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Vitamin D Headlines (5.9.2025)
Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
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Emulation trials in SLE: Real or Fake?
Recently a landmark paper was published in A&R studying the results of an emulation trial on SGLT2i (sodium-glucose co-transporter 2 inhibitors) showing benefit in SLE patients with diabetes mellitus (DM), for both renal protection and reducing cardiovascular events, using data from an American large insurance claim database. My colleagues and I were able to write an editorial on this paper and describe emulation trials.
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Carpal Tunnel Syndrome as a Harbinger of Rheumatoid Arthritis
MedPage Today
Rates of carpal tunnel syndrome were significantly greater in patients later diagnosed with rheumatoid arthritis, according to a large, long-running observational study.
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Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/C0dpThYcMT
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More Women with Autoimmune Diseases Die from Cardiovascular Disease
Women with the autoimmune diseases rheumatoid arthritis, lupus or systemic sclerosis may have a higher rate of death related to cardiovascular disease than men with the autoimmune diseases, according to new https://t.co/Px9ayANsFL
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RA nodules respond to JAKi. Small case series of 7 established/refractory moderate-to-severe#RA pts w/ rheumatoid nodules who were treated w/ JAKi (tofacitinib, upadacitinib)-- 5/7 had complete resolution & 1 reduced nodules size (w/in 3-12 mos) on JAKi therapy. https://t.co/oQWHMBVQEi
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single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/JfaBtfvujU
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Carpal Tunnel Syndrome as a Harbinger of Rheumatoid Arthritis
Rates of carpal tunnel syndrome (CTS) were significantly greater in patients later diagnosed with rheumatoid arthritis (RA), according to a large, long-running observational study.
https://t.co/JiYvjhsKEp https://t.co/szmG5vrvcd
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Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/JcTug1wsTZ
Dr. John Cush RheumNow ( View Tweet)
RA nodules respond to JAKi. Small case series of 7 established/refractory moderate-to-severe#RA pts w/ rheumatoid nodules who were treated w/ JAKi (tofacitinib, upadacitinib)-- 5/7 had complete resolution & 1 reduced nodules size (w/in 3-12 mos) on JAKi therapy. https://t.co/YGK1EGiJiJ
Dr. John Cush RheumNow ( View Tweet)
single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/pBJDhXOgut
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Retrospective Medicare Claims data study of RA pts w/ metastatic non-small cell lung cancer who recv Rx w/ immune checkpoint inhibitor; found that ICI- Rx RA had the same survival as non-RA pts, and sterid use was not associated with worse survival https://t.co/JLlCfrRwvN https://t.co/DNEM32yocL
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Triple positivity (anti-CarP Abs, RF, ACPA) assoc w/ increased Dz activity in RA. Single center, 138 RA pts. Triple pos. pts had signif more TJC (10 v 7.7), Pain (6.3 v 5.1), DAS28-CRP (4.7 vs. 4.0), ESR (33 v 23), ACPA (395 v 369), but lower RF (164 v 453). NO diff in Bone https://t.co/DexENW4W2T
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DANBIO registry study of 720 RA pts w/ a prior solid cancer (breast, colon. lung, endometrial, melanoma, bladder) in remission who received any biologic DMARD, TNFi or RTX found no incr risk of CA recurrence w/ any bDMARD, TNFi, RTX. Specifically, no incr in breast CA recurrence https://t.co/YJw8qXz1yM
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Complex Evolution of RA Management and Outcomes
FIRST is a Japanese longitudinal, real-world registry of rheumatoid arthritis (RA) management, and over the last 20 years has shown significantly improved outcomes, yet significant challenges and unmet needs remain. https://t.co/Vqe70WAijN
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Japan IORRA RA registry shows from 2011 to 2023, despite better Rx & control & less pred, Fractures went up in RA. From 2011 to 2023- DAS resmission 38 to 65%, bDMARD use 14 to 42%, GC use 38 to 22%, OP Rx 32 to 38%; But all FX incr 47 to 53/1000 Pys. https://t.co/cgz0Gkasai https://t.co/D2Uro7mEAT
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US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/C42QMd2zap
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No Extra Cancer Recurrence Risk with Biologics in RA
Rheumatoid arthritis (RA) patients in Denmark with a history of solid tumor cancers, now in remission, faced no greater likelihood of cancer relapse when they were treated with biologic agents, compared with conventional https://t.co/dCspjN2oys
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Retrospective Medicare Claims data study of RA pts w/ metastatic non-small cell lung cancer who recv Rx w/ immune checkpoint inhibitor; found that ICI- Rx RA had the same survival as non-RA pts, and sterid use was not associated with worse survival https://t.co/JLlCfrRwvN https://t.co/zeqeYt5ZHq
Dr. John Cush RheumNow ( View Tweet)
Complex Evolution of RA Management and Outcomes
FIRST is a Japanese longitudinal, real-world registry of rheumatoid arthritis (RA) management, and over the last 20 years has shown significantly improved outcomes, yet significant challenges and unmet needs remain. https://t.co/TwDIf5MJqF
Dr. John Cush RheumNow ( View Tweet)
