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Trends in Rheumatoid Arthritis Mortality

Jack Cush, MD

A recent study examines trends in rheumatoid arthritis (RA)-related mortality among U.S. postmenopausal women (aged 55 and older). They found RA mortality rates have declined, yet disparities in who is most affected persist, especially for white women, and those over 85 yrs of age.

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The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

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IXCHIQ - a live-attenuated chikungunya virus vaccine: 10-30% have mild-moderate adverse effects, w/ headache, fatigue, & myalgia. <3% have severe AEs. Rare reports of encephalitis in elderly post Ixchiq, due to type I IFN-neutralizing autoantibodies (same w/ yellow-fever Vax) https://t.co/3VlZCd4sGc
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Turkish study of 128 Psoriatics (62 PSO, 66 PsA) found more periodontitis in PsA vs PSO (47% vs 31%; P=.058). Signif. higher levels of Dz activity seen for PSO (CPDAI: OR 1.38; P = .001) & enthesitis (MASES: OR 1.39; P < .001) if periodontitis present in PsA patients. https://t.co/d8OfarFWeG
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French Retrospective study (2011-22) of 36129 adult psoriasis pts on biologics who recv antibiotics (9366/26% @ baseline, 61% during FU). Abx treatment assoc w/ 12% greater risk biologic D/C (HR 1.12); more for multiple Abx courses (HR 1.29; 95% CI, 1.24-1.35) https://t.co/2Jv5xCibyd
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Diffuse Alveolar Hemorrhage in Rheumatic Disease A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/K1fLo5iHpd
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Mu3OyA4EOD
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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/NU553QwCtj
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Diffuse Alveolar Hemorrhage in Rheumatic Disease A retrospective, cross-sectional, single-center study of adult rheumatic disease patients with diffuse alveolar hemorrhage (DAH), demonstrates a high proportion have coexistent pulmonary infection and significant mortality risk. https://t.co/vpzF8Dnspr
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Retrospective study of recombinant zoster vaccine Rheumatic (RMD) pts on DMARDs (32% JAKi) (114) vs 65 normals. HZoster reactivation: no controls vs 1in RMD. 1 Dz flare requiried steroids. Minor AE (ISR, HA, myalgia) seen in 17.5% & 21.5% w/ 1st & 2nd dose. RZV is safe in RMD https://t.co/Hf7HaGOLXd
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Retrospective single center --103 EGPA pts finds 36 (35%) w/ cardiac involvement, having cardiac Sxs & biomarkers. Most common: pericarditis (77%), cardiomyopathy w/ CHF (55%), myocarditis (36%), cardiogenic shock (14%), cardiac arrest (6%), coronary v.asospasm (8%) https://t.co/JNdVNlVWvA
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A 2 yr. old female pt reported w/ a a novel P435S gain-of-function variant in TLR7 (thought pathogenic in SLE) - pt dx w/ juvenile SLE, recurrent infection, and neuroinflammatory features. A review of 12 other TLR7 GOF variants revealed similar SLE associations. https://t.co/TGgKDQ0D7F
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DANFLU-2 RCT of 332 438 elderly (43 881 w/ diabetes) tested high (HD-IIV) vs standard dose SD-IIV) flu vaccine. HD-IIV signif. reduced cardioresp., CV, CHF, influenza, hospitalizations vs SD-IIV, irrespective of DM status. Similar results previously seen in a Canadian RA pop. https://t.co/GGZPThoHrs
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Best of 2025: Distinguishing Septic and Gouty Arthritis A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal https://t.co/G31CazbqmR
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Hyperferritinemia is common in Hyperinflammatory syndromes but is a hallmark of Macrophage activation syndrome and Sepsis; and is a poor prognostic sign too. MAS is excessive activation of T-lymphocytes & macrophages leading to cytokine storm & multi-organ damage. https://t.co/PTJPhcvnzC
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