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ACR Updates Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With COVID

d Jack Cush, MD

A Task Force from the ACR has provided an updated (version 3) guidance for the diagnosis and management of Multisystem Inflammatory Syndrome in Children (MIS-C), a COVID related condition characterized by fever, inflammation, and multiorgan dysfunction.

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DIP,OA

Why Would Hand OA Be Less Severe in Black People?

d MedPage Today

Osteoarthritis (OA) of the hand was less severe according to objective and pain-related markers in Black patients versus those of other racial/ethnic groups after adjustment for known risk factors, researchers found.

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VitD_1.jpg

Vitamin D and the Risk of Autoimmune Diseases

d Jack Cush, MD

The results of the VITAL study (presented at ACR 2021) are now published by BMJ, showing that vitamin D and omega 3 fatty acids reduce the overall risk of autoimmune disease (AID) in a population based intervention trial.

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computer screen safety

Methotrexate Side Effects

d Jack Cush, MD

Data came from the UK Rheumatoid Arthritis Medication Study (RAMS), a prospective cohort of early RA patients starting methotrexate (MTX) shows that in the first year, adverse events (AE) were common, but not serious.

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Among 10,205 admissions for psychosis, 19% were tested for ANA, 15% of those were ≥1:160; BUT ONLY 4 patients met 2019 ACR/EULAR criteria for SLE, & 2 met criteria for Neuropsychiatric SLE - NPSLE prevalence of 1.5% ANA+ psychosis pts https://t.co/r2sTSVKC66

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NEJM study of ~2000 persons showed that prior PCR proven SARS-CoV-2 infection was effective at preventing Symptomatic Reinfection against alpha variant (90.2%), beta ( 85.7%), delta (92%), but not omicron variant (56%). https://t.co/xlyGmJPRnj

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Analysis of nearly 1000 undifferentiated-arthritis(UA) pts show that MRI use is most effective when applied to those who are seronegative or who have oligoathritis. https://t.co/aKIp2rZSNk

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Retrospective study of 179 antiphospholipid syndr pts, looked at noncriteria findings- their presence incr relapse rates (59% vs 34%;p=0.018) triple positivity & need for Rx. (cytopenias, APS nephropathy, livedo, CNS, Libman Sachs endocarditis) https://t.co/KW6WO1tc1l

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Women Heroes in Rheum: - Barbara Ansell - JIA - Nanna Svartz - SSZ - Gertrude Elion - Nobel Prize for allopurinol, AZA - Tsai-Fan Yu - gout Rx - Mary Betty Stevens - lupus & vasculitis - Marian Ropes - 1st F ARA president - Fionula Brennan - TNFi & more https://t.co/a9tKUyWBBu https://t.co/UsHDpzJ8ma

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A prospective study of 124 pediatric SLE pts from UK - estimated Incidence 0.36/100 000. In 1st year 71% on systemic steroids, 98.2% on immunosuppressives, 20.4% accruing damage (mostly neuropsychiatric); most needing multiple speciality team care https://t.co/wdh52pn1Fd

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Prevalence of PsA, axSpA & RA (2017) in Norwegian adults is 0.46%, 0.41%, & 0.78%. In 2017, 27.3% of RA patients, 25.7% of PsA patients and 35.1% of axSpA patients used biologic DMARDs (biologics more freq in youngers; infrequent if ≥55 yrs https://t.co/oqlpPmam6R

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Hip fractures in elderly occur at >250 000/YR in US w/ a 1-yr mortality rate, 12%-37%. During COVID-19, surgery volumes among older individuals were lower than 2 years previously starting spring 2020 until vaccine was widely available https://t.co/80YQq1gyhA

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The July 2021 RheumNow “Live Vote” surveyed US and non-US rheumatologists on their knowledge and practices when dealing with the bone disorder, X-linked hypophosphatemia (XLH). https://t.co/6ztalAZrII https://t.co/ONXaGJI15v

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ICYMI: Radiographic progression in AxSpA studied in 101 Spanish Pts - pts w/ sustained low ASDAS had less XRay progression than those with active Dz (2.33 vs 1.76, p=0.027). Long term TNFi use didnt influence progression until the 3rd Yr https://t.co/TchcLL2ivN

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Despite guidelines rec against hyaluronic acid knee injections, HA injx by ortho significantly increased from 1,090,503 in 2012 to 1,209,489 in 2018 (p = 0.04).amongsts Medicare beneficiaries https://t.co/fIEb5pq20I

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Psychosis is rare in SLE; Retrospective cohort review finds 18/709 SLE or 2.5% developed lupus psychosis. Psychosis remitted in 12/18 w/ a combo of antipsyschotic (in 38.9%) and immunosuppressive (steroid 72%, CTX 56%, RTX 17%, etc) https://t.co/AnCPaPS8QE

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BMJ reports that dementia is associated with multimorbidity (>2 chronic diseases) in midlife (before ge 55 yrs)rather than late life; and greater risk with greater multimorbidity before 55 yrs. https://t.co/hCo8b8ufYG

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We are excited to announce that Dr. Philip Mease will be joining us at RheumNow Live, leading a presentation and discussion on Axial Psoriatic Arthritis & Fatigue and Central Sensitization. Join the discussion on March 19-20, on site or virtually! https://t.co/3CeULLDgf5 https://t.co/M2ZUoXzlAK

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ICYMI: Top Tweet in January Clinical trials generally fail in Sjögren's syndrome; but now a study shows that a biologic B cell inhibitor, ianalumab, met its primary endpoint with a dose-related decrease in disease activity (measured by ESSDAI) at week 24. https://t.co/SLn2qs8En4 https://t.co/nMOUm2C9It

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TB is uncommon in idiopathic inflamm myopathies (3.58%), esp in endemic areas (eg, Asia). Disseminated and Extra-pulmonary (47%) was as common as pulmonary TB (49%); TB Muscle dz seen in 24%. More with M. TB than Non-tuberculous Mycobacteria https://t.co/h6uDsdWj3f

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