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Psoriatic Arthritis at Risk for Interstitial Lung Disease

d Jack Cush, MD

A TriNetX EHR study shows that psoriatic arthritis, but not psoriasis, patients are at increased risk for interstitial lung disease (ILD).

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Should You Add MTX to a TNF Inhibitor in Psoriasis?

d Jack Cush, MD

Target emulation trial shows adding methotrexate (MTX) to adalimumab (ADA) does not augment the effectiveness and persistence of adalimumab alone in treating plaque psoriasis in adults. 

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Autoimmunity Rising in Expectant Mothers

d 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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Methotrexate Fails in Knee Osteoarthritis

d MedPage Today

We'll be blunt: methotrexate flopped in a randomized placebo-controlled trial among patients with osteoarthritis (OA) of the knee.

Contrary to results from a previous trial in hand OA, the old-line disease-modifying anti-rheumatic drug (DMARD) failed to bring any improvement relative to placebo in either pain or an objective measure of joint inflammation after a year of treatment, according to Changhai Ding, PhD, MD, of Southern Medical University in Guangzhou, China, and colleagues.

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Type 2 SLE: Insights from a Biopsychosocial Framework

d Jennifer L. Rogers, MD

Many of the common symptoms of lupus - fatigue, nociplastic pain, brain fog - can be invisible and difficult to measure, and can often co-occur with impaired sleep, depression and anxiety. These symptoms have led to a well described discordance between physician and patient perception of lupus activity and flares, and this discordance can impact communication, trust, medication adherence, and ultimately outcomes. We developed the Type 1 and Type 2 model many years ago as a means to bridge this gap.

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Global incidence of alopecia areata increased betw 1990 - 2021; from 20.43 million (19.77-21.09 million) in 1990 to 30.89 million in 2021 ( range of 29.95-31.82 million) - highest in USA 550/100,000. High in N.America, S.America, Southeast Asia, Australia. Lowestin Africa, Middle https://t.co/d3WA3CRFRC
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Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ https://t.co/pBo1IDe8pQ

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Save the date! RheumNow will be at EULAR '25 June 11-14. https://t.co/J0dq4PWf6q
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CMAJ reminds us that w/ parvovirus B19 infection, Arthropathy seen in ~60% of adolescents & adults, but the classic “slapped cheek rash” is uncommon. Symmetric, polyarticular inflamm arthralgias/itis affects PIPs, MCPS mostly. Sxs resolve w/in 3 wks. ~20% can last mos-yrs https://t.co/2SuL5igcnz
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Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a https://t.co/VXFuHGpDjB
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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
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IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/2sIgMYK7xo
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Environmental and Geographic Risks for SLE Dr. Karen Costenbader, a rheumatologist at the Brigham and Women's Hospital and a Professor of Medicine at Harvard Medical School in Boston, discusses environmental and geographic risks for systemic lupus. https://t.co/UDMgB8f0WZ https://t.co/ec5S5wGr9C

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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

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Psychological Bulletin has published that invalidating (gaslighting) pts Sxs can have harmful consequences. Includes pts dx w/ Ehlers-Danlos, endometriosis, fibromyalgia, ME/CFS, POTS, Gulf War, IBS, long Covid, multiple chemical sensitivity, SLE, and vulvodynia.

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SLE Treatment Landscape: Abundance or Overload? Imagine a world where the multiple drugs in Phase 2 and 3 trials actually get approved, and we get access to them? I know you may be thinking that I am overly optimistic, but there are so many drugs in development in lupus that we https://t.co/1SsSMqfZWz
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Moneyball Rheumatology (5.30.2025) Dr. Jack Cush reviews the book/movie, "Moneyball" and a suggests moneyball strategy is needed to find next level responses for our patients. https://t.co/c79y9UNTcQ https://t.co/at7mDderOP

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Sacroiliitis is a rare adverse reaction of isotretinoin. Review of 67 pts finds median age 21 yrs, onset median 2.5 mos (0-24) post isotretinoin. Sxs: LBP 70%) & hip pain 45%. Dx by MRI (73%) w BME. Full recovery 81% isoretinoin D/C & NSAIDs (< 10% biologics)

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PPACMAN Consensus Recs. for CV risk in PSO/PSA published for Rheums/Derms/PCPs - check BP, Wt, Lipids, Cr. - Look for HTN, DM, smoking, obesity, metabolic synd. - Risk stratify w/ hsCRP, Lipids - Lifestyle management https://t.co/MkgYopTNAX https://t.co/6yyxVIxpC0

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Review of ARF & Post-streptococcal reactive arthritis (PSRA) following Group A strept infxn. Early Dx & Rx of Strept can prevent ARF & PSRA. PSRA is a sterile arthritis, bimodal age onset, lower extrem arthritis, usually resolves without lasting sequelae https://t.co/ld208yf0Zk

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