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2023, Year, Wordle

2023 Rheumatology Year in Review

Jack Cush, MD

Here is my top 10 list (in no particular order) of 2023 advances, game-changers, and developments that changed, or will soon change, rheumatologic practices.

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Is MTX Safe in the Elderly? (12.1.2023)

Jack Cush, MD

Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.

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multiple traffic lights

When should we be starting therapy in GCA and PMR?

David Liew, FRACP

The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind a shrug of the shoulders, or the ambiguity of therapeutic inadequacy. The question that follows the presence of a therapy is the question as to how to best use it.

GCA and PMR are at the stage in the growth of their therapeutic development where this problem is moving to the front of mind, and it made for a fitting topic in the ACR Great Debate. Drs. Rob Spiera and Phil Seo - two luminaries in the vasculitis and PMR worlds - were pitted head to head to discuss.

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ACR Best

#ACRbest Abstracts – Day 2

Jack Cush, MD

Our reporters have been prolific in finding the hot abstracts, those that were most attended or those that are getting the most buzz on social media.  Here are RheumNow's #ACRbest abstract reports from Monday, November 13, 2023 at #ACR23, covering The Great Debate, SGLPT2 inhibitors in SLE, the SMART Study of MTX, TMP/SMX Prophylaxis, RA-ILD & TNF Inhibitors, cancer research and more. 

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ICYMI: When PMR Strikes Young, It Hits Hard https://t.co/rUuPnbcgCY https://t.co/AMpqGCJhIa

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Dr. John Cush RheumNow ( View Tweet)
Full Read review of #PMR in Lancet: - Start @ 12·5–25mg prednisone qd - Remission in most but, relapses in 40–60% - Onset sudden; AM stiffness predominates; Shoulders>Pelvic ~50% have distal MSK Sxs - US: look for B/L sub-acromial/deltoid bursitis https://t.co/NwrbdMMdLU https://t.co/eRls0fLMJs

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Dr. John Cush RheumNow ( View Tweet)
Best of 2023: PMR: glad or bad tidings? “Life was turned upside down overnight” – PMR patient. https://t.co/l7jZei5Kfm https://t.co/Ct3qlHd34P

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Dr. John Cush RheumNow ( View Tweet)
When should we be starting therapy in GCA and PMR? The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind the ambiguity of therapeutic inadequacy. https://t.co/oRWTeH5Q9h https://t.co/BbswdffoKM

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Dr. John Cush RheumNow ( View Tweet)
Full read BMJ ovverview of PMR - PMR Clinically recognized 1957 - Is it a uniquie vs overlap entity - Is there subclinical GCA in PMR? - Is PMR for PCPs? https://t.co/0BKGdt5Kxf https://t.co/sfAZoYyVan

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Dr. John Cush RheumNow ( View Tweet)
2023 EULAR #PMR referral recommendations: 1 Suspected/Dx pts: consider Rheum eval 2 Do full Hx+PE+Labs before referral 3 Refer Severe Sx PMR to rapid access 4 Defer steroids til rapid Rheum eval 5 Rheum Dx PMR w? +steroid response can be Rx by PCP https://t.co/42bL8BL3QJ https://t.co/ffpKoKXZJM

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Dr. John Cush RheumNow ( View Tweet)
Biologics as First-line Therapy for PMR and GCA? Dr. Eric Dein talks with Dr. Philip Seo, one of two panelists for the Great Debate: Should PMR and GCA Be Treated with Advanced Therapies at Disease Onset? https://t.co/eezZkBr8x7 https://t.co/D0dTSkjsNS https://t.co/nBlFyKNkHM

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Dr. John Cush RheumNow ( View Tweet)
TM66 at #ACR23 60 yo M w/ worsening PMR symptoms (polyarthralgias, difficulty raising arms) & b/l vision loss PMH: PMR, central serous chorioretinopathy, HTN VS: 100.2 F, HR 108 Labs: - CRP 100 mg/dL, ESR 81 mm/h - UA: proteinuria (100 mg/dL) - ANA > 1:10,000, dsDNA > 300… https://t.co/T7Nov5vyoc https://t.co/3GuXVgh03Z
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)
👨‍⚖️ The Great Debate: should we use advanced therapies / biologics at disease onset in PMR & GCA? #ACR23 By Dr. Robert Spiera & Dr. Phil Seo @philseo #Vasculitis #PMR #GCA https://t.co/rkcUeEBLeZ
Mithu Maheswaranathan, MD  ( View Tweet)
Clinical Year in Review at #ACR23 By @philseo (@jhrheumatology) Review some of the most impactful scientific studies in #Rheumatology in the past year! 🍕 https://t.co/ystEjzrU8u
Mithu Maheswaranathan, MD  ( View Tweet)
International collaborative has discussed early referrals for PMR - this is what they’re recommending Better plans to get the right patients into rheumatologists is a big part of helping #MakeRheumForPMR ABST2395 #ACR23 @RheumNow https://t.co/Kea07IGxhG
David Liew drdavidliew ( View Tweet)
#irAE Baseline immune suppression does NOT protect against worsening synovitis flares when using check point inhibitors in Pts with established #inflammatory #arthritis #ACRbest #ACR23 @ACRheum @RheumNow abst1075 Data from #CanRIO database https://t.co/lOCf8Tbgta
Janet Pope  ( View Tweet)
1-PJP prophylaxis or not in ANCA? 2-MTX single dose or split dose? 3-IL6 blocker early on in GCA/PMR? 4-SGLT2 in DM/Lupus nephritis? 5-Cervical cancer screening in Lupus? 6-TNF induced ILD? https://t.co/mzGXajmQqE @RheumNow , Daily recap #ACR23

Nouf Al hemmadi  ( View Tweet)

Still uncomfortable with IL-6i in GCA or PMR especially given the pt population and potential AE? Be on the look out for NEW biologics! Mavrilimumab Secukinumab and MORE! @RheumNow #ACR23 https://t.co/gdcDIcvffa
Robert B Chao, MD  ( View Tweet)
More nuanced poll for #GreatDebate #ACR23 @RheumNow How should we use biologics for PMR/GCA?

Eric Dein  ( View Tweet)

#ACR23 Great debate: should we use biologics at PMR/GCA onset? Dr Spiera (Cons) -Need to agree on clin important diff & flares -No evidence as disease modifying in GCA - No need for disease modifying in PMR -Most pts can be treated with steroid & rapid taper -Cost @RheumNow https://t.co/ptM8E7EQzF
Md Yuzaiful Md Yusof  ( View Tweet)
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