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MTX Fails Knee OA (6.6.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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Autoimmunity Rising in Expectant Mothers

Jack Cush, MD

Lancet Rheumatology has published a UK study showing a significant increased in the number of expectant mothers beginning their pregnancies with autoimmune conditions.

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How Living With Childhood-Onset Lupus Impacts Mental Health

Kaveh Ardalan, MD

Children, teens, and young adults living with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent serious organ damage. By the mid-2010’s, multiple studies were published that showed high rates of depression, anxiety, and suicidal thoughts among children and youth with cSLE. Importantly, young adults who were diagnosed with lupus in childhood were more likely than young adults with adult-onset lupus to experience major depression episodes, with a higher risk of recurrent episodes of depression well into adulthood.

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Why Childhood SLE is More Severe than Adult SLE

About 10 to 20% of all lupus patients are children, and the criteria to make the diagnosis of lupus are the same in pediatrics and adults. Why is pediatric lupus often more severe than adult-onset disease?

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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/bEqAxzRoq6

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Dr. John Cush RheumNow ( View Tweet)
FDA has approved a SC autoinjector of Benlysta (BEL) for use in pediatric lupus nephritis & pts > 5rs of age for SLE and active LN. BEL SC dosing for Pediatric SLE: 200 mg qwk (>40 kg) or 200 mg EOW (q2wk) if 15-40 kg. https://t.co/zrskHdw9Jx https://t.co/jkqygmfJPv

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Dr. John Cush RheumNow ( View Tweet)
FDA has approved a SC autoinjector of Benlysta (BEL) for use in pediatric lupus nephritis & pts > 5rs of age for SLE and active LN. BEL SC dosing for Pediatric SLE: 200 mg qwk (>40 kg) or 200 mg EOW (q2wk) if 15-40 kg. https://t.co/xrMJUgdSWv https://t.co/UJ2LZ3dU5p

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Dr. John Cush RheumNow ( View Tweet)
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS Several monogentic mutations in primary HLH- these panels can be available.. #EULAR2025 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

Age of onset is really important when thinking about #MAS Primary HLH more frequent in pediatric population. But can continue to adulthood. #EULAR2025 @RheumNow https://t.co/J7xmTiQiwr

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Bella Mehta bella_mehta ( View Tweet)
🚨 Type I IFN in Pediatric SLE: Expanded Insights! •🩺 IFN-I Impact: Fuels pediatric SLE; drives T-cell autoreactivity, autoantibody production, proinflammatory cytokines. •📈 Key Pathways: Plasmacytoid dendritic cells overproduce IFN-I via cGAS-STING-TBK1, TLR4/TLR9; https://t.co/4i3MktOoVd

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Dr.Mukesh , MD , DM dr_immuno29 ( View Tweet)
Closing the care divide in #JIA treatment plenary session Overall theme in #EULAR2025 is everyone talking about AI and digital health on day 1 Biologics have changed the game! @RheumNow https://t.co/qDqbz8JApe

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Bella Mehta bella_mehta ( View Tweet)
Young Patients’ AREA empowers teens/young adults w/ autoimmune disease to shape research. US-based, youth-led & grounded in empowerment, they co-design studies, train peers & advise researchers. A truly positive and meaningful initiative esp for PPIE @RheumNow #EULAR2025 #OP0008

Mrinalini Dey DrMiniDey ( View Tweet)

Muscle biopsies form 3 treatment-naïve juvenile dermatomyositis (JDM) finds transcriptomic evidence of mitochondrial dysfunction consistently in JDM muscle, independent of interferon-driven inflammation. Treating mitochondrial dysfunction may improve JDM outcomes https://t.co/u5tMhT23si
Dr. John Cush RheumNow ( View Tweet)
Treatment of MAS, or the bête noire in Still's disease, presented at the Plenary session by Peter Nigrovic #Plenary room #EULAR2025 @RheumNow https://t.co/S4SG2VflNg

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Nelly ZIADE 🍀 Nellziade ( View Tweet)
Single-centre retrospec study of 39 Juvenile Dermatomyositis pts Rx w/ JAKi. Partial/complete Clin inactive Dz achieved in 32/39 w/in 6 months w/ steroid reduction and W/D of other DMARDs. Only TIF1γ) Ab (+) was assoc w/ nonresponse to JAKi (P < 0.001). 5 w/ H. Zoster

Dr. John Cush RheumNow ( View Tweet)

Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/IIJbJ7x2WB
Dr. John Cush RheumNow ( View Tweet)
Single-centre retrospec study of 39 Juvenile Dermatomyositis pts Rx w/ JAKi. Partial/complete Clin inactive Dz achieved in 32/39 w/in 6 months w/ steroid reduction and W/D of other DMARDs. Only TIF1γ) Ab (+) was assoc w/ nonresponse to JAKi (P < 0.001). 5 w/ H. Zoster

Dr. John Cush RheumNow ( View Tweet)

How Living With Childhood-Onset Lupus Impacts Mental Health Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush RheumNow ( View Tweet)
🍋 or ‘Lyme’ - is it Lyme disease? Dr Elizabeth Stringer discusses Eastern Canada 🇨🇦 Epidemic of #Lyme #arthritis Which mimics #pauciarticular #JIA When it is #chronic Work up of all oligoarthritis in endemic areas in kids Includes Validated Lyme test @ORAexec #ORA25 https://t.co/WxU1vaOa7z

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Janet Pope Janetbirdope ( View Tweet)
Do you routinely recommend SLE +Ro/La pregnant Pts to have routine screening for #congenital #heart #block #LUPUS2025 @RheumNow

Janet Pope Janetbirdope ( View Tweet)

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