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Autoantibody Associations in Systemic Sclerosis

d Jack Cush, MD

Analysis of two large cohorts of systemic sclerosis (SSc) patients shows a signfiicant minority of patients to have autoantibodies typical of rheumatoid erosive arthrits, but their presence in SSc patients was associated with unique manifestations of SSc. 

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Spesolimab, an IL-36 Blocker, in Pustular Psoriasis

d Jack Cush, MD

The NEJM has published the results of a phase 2 randomized trial showing that the use of an interleukin-36 receptor inhibitor, spesolimab, resulted in rapid improvement of generalized pustular psoriasis (at 1 week), but that adverse events and infections were of concern with 12 weeks of foll

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Safety of COVID-19 Vaccines in Rheumatic Patients

d Jack Cush, MD

Since the introduction of COVID-19 vaccines in January 2021, rheumatologists have fully advocated the protective benefits of their use - yet many have rarely noted flares and reactive side effects worrisome to patients.  Now a multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease is safe, well-tolerated with very rare serious adverse events.

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Safety of COVID-19 Vaccines in Rheumatic Patients A multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease (I-RMD) is safe, well-tolerated with very rare serious adverse events (AEs). https://t.co/d30zbfa0f8 https://t.co/OM6GzAzTvQ

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Cosentyx (secukinumab) was FDA approved for use in pediatric psoriatic arthritis & enthesitis-related arthritis, based on results of the ph III JUNIPERA study. Dosing based on weight (SEC 75 mg sc if 15-50kg; SEC 150 mg sc if 50 kg or more) https://t.co/1nv3iJ7EJ3

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Does COVID Vax reduce adolescent MIS-C risk? In France 77% of teens recv COVID Vaccine by 10/2021. From Sept-Oct 2021,107 MIS-C kids were hospitalized in France; 31% were eligible but not vaccinated. MIS-C risk dropped 91% (0.09) after 1st first vax dose https://t.co/mF0L2VnEoi https://t.co/R33n1FCN3X

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Of 173 autoimmune inflammatory rheumatic Dz pts w/ respiratory Sx, 46 had Pneumocystis jirovecii. Higher risk of PJP w/ high-dose steroids, recent immunosuppressives, combo w/ CsA, hx of chr lung dz, high LDH, ground glass CXR https://t.co/P8KtC2Hab8

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Study of biologic/ts DMARD switching in 8,398 axial spondyloarthritis pts from 5 Nordic registries showed a low rate of multiple switches (refractory?) over 3 years; ≥3 DMARDs (8%), ≥4 (3%) & ≥ 5 (1%); more w/ women, comorbiditiy & psoriasis https://t.co/ZQDvl6AaZz

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Best of 2021:Hydroxychloroquine related hyperpigmentation appears as blue/ black discoloration of skin or mucosa, occurs in 7-30%; Recent report says ~5%; Risk factors include steroids, bruising, anti-coagulants & trauma - theyr slow to resolve if you D/C https://t.co/IJDolwNyDx

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Best of 2021: Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005). https://t.co/4RB7SxuGx7

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121 Sjögren’s pts dx w/ non-Hodgkin's lymphoma - 76% were MALT lymphoma (9% Diffuse Large B Cell, 7% Nodal Marginal Zone Lymphomas). MALT 10-yr survival was 79% MALT. Predictors were Cryoglobulinemia, focus score, ESSDAI at Dx https://t.co/EYsB06DU4s

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Best of 2021:Danish Cohort study of 5310 cutaneous LE/SLE pts between 1995-2014 (7-8 yrs F/U & 40.724 PYs) shows overall increased cancer risk for CLE (SIR 1.35)and SLE (1.45), esp a 3-4 fold increased risk for NHL, hematological, pancreatic & lung cancers https://t.co/Lgbe2hwtNj https://t.co/NzjM5LCuaX

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Best of 2021: Cutaneous manifestations of ANCA-assoc vasculitis studied in 1184 GPA, MPA, EGPA pts and found to assoc w/ more severe disease. Common were petechiae/purpura (15%); allergic Sxs such as pruritus, urticaria, were more common in EGPA

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Are autonomous practices disappearing. With pandemic closures and big network buyouts of practices, less than 50% of practices are MD owned. This WSJ article (by the daughter of a Brooklyn Rheumatologist) explains why this is not good for patients. https://t.co/lVxBrhpHbh

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Clinic.... "is like a box of chocolates, you never know what you're gonna get" - Forest Gump

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Best of 2021: Seronegativity in RA studied using sera and microarrays from 559 RA (283 ACPA-) found 9 autoAbs w/ >90% specificity for seroneg RA. anti-PTX3 & anti-DUSP11 had best performance w/ sensitivity 38% & specificity 88% https://t.co/4ZQ7KmMszT

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Best of 2021: Avacopan - Is it Really a Win for ANCA-Associated Vasculitis? The NEJM has reported the results of a study showing that avacopan, a C5a receptor inhibitor, is as effective as steroids at treating patients with ANCA-AAV. https://t.co/vaoTNLy6ts https://t.co/euv8u0ScGH

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Best of 2021: Single center, 40 yr experience shows lupus psychosis to be rare. Among 709 SLE pts, 18 (2.5%) developed lupus psychosis. 2/3 remitted w/ antipsychotics & immunosuppressive Psychosis more likely w/ RNP and less likely w/ cardiolipin Abs. https://t.co/sKaZBqClyA https://t.co/i32kbIuEaX

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Best of 2021: Jack of All Subspecialties https://t.co/Nskfl0Y9qw https://t.co/BmMaoj2tuO

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Best of 2021: Perspectives on CV safety: JAKi (Tofacitinib) and TNF inhibitors https://t.co/pNBLklf6tY https://t.co/siJV8uhQOf

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