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How Does Your Garden Grow (9.26.2025)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA.
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What is IPAF?
Idiopathic Interstitial Pneumonia with Autoimmune Features - or IPAF - describes patients with interstitial pneumonia with autoimmune features, but they don’t meet a diagnosis of a CTD.
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Polypharmacy Impairs Rheumatoid Arthritis Outcomes
A French early rheumatoid arthritis (RA) study has shown that polypharmacy (PP) was associated with significant lower treatment responses and more serious adverse events (SAEs).
Malignancies Not Increased with Biologic Therapies
The risk of malignancy in rheumatoid arthritis (RA) patients receiving biologic agents was evaluated by metanalysis of randomized controlled trials (RCTs) and found no significant increased risk of malignancy compared with other disease-modifying antirheumatic drugs (DMARDs) or with placebo.
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Rheumatoid arthritis begins long before symptoms
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EurekAlert!
Scientists have discovered that rheumatoid arthritis (RA) doesn’t start when the pain begins. It silently starts years earlier.The new research reveals that people at risk for RA experience dramatic immune system changes long before they feel symptoms.
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QD Clinic: ILD with Positive SSA and Rash
Dr. Elena Joerns, Rochester, Minnesota discusses a case of ILD with positive SSA and rash, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025.
https://t.co/Yuz8CuIN5H https://t.co/3M9emsIXVf
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ILD and ANCA: What to do?
Several cohort studies conducted in Asia, Europe and the Americas have evaluated the clinical significance of ANCA when detected in patients with ILD as well as the types of ILD encountered in patients with microscopic polyangiitis (MPA) and their https://t.co/nrToywCaKm
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Rheum to Breathe Journal Club
In this journal club, we will discuss two pivotal studies in ILD, the FIBRONEER study and the RECITAL study: Nerandomilast in Patients with Progressive Pulmonary Fibrosis, Maher, T.M. et al. NEJM. 2025 May 19.
https://t.co/L0gIsP5nAn https://t.co/026GbJdCvJ
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Screening for RA-ILD: metanalysis of 9 studies, 1380 RA pts - RA-ILD prevalence ranged from 6.7-42.7%; 18.9% via HRCT. None examined risk factors. Male sex & smoking were ~12% higher in RA-ILD & RA disease onset age was 7 years higher in RA-ILD pts. DAS didnt https://t.co/qA2oitwQg5
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CAR-T Product Shows Early Promise in Lupus
Five patients with systemic lupus erythematosus (SLE) in China have been treated with a potentially groundbreaking form of chimeric antigen receptor (CAR) T-cell therapy, researchers reported, with encouraging results after 3 months. https://t.co/eg37PZK6kn
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PPP syndrome = a rare triad
👉 Pancreatitis + Polyarthritis + Panniculitis
🔬 Pathogenesis: circulating pancreatic enzymes (esp. trypsin) → fat necrosis in subcutis & bone marrow.
📌 Clue: painful nodules + arthritis, often with minimal abdominal symptoms.
#Rheumatology https://t.co/3qniCmahgl
ILLIASUL IBAD IlliasulK ( View Tweet)
Inception SLE study of 674 pts (without LN), mean age 34 yrs - 154 (23%) developed new proteinuria (LN) after median of 3.6 yr. Cumulative antimalarial exposure did NOT lower risk of LN (HR 0.98; 0.94-1.02); same for those w/ serologically active SLE (HR 0.97) https://t.co/8OU3yJAvhN
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OL study of 60 pts w/ new idiopathic retroperitoneal fibrosis (GFR >30) Rx w/ low dose MTX+pred VS Pred only. @ 9 mos remission: 90% MTX+Pred vs 81% Pred (noninferior). Time-to-remission, RPF thickness & relapses were same; but pred use was lower w/ MTX+pred (p < 0.001) https://t.co/13cjnl4Ke4
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Turkish study of 799 psoriasis pts - 30% had concurrent onset PsO & PsA & in 70% there was a long transition time (~13 yrs) from PsO-to-PsA. Factors assoc w/ prolonged interval included Depression, fatigue, scalp PsO(OR 7), nail PsO (3.2), +Fhx & enthesitis ever (OR 2) https://t.co/wqtSbeQ2vz
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Canakinumab in VEXAS - 47 males Rx w/ anakinra (44), canakinumab (9), or both(6). Response @1 mos: ANAK 34% vs CANK 100%; 22% vs 78% @ 3 mos. Drug survival was 54 mos CANK 300/m; 7 mo CANK 150/m; 1 mo ANAK. More ISR (47% v 0) & infx w/ ANAK https://t.co/Y3iSfajTal https://t.co/qTNamGDwVI
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Prospective French study of 101 RA-ILD (mean 66yrs) assessed for shorter WBC telomere length (LTL); short LTL seen in 43% & assoc w/ lower FVC (82% vs 93%pred) & TLCO (49% vs 63%) & greater FVC/DLCO decline & lung progression after 12 mos (47% vs 22%; p<0.001) https://t.co/ObVeon0riy
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Monthly survey - 351 ArthritisPower #RA Registry pts reported 523 nonserious infxns (31% ; most URI), few resulted in ED or hospitalization. But NSIA led to missed work (37%) or RA Rx interruptions (26%) and more fatigue. NSIE may contribute to more disease flares https://t.co/Al5B5oxvFg
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DERM on RheumNow Podcast (September 2025)
Content curated for dermatologists and skin deep HCPs – on Psoriasis, CLE, vasculitis, HS and dermatology drugs use, efficacy and side effects and more.
https://t.co/zZpheX1epS https://t.co/uOd9Gy0V2E
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QD Clinic: Stick or twist (when not to change treatment
Dr. Richard Conway, Dublin, discusses a case about when not to change treatment, as part of RheumNow's Rheum to Breathe: ILD campaign, presented throughout the month of September 2025.
https://t.co/kUopZ1bpVi https://t.co/mt0tKcQzKQ
Dr. John Cush RheumNow ( View Tweet)
Assessing ILD in Rheumatology
Janet Pope, MD, shares practical insights on how rheumatologists should assess ILD in their patients. Sponsored By: Boehringer Ingelheim
https://t.co/Mxg9P50m7C
#ILD #Rheumatology https://t.co/aAuxbJBxBn
Dr. John Cush RheumNow ( View Tweet)
