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Immunosuppression Increasing (2.23.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.

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CD19 CAR T-Cell Therapy in Autoimmune Disease

d Jack Cush, MD

The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.

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Study of 43 SSc patients w/ gangrene shows Smoking Hx ; positive-ACA, ANCA, APL Abs & high ESR were independent risk factors for digital gangrenes in SSc. Vasculitis and macrovascular disease may contribute to the progression of digital gangrene https://t.co/3DY2Hx19s0 https://t.co/BfXANmckwF

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Dr. John Cush RheumNow ( View Tweet)
Marketing analysis of systemic sclerosis prevalence estimates, from 7 major countries, ~150,000 SSc pts in 2022 (47% from US; 20% Japan; 10% UK). https://t.co/0zJFdq05Xd https://t.co/HWM3LNtHbS

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Dr. John Cush RheumNow ( View Tweet)
Full read overview of SJOGRENS SYNDROME, which can be Primary SS or Secondary (15% in SLE, 20% RA, & 30% systemic sclerosis). SS Organ involvement: - CNS 2-17% - Renal <=10% - ILD 10-20% -MSK 45-56% https://t.co/RElOFfP2xr https://t.co/aJI041VCuE

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Dr. John Cush RheumNow ( View Tweet)
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VITAL Info on Autoimmune Disease (2.9.2024)

d Jack Cush, MD

Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".

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Inflammatory Arthritis in Systemic Sclerosis is Problematic

d Jack Cush, MD

Inflammatory arthritis (IA) is a common manifestation in systemic sclerosis (SSc), affecting nearly one-third of patients.

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Dead Words Eulogy

d Jack Cush, MD

The trouble with rheumatology may be the words we live by. Welcome to the eulogy for rheumatology 'dead words'. We're here today to celebrate the loss of rheumatology past. These are dead words in rheumatology, words fortified unfortunately by history and habit. The lexicon of rheumatology is unique, it's challenging and it's mostly incomprehensible to those who don't know...but those are the cornerstones of the greatest of medical subspecialties. 

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NVC in 1356 #SSc registry pts classified as early, active or‘late. Late pattern seen in 40%: signific. assoc w/ dcSSc (OR=1.96), ILD (OR=1.29), renal crisis (OR=3.46), digital ulcer (OR=1.29), &amp; topoisomerase I Abs (OR=1.39) https://t.co/RgET0HbImf https://t.co/Ex3nKto6JW

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Dr. John Cush RheumNow ( View Tweet)
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CBT or Naltrexone in Fibromyalgia (12.8.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Be sure to catch the early registration break for 2024 RheumNow Live.

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Polands disease study (sarcoidosis 78.6K; #AOSD 3294; systemic sclerosis 35.5K) betw 2009-2018. Avg hospitalization was 5.39 days sarcoidosis, 6.22 days scleroderma, & 7.44 days for Still’s (latter decr 11.7 to 5.8, betw 2008-2014) https://t.co/OcNzt7IKC5 https://t.co/uPcbOyizQN

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Dr. John Cush RheumNow ( View Tweet)
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Is MTX Safe in the Elderly? (12.1.2023)

d 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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Chemokine CXCL10 a potential biomarker for ILD in systemic sclerosis (SSc)? Study of 165 SSc pts (41 w/ SSc-ILD) found higher serum CXCL10 in SSc-ILD (126 vs. 78.5 pg/ml). Hi levels incr risk of ILD 2.74-fold. Most CXCL10 from inflammed lung tissues https://t.co/Z8pIAZYaC0 https://t.co/ErRsD9Msn1

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Dr. John Cush RheumNow ( View Tweet)
Trajectory of FVC in Systemic sclerosis associated ILD in open label SENSCIS study Decline in FVC over 52 weeks decreased by 57% on nintedanib But am I also just seeing a study FVC decline even with nintedanib? @RheumNow #ACR23 Abs#2594 https://t.co/3h4mhm0ceU
Robert B Chao, MD  ( View Tweet)
1st Large real world observational head to head study on tx of Systemic sclerosis - ILD No difference in treatment effectiveness of FVC change between tocilizumab, rituximab, mycophenolate and cyclophosphamide! @RheumNow #ACR23 Abs#2596 #ACRBest https://t.co/GaSnZSCcnZ
Robert B Chao, MD  ( View Tweet)
Fecal transplant for treatment of GI complications of systemic sclerosis? No change in those who received transplant... Overall procedure safe @RheumNow #ACR23 Abs#2597 https://t.co/TEdeGHuzpi
Robert B Chao, MD  ( View Tweet)
Continued interest on CAR-T cells in systemic sclerosis! 6 mo f/up data on 3 pts who received CAR-T cell treatment - stable dz overall Skin findings improved in all 3 pts Previous finger ulcerations resolved Lung function stable in 2 pts, improved in 1 @RheumNow #ACR23 Abs#2598

Robert B Chao, MD  ( View Tweet)

#ACR23 Abs 2598 show data on 1st 3 CD19 CAR-T treated SSc pts. Tx well tolerated and dz stabilized off tx x 6 months. Promising, but more data needed for further evaluation. https://t.co/RAKhT6Eygn @rheumnow

Dr. Rachel Tate  ( View Tweet)

Part 2: Clinical Year in Review #ACR23 https://t.co/Yb8Xh2UKFY
Mithu Maheswaranathan, MD  ( View Tweet)
🚩Adjunct therapy to treat vasculopathy of MDA5-DM ⭐️Botox heals digital ulcerations and improves Raynaud's (slide 1) Dr. Katherine Shaw injects Botox for healing recalcitrant ulcerated Gottron's papules (example patient failed nifedipine, sildenafil, pentoxyfylline & while on… https://t.co/4XCvRrzeTL https://t.co/yxUCzS30W1
Meral K. El Ramahi, MD MeralElRamahiMD ( View Tweet)

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