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D-Lay Trial: High-Dose Vitamin D Retards Multiple Sclerosis

Jack Cush, MD

A randomized clinical trial with oral high-dose cholecalciferol ( vitamin D3) was shown to prevent or delay the onset of clinically isolated syndrome (CIS), typical for multiple sclerosis (MS).

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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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Prophylaxis Against PJP in SLE: I'll Pass

Michael Putman, MD, MSCI

I think we're all somewhat familiar with PJP prophylaxis. This is the thing we do to stop the scary, opportunistic infection that affects people who are immunocompromised. I'm going to start by actually steelmanning the case for doing PJP prophylaxis before I explain why I think you probably shouldn't be doing too much of it.

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Stable SLE - Should you Withdraw Immunosuppressant or Glucocorticoids?

Jack Cush, MD

An open-label, single-centre, randomized controlled trial tested whether immunosuppressant (IS) withdrawal is noninferior to glucocorticoid (GC) withdrawal in systemic lupus erythematosus (SLE) patients and found that IS withdrawal is noninferior to GC withdrawal in SLE patients in long-term

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Keys to Mastery (5.2.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.

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Secondary Benefits to SGLT2 Inhibitor Use in SLE

Jack Cush, MD

An emulation trial of sodium–glucose cotransporter 2 inhibitors (SGLT2i) in systemic lupus erythematosus patients yielded a significantly reduced risk of several cardiorenal complications among patients with SLE and type 2 diabetes.

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Using 16S rRNA gene amplification, Gut bacterial taxa from 53 CRPS pts compared to 52 controls. Differences were seen in microbiome and plasma short-chain fatty acid levels between CRPS patients and controls, w/ >90% accuracy https://t.co/TO7CCmmtD5 https://t.co/zM1wKxjGBX

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GLP-1 agonists effective in Rxing MASH - metabolic dysfunction-assoc steatohepatitis (AKA NAFLD, NASH). DBRPCT w/ 1100 pts (mean BMI 34-35). A good perspective article from Sensible Medicine. https://t.co/NeaX5qcnPA https://t.co/loRPcwv8B9 https://t.co/ul8ko9cU4K

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67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/PpPsAQbj5M

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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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D-Lay MS trial: DBRPCT of Oral cholecalciferol 100 000 IU q2wks x 24 mos.signif reduced Dz activity in clinically isolated syndr(CIS) & early relapsing-remitting MS typical for MS. Dz activity seen in 60% w/ Vit D vs 74% w/ PBO (HR 0.66). Also time to Dz activity (432 vs 224d; https://t.co/GQsnnuWS9R
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Circulating miR-126-3p is a mechanistic biomarker for knee osteoarthritis. Study of 145 pts w/ #OA undergoing knee or hip arthroplasty or arthroscopy. miR-126-3p highest in subchondral bone, fat pad &synovium, not cartilage. IV or IA miR-126-3p given to mouse model of kneeOA https://t.co/DzudhYAK8E
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45 southern African American SLE pts compared to multiethnic cSLE, AA pts had signif higher Dz activity & greater damage accrual. Their mean SLICC score was 8.4, SLEDAI 13, but was 7.4 @6 mos & 4,7 @1 yr. They traveled an avg distance 75 miles to see Rheum https://t.co/R8WimzY0Az https://t.co/1lOJpjO2SY

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2023 report from US NHANES study says #Gout affects 12.1 million in the USA. Gout prevalence incr from 3.6% in 2011/12 to 5.1% in 2017/2018. Recent increases do to doubling in Asian Americans from 3.3% to 6.6%. https://t.co/IBa3fOt83c https://t.co/06Ltm0FycI

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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
Dr. John Cush RheumNow ( View Tweet)
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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Immune Checkpoint Inhib causing Myasthenia Gravis w/ poor outcomes - 16 ICI Rx pts (9 Lung CA, 7 other tumors) Dx w/ MG; 11 w/ overlap myositis. Mean onset @ 49d. All Rx wp steroids, 6 immunosuppressives, 5 plasma exchange; only 2 complete resp. 6 deaths re: MG complications https://t.co/re73lh2Xfs
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)
67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/EZGgVYpxAl

Links:

Dr. John Cush RheumNow ( View Tweet)
45 southern African American SLE pts compared to multiethnic cSLE, AA pts had signif higher Dz activity & greater damage accrual. Their mean SLICC score was 8.4, SLEDAI 13, but was 7.4 @6 mos & 4,7 @1 yr. They traveled an avg distance 75 miles to see Rheum https://t.co/NMlT4uo8jn https://t.co/uG5ofMGE6O

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Dr. John Cush RheumNow ( View Tweet)
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