) HMGCR ab positive — do NOT need biopsy and can treat as statin associated necrotizing autoimmune myopathy! @RheumNow #ACR22 https://t.co/VHxPRkCWwj
Robert B Chao, MD doctorRBC ( View Tweet)
What if my #myositis patient gets pregnant? Abstract #0952 #ACR22 @RheumNow 🫁10 pregnancies ➡️ 1 miscarriage -2 preterm -3 low birth wght -1 HELLP -Mean gestational age 36w 🫁 Higher disease activity ➡️ more adverse pregnancy outcomes

Catherine Sims, MD DrCassySims ( View Tweet)

Key points in managing MDA5+ DM 1. Monitor lungs - HRCT/PFTs 2. Test muscle endurance (ref: IMACS site) not just strength 3. Close observation 4. MTX/MMF initial treatments 5. Repeat muscle biopsy if diagnosis unclear Meet the Expert Lundberg I, IMM session @RheumNow #ACR22 https://t.co/ZVFsYgDBx2
Dr. Antoni Chan synovialjoints ( View Tweet)
Dey @DrMiniDey @ElenaNikiUK @docrota @LatikaGupta_ et al. COVID vaccination in IIM+multimorbidity. Adverse events more common, but still infrequent. Both multimorbidity and active IIM increased risk of AEs. @rheumnow #ACR22 Abstr#0177 https://t.co/HA5NaRrPYL https://t.co/TKtagwa0gG

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Richard Conway RichardPAConway ( View Tweet)
Cancer screening in myositis: the path has always been unclear and inconsistent Workable consensus recommendations @Dr_Alex_Oldroyd risk stratification but still extensive investigation burden for most now need to look at effectiveness including cost ABST0002 #ACR22 @RheumNow https://t.co/322qnGjB9K
David Liew drdavidliew ( View Tweet)
Consensus for #cancer screening in IIM Presented: How Often to Screen #Plenary #ACR22 @rheumnow #myositis https://t.co/h1kp7Z9ynO
TheDaoIndex KDAO2011 ( View Tweet)
Consensus for #cancer screening in IIM Presented: What tests to order for screening #Plenary #ACR22 @rheumnow #myositis https://t.co/pPLcsFLtG9
TheDaoIndex KDAO2011 ( View Tweet)
Consensus for CA screening in IIM Presented: Risk factors to consider screening #Plenary #ACR22 @rheumnow #myositis https://t.co/CDNPaRUpPS
TheDaoIndex KDAO2011 ( View Tweet)
Risk stratification for cancer in myositis @RheumNow #ACR22 #Plenary https://t.co/j7R7P3PS7c
Julian Segan JulianSegan ( View Tweet)
Some suggested screening tests for malignancy in myositis. Recommendations based on assessment of risk factors @RheumNow #ACR22 #Plenary https://t.co/B0eASeo8hG
Julian Segan JulianSegan ( View Tweet)
A #myositis discussion will not be complete without a slide on myositis antibodies - @JuliePaikMD Great review slide for trainees! #ACR22 @Rheumnow #RheumTwitter @rheumarhyme @PhRheumaJr @doktora_ging https://t.co/e6cB344vH8
sheila RHEUMarampa ( View Tweet)
🔸DM pts who are anti-TIF-1 Ab+ have higher risk of malignancy 🔸Ovarian cancer - most common Really important to do cancer screening in #dermatomyositis #ACR22 @RheumNow https://t.co/jErqcR0Gyr
sheila RHEUMarampa ( View Tweet)
Year in review #ACR22 IVIG received FDA approval for dermatomyositis in 2022! @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Year in Review #ACR22 IVIG received FDA approval for adult dermatomyositis, shows benefit versus placebo First approved Rx for inflammatory myositis ⁦@RheumNow⁩ https://t.co/T6qVTQQdTp
Eric Dein ericdeinmd ( View Tweet)
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Intravenous Immune Globulin in Dermatomyositis

d Jack Cush, MD

Few drugs have been studied well in the treatment of dermatomyositis (DM) and only recently has intravenous immune globulin (IVIG) been granted FDA approval for the treatment of DM, based on this pivotal trial.

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