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Why Childhood SLE is More Severe than Adult SLE

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About 10 to 20% of all lupus patients are children, and the criteria to make the diagnosis of lupus are the same in pediatrics and adults. Why is pediatric lupus often more severe than adult-onset disease?

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Shifting the Management Paradigm for SLE and Lupus Nephritis

d Karen Costenbader, MD, MPH

The paradigm for treating patients with systemic lupus erythematosus (SLE) is rapidly shifting and our patients will surely benefit with improved outcomes.

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No Cancer Recurrence with Biologic DMARDs in RA

d Jack Cush, MD

A prospective Danish rheumatoid arthritis (RA) registry study look at the risk of recurrence when a biological disease-modifying antirheumatic drugs (bDMARDs) was ued in patients with a a prior solid cancer (in remission) and found no increased cancer

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Tocilizumab vs. Methotrexate in Rheumatoid Arthritis

d Jack Cush, MD

A large randomized rheumatoid arthritis (RA) clinical trial compared subcutaneous tocilizumab (TCZ) vs oral methotrexate (MTX) vs. the combination of subcutaneous TCZ and MTX, and showed that TCZ was superior to MTX, either given as TCZ monotherapy or in combination with MTX. 

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Moving Targets in Lupus and Lupus Trials

d Joan T. Merrill, MD

Clinical trial data quality is a moving target. Lupus is also a moving target. Can we address the moving target of lupus pathology with the moving targets of quality clinical trials and scientific treatment selection?

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Is Lupus Just a B Cell Disorder?

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I'm very happy to give you some insights entitled, “Is Lupus a B-Cell Disorder”. I will review some aspects, mainly pros and cons, but at the end you may forgive me, I will escape a little bit from a clear yes or no.

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Assessing neuropsychiatric SLE by 3-T, 3D contrast-enhanced vessel wall imaging. 47 w/ NPSLE vs 42 without (just SLE) showed the NPSLE had 2 fold more 1ntracranial contrast-enhanced vessel wall imaging (CE-VWI) w/ AUC 0.78 for CE-VWLs, & sensitivity 60% , specificity 87%.

Dr. John Cush RheumNow ( View Tweet)

If vagus nerve stimulation improves RA; then what if vagotomy? Danish study of vagotomy (1977-1995). 6070 vagotomy matched w/ 60,699 comparators. Truncal vagotomy was assoc w/ signif incr RA incidence (OR 2.62), but not superselective vagotomy (OR 1.05). NO diff in incident OA https://t.co/Rs1EyrQd57
Dr. John Cush RheumNow ( View Tweet)
Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/YbYPaJUEbz
Dr. John Cush RheumNow ( View Tweet)
Infusion/injxn-reactions (IRRs) w/ biologics studied in 1,832 RA pts - IRRs seen in 9.7% & were signif more common w/ being younger (OR1.79), secondary Sjögren's (OR 2.17), prior leflunomide (OR 1.5); but less common w/ Abatacept (OR 0.26) & tocilizumab (OR 0.42), golimumab (OR https://t.co/IaHajITWri
Dr. John Cush RheumNow ( View Tweet)
Emerging therapies targeting the NLRP3-inflammasome (active in Autoinflammatory Dz, Gout, neurodegenerative Dz/Alzheimers). Currently no FDA approved drugs, but many in trials. eg, Oxidized DNA (DAMP) activates NLRP3 & may be blocked by repurposed glycosylase inhibitors to reduce https://t.co/CJv50LVKhy
Dr. John Cush RheumNow ( View Tweet)
CAR-T and cellular depletion therapies gone wild! Currently there are over 85 different therapeutic candidates aiming to reset the immune system in >380 clinical trials. Review article looks at indications, targets, modalities & outlook. https://t.co/yleR4B48IY https://t.co/WwSPzIPomk

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Dr. John Cush RheumNow ( View Tweet)
Lupus Clinical Slides: Set 1 https://t.co/zFQqHfl8Ch https://t.co/MBzsixwhQc

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Dr. John Cush RheumNow ( View Tweet)
QD Clinic - Tackling Lupus Pregnancies Managing Lupus Pregnancy - pre-pregnancy, labs & safe drugs https://t.co/rtDVCCVqnD https://t.co/IRi1qYYqAA

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Dr. John Cush RheumNow ( View Tweet)
Panacea of Prednisone & Cannabis (5.16.2025) Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow. Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too! https://t.co/QDtxItYSco https://t.co/s4nYmMe3vs

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Dr. John Cush RheumNow ( View Tweet)
Pregnancy planning, contraception and safe drugs in Pregancy. Featuring Dr. Megan Clowse, Durham NC https://t.co/sZuq475VJv https://t.co/HZv9FuviaR

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Dr. John Cush RheumNow ( View Tweet)
SLE, Antiphospholipid Antibodies, and the Placenta It is well established that women with SLE are at increased risk for adverse pregnancy outcomes, including preeclampsia, preterm birth, and pregnancy loss. However, the pathophysiologic mechanisms driving these complications https://t.co/f8Up1112m9
Dr. John Cush RheumNow ( View Tweet)
Vitiligo affects up to 2% of people globally; more in blacks & hispanics than whites & more common in women > men. The prevalence has increased over time. Oral corticosteroids are most frequently prescribed, followed by other immunosuppressive drugs https://t.co/wNh6z3lKg1 https://t.co/hQo9sNn4kg

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Dr. John Cush RheumNow ( View Tweet)
Periprosthetic femoral Fx (PPFF): metanalysis of 36 studies found PPFF risk factors: Uncemented stems (OR 3.36), major teaching hosp (2.0), female (1.6), obesity (1.4), Hi comorbidity(1.4), RA (1.89), (1.67), revised THR (2.6). OA = protective (0.51) https://t.co/y2BpH8LUb6 https://t.co/EjX6R9QTK3

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Dr. John Cush RheumNow ( View Tweet)
MTX works in pulmonary Sarcoid! NEJM reports Open label RCT of 138 un-Rx pulm. Sarcoid pts w/ either MTX or placebo. After 24 wks MTX was noninferior to PBO w/ mean change in FVC (-6.7 vs -6.1). AE: more Wt gain, insomnia w/ pred & more Nausea fatigue LFTs w/ MTX https://t.co/8XMCM2DitR
Dr. John Cush RheumNow ( View Tweet)
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