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Best of 2021: Jack of All Subspecialties
It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.
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Best of 2021: Perspectives on CV safety: JAKi (Tofacitinib) and TNF inhibitors
Safety comparisons of JAKi (tofacitinib) vs. TNFi from Oral Surveillance showed that, in patients with active RA on MTX and aged >50 years with one or more CV risk factors, that there was numerically more MACE events, malignancies, and VTE especially in higher dose.
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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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Best of 2021: A serious shortage of pediatric rheumatologists in the USA, where we need at least 1 ped rheum per 400,000 population. @RWCSmtg https://t.co/hUroLwclxz https://t.co/QHHNH99wJ0
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Best of 2021:Synovial Tissue Signature Guiding Targeted IL-6 Therapy in RA
RNA sequencing-based stratification of rheumatoid arthritis synovial tissue showed stronger associations with clinical responses compared with histopathological classification.
https://t.co/SD8ceTmbnm https://t.co/D98XBLj1YY
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Best of 2021: FDA Puts Boxed Warnings on JAK Inhibitors
https://t.co/O5RnyWcDQl https://t.co/EAiU7DRmBU
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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/JXVU9uoO4j https://t.co/SBxsgNRMr8
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Best of 2021: High Risk Cancer Profiling with Inflammatory Myositis
A recent metanalysis of studies suggest you may be able to use certain clinical factors to stratify cancer risk in patients with idiopathic inflammatory myopathies (IIMs).
https://t.co/v4F3jmfnNK https://t.co/1lflsgMZtE
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Best of 2021: Abbvie has released data from KEEPsAKE-1 and KEEPsAKE-2 studies (1407 pts) showing Risankizumab (IL--23 inhibitor) is effective in Psoriatic arthritis; RIS Rx pts achieved ACR20 of 57% and 51% at week 24 (vs PBO 34% and 27%; p<0.001) https://t.co/0C07aTlEQY
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Best of 2021: Vagal Nerve Stimulation in Rheumatoid Arthritis
Lancet Rheumatology has reported the results of a proof of concept trial, wherein vagal nerve stimulation was shown to ameliorate rheumatoid arthritis (RA) disease activity.
https://t.co/cXCVN85HTG https://t.co/BePEkIn9l8
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Best of 2021: Alveolar Hemorrhage and Mortality in Lupus
Metanalysis of patients with DA), show this to be a rare and life-threatening complication of SLE, that is more apt to affect older, severe lupus patients with active infection.
https://t.co/QvXiWKLTlm https://t.co/IFAS1loBId
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