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Vitamin D and Lupus Outcomes (11.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Retrospective study of 39 pts w/ MDA5 + DM-ILD Rx w baricitinib. 31 (79.5%) had improvement in Gottron’s, heliotrope, dyspnea, HRCT score, ferritin, LDH, steroid dose & 6 mo survival (87% vs. 70%, p = 0.047). https://t.co/8whN2I1hXh https://t.co/voSVzPQWUI
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A New Disease Activity Score for Antiphospholipid Syndrome?
APS is a systemic autoimmune disorder. It is characterised by the presence of antiphospholipid antibodies and a broad spectrum of clinical features, causing obstetric as well as thrombotic, microvascular and https://t.co/eouynDPLUX
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In 2024, 77 pts referred to Rheum for possible PMR were ultimately Dx w/ B19 viral infx. 96% had arthralgia & 7% had PMR-like features (5/5 w/ BL shoulder/neck. prolonged AM stiff, fever & Hi CRP/ESR - none had hip pain. 4/5 were male, w/ mean age of 55 yrs. None were RF/CCP+ https://t.co/lIX4gDLjqd
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25-Hydroxyvitamin D levels and Lupus Outcomes
Lupus patients entering a prospective cohort study with low vitamin D levels faced doubled all-cause mortality risk and tripled risk for major cardiovascular events during follow-up averaging 6 years, researchers said. https://t.co/CYwVy7ls7y
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Lupus Nephritis study of 136 pts followed 121 mos. Median time to wean GC to 7.5 mg/day, 5 mg/day & D/C was 9, 12 & 29 months post-Dx. Predictors of shorter time to D/C= Sustained CR/SLEDAI-2K≤4, membranous LN, & HCQ. Prolonged GC & renal flares increase damage accrual
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New quadrivalent modRNA influenza vaccine is more efficacious than conventional inactivated quadrivalent influenza vaccine. Really interesting excited to see mRNA technology transforming therapies. https://t.co/ZM13ojQUCl
Alberta Hoi alberta_hoi ( View Tweet)
PROSPERO meta-analysis shows an effect of diet on #RA risk. 8 independent studies (n=270,121) showed a reduced risk of incident RA with Anti-inflammatory (OR 0.56; 0.31–0.99), Mediterranean (OR 0.88; 0.78–0.99), and HEI (OR 0.60; 0.25–1.47), but not DASH diets https://t.co/qf4kTVyJ0m
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"Play the game for more than you can afford to lose... only then will you learn the game.”
- Winston Churchill
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Retrospective cohort study adult RA patients shows that TRIPLE Positivity (RF + /ACPA + /ANA +) was consistently associated with higher disease activity at baseline and 12 months of follow-up and lower rates of sustained remission compared to RF + /ACPA + /ANA- https://t.co/l2TQDShFYi
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No risk of MACE seen w/ initiation of IL-17(R)A inhib. French study of 34 241 ipts Rx IL-17(R)Ai and 381 MACEs. MACE risk was not elevated (OR, 1.25 [95% CI, 0.75-2.08] vs TNF-α inhibitors. https://t.co/WcjgRhr8mj https://t.co/Gp54eLlXSI
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APEX Study: Inhibition of structural damage progression with Guselkumab in PsA
Guselkumab, a human IL-23 inhibitor, was evaluated in patients with active PsA and shown to have both clinical and radiographic benefits at weeks 24 and 48.
https://t.co/iNEziysnVZ https://t.co/XgFGFfGf3b
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Pulse Steroids and Mycophenolate in Juvenile Dermatomyositis
JAMA Dermatology has published a pilot study demonstrating the safety and efficacy of intermittent intravenous methylprednisolone pulse (IVMP) therapy plus mycophenolate in 28 patients with JDM. https://t.co/i2HBycbWY9
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Rheumatology Supply and Demand (2009 - 2024)
A retrospective review of US rheumatology manpower and training from 2009- ‘24 shows that US rheumatology training has become competitive, with an increasing surplus of applicants compared to available training positions. https://t.co/2yWZt8eeEJ
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Target emulation trial of 12,145 Pts (87% female; age 80 yrs), shows that compared to teriparatide, Rx w/ romosozumab was assoc w/ significantly lower risk of osteoarthritis (RR 0.79); especially for knee OA (0.79). https://t.co/nEdENoNae7 https://t.co/JiyRd6ThXu
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Cochrane review & metanalysis of Colchicine & CV outcomes. 12 studies, 22,983 prt (11,524 on colchicine). Good evidence colchicine signif. reduces the risk of MI (RR 0.74), stroke (RR 0.67), but does not incr serious adverse events (RR 0.98), but causes GI AEs (RR 1.68) https://t.co/wqOtGLdxep
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Study of 489,569 UK Biobank participants (40 to 69yrs) betw 2006–2010 showed incident RA in 5404. Having self reported eating disorders (anorexia nervosa, bulimia, etc) was associated with a higher risk of developing RA (ad HR 1.76; 1.12–2.76), moreso in men (HR 5.09). https://t.co/GPV3YoE3kt
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Myelodysplastic & chr myelomonocytic leukemia pts rarely get lupus. Review of 19 w/ SLE & 5 w/ CLE; these were older (65 yrs), more male (15M/9F), w/ less renal [10%] & articular [36%] Dz w/ less dsDNA [32%]. Thought to be clonal inflammatory, & not autoinflammatory, process. https://t.co/EAvkJm6GQs
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ACR Applauds Bipartisan Support for Prior Authorization Reform Bill
The ACR commended the more than 295 bipartisan, bicameral cosponsors of The Improving Seniors’ Timely Access to Care Act, which, if enacted, would reform the prior authorization process for Medicare Advantage https://t.co/n0MKkSqRwO
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