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Dot the "i", Cross the "t" (10.11.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.
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2023 EULAR Recommendations on Management of Fatigue
A 2023 EULAR task force has made recommendations to the approach and management of fatigue in patients with inflammatory rheumatic and musculoskeletal diseases (I-RMDs).
Which One is the Loneliest Number (9.27.2024)
Dr. Jack Cush reviews the regulatory approvals, announcements, guidelines and interesting journal articles from the past week on RheumNow.com. When not to use muscle relaxants, how frequent is loneliness in RA/PsA/SpA, and when to refer patients with Still's disease.
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ANA+ consult? 2 Yr study of 207 asymptomatic ANA-pos, found only 11% progressed to systemic autoimmune rheum Dz (89% did not). Progressors developed SLE (48%), Sjögren (22%), scleroderma (13%), RA (4%); Arthritis (RR 1.74) more likly in progressors https://t.co/53bmkQ0qj0 https://t.co/8VUxqxnuGl
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#SLE and biologics (approved & under study) - Full read review:
Anifrolumab
Belimumab
Ocrelizumab
Obinutuzumab
Ofatumumab
Veltuzumab
Epratuzumab
Tocilizumab
Secukinumab
Ustekinumab
Eculizumab https://t.co/RGS2DJgzyS https://t.co/PhqXt0hIzY
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University cohort study of 673 adults w/ CLE or dermatomyositis finds that 32% take herbal supplements, esp in younger & Hispanic pts. 31% of DM experienced Dz onset or flare after supplements (vs 10% in CLE). Elderberry had highest risk of exacerbation https://t.co/BZluGYzr3t https://t.co/5zJD7AwwNK
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World renowned faculty delivering state of the art lectures. Early bird registration for RheumNow Live is now open!
https://t.co/Yk8dKDdZie https://t.co/d14Mq2AxlI
Links:
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Upcoming at #ACR2024 -- New updated Lupus Nephritis management Guidelines. Look for it! https://t.co/i5MbtBHhAb https://t.co/udm2YHYlRi
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VASCULTIS Literature analysis shows most frequent citations, research centers and reveals the top 3 vasculitis topics to be:
1. Immune checkpoint inhibitors
2. GPA/Wegener's granulomatosis
3. SLE - lupus vasculopathy
https://t.co/FS2cuv9gt4 https://t.co/ziI4sfexrm
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Have a a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/wvZYVbVW83 https://t.co/n26xAeU64s
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Mycophenolate in New-Onset SLE
How aggressively do you treat newly diagnosed new-onset systemic lupus erythematosus (SLE), or should you wait for organ involvement? A trial of early use of mycophenolate mofetil (MMF), in addition to prednisone and hydroxychloroquine, decreased… https://t.co/TGLGJAg8SA https://t.co/392tItoTn7
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Lupus nephritis & CKD considerations:
- Non-immune factors: obesity, HTN, Na- or protein-diets, NIDDM, pregnancy, mephrotoxic meds, smoking can add to CKD
- use inhibitors renin–angiotensin & SGLT2 inhibitor w/ proteinuria & low GFR https://t.co/IgL4hpixOm https://t.co/FvmLhf7tQq
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UCB & Biogen report positive topline results of Phase 3 RCT of Dapirolizumab Pegol (anti-CD40L) in #SLE & will launch a 2nd Ph 3 RCT in 2024. Phase 3 PHOENYCS GO study was 48 wks of DAP vs PBO in mod-severe SLE w/ BILAG improvement by wk 48 https://t.co/G1DJf31T6t https://t.co/DgpTObIXrB
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Genentech announced top line results of the REGENCY Phase III study of obinutuzumab (Gazyva) in lupus nephritis. 271 LN (class III or IV; +/- V) taking MMF & steroids were given placebo or OBIN for 76 wks. OBIN was superior @ complete renal resp at 76 wks… https://t.co/Um9du7fgxE https://t.co/RRWumnbTuy
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NEJM Clinical Images: DLE - A 42-year-old woman presented with a 2-year history of a facial rash. A skin examination after removal of her makeup showed an indurated plaque, areas of hyperpigmentation and hypopigmentation, and scattered nodules. https://t.co/dcmLEwV359 https://t.co/XIjZblDSC3
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Neoself-antigens are targeted by autoreactive T cells clonally expanded in SLE. Neoself-antigen presentation results in clonally expanded neoself-reactive T cells, leading to the development of lupus-like disease in mice. https://t.co/iFXNLNRxO5 https://t.co/9TEJUqfEbo
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Full read review of Neonatal lupus syndrome - caused by pathogenic maternal autoAbs (SSA, SSB) in fetal circulation. Mild Sxs in 25%, severe Sxs are rare; Heart block in up to 2% of neonates born to mothers with positive antibodies. https://t.co/iH4MBRGvg1 https://t.co/kXxIeQC47m
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Exploratory analysis from an academic center showed SLE pts w/ higher odds of positive ANA vs. other ANA-asso diseases (OR 2.10). Over 20 yrs, ANA titers are more dynamic than expected; & average titers being higher in early disease and decreasing over time.… https://t.co/iQXN0nPSIG https://t.co/viMTGen34K
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Retrospective analysis of 63K Alopecia areata pts shows a higher risk of developing psychiatric (aHR 1.3) & autoimmune Dz (aHR 2.7), including SLE (aHR 5.7), atopic dermatitis (4.3), vitiligo (3.8), Sjogrens (3.7), Morphea (3.6), PsO (2.8), RA (1.8) https://t.co/gnEm9TsyoV https://t.co/XWA98sbRLp
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PEDIALUP registry includes 138 childhood-onset SLE (cSLE) pts.w/ 15.4 yrs median F/U, showed signif increase in SLICC-damage index (DI) scores. 34% cSLE pts had active dz w/ SLEDAI ≥6. sub-Saharan African ethnicity 7-fold incr risk of active cSLE https://t.co/iLz7DMTQuf https://t.co/tJpEvst7p4
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