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Opioid Deaths are Down (2.28.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.  Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!

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Valentine RNL 2025 Review (2.14.2025)

Jack Cush, MD

Dr. Jack Cush reviews highlights from RheumNow Live 2025 held in Dallas, TX on Feb. 8-9, 2025.

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EGPA in 2025

Richard Conway, MBBChBAO, PhD

Formerly classified as an ANCA-associated vasculitis, EGPA is both most commonly ANCA negative and clinically different to the other two ANCA-associated vasculitis conditions, GPA and MPA. The management of EGPA has frequently fallen into the trap of being copied from its more common and well-known cousins. Now, however, we are seeing a discordance and following GPA/MPA management will potentially lead to both over-treatment and suboptimal treatment for EGPA. In this context, the Sunday morning session at RNL 2025 on “EGPA management in 2025 and beyond” by Dr. Michael Wechsler was both timely and clinically relevant.

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Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C)

Jack Cush, MD

A nationwide cohort study of patients with multisystem inflammatory syndrome in children (MIS-C), a life-threatening complication of COVID-19 infection, showed that many had severe disease during the acute phase, but most recovered quickly and had a reassuring midterm prognosis.

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BACHELOR Trial - Baricitinib in Early Polymyalgia Rheumatica

Jack Cush, MD

Lancet reports a French study demonstrating the efficacy of baricitinib in patients with polymyalgia rheumatica (PMR).

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Alive in 2025 (1.10.2025)

Jack Cush, MD

Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com

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A Modifiable Vascular Risk in SLE

MedPage Today

Atherosclerosis progression was more than twice as common in younger people with SLE than in healthy controls in a prospective study from Greece, but the rate difference narrowed substantially with sustained SLE remission and conventional cardiovascular risk factor management.

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Livedoid vasculopathy (LV) is a rare chronic microvascular thrombosis dz w/ hypercoagulability and inflammation. Lit Search found 15 articles, 41 LV pts Rx w/ biologics & JAK inhib. 88% w/ positive responses & pain relief. TNFi were most used, then JAK inhibitors… https://t.co/3ugGdUlYcI https://t.co/0aXRKRi5RA
Dr. John Cush RheumNow ( View Tweet)
EGPA in 2025 Eosinophilic Granulomatosis with Polyangiitis (EGPA), the artist formerly known as Churg-Strauss syndrome, remains somewhat of a rogue agent among the vasculitides. https://t.co/4ofjQRYsMH https://t.co/PoVhaQ9QiZ

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Dr. John Cush RheumNow ( View Tweet)
Dr Rhee @RennieRhee mimics of medium/large vessel vasculitis. Increase in cross-sectional imaging use has increased the number of these we get referred. Segmental arterial mediolysis also pops up a fair bit. @RheumNow #RNL2025 https://t.co/yozRGE9Ncl

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Richard Conway RichardPAConway ( View Tweet)
#RNL2025 @RheumNow Dermatomyositis is VASCULAR disease -IVIG may help DM by blocking complement deposition on endomysial capillaries -CK levels not reliable Pruritus common in up to 86% of DM patients Dr. Charles-Schoeman, UCLA

Eric Dein ericdeinmd ( View Tweet)

RheumThoughts: Overlap Syndrome with ILD How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis? https://t.co/4RyV1zkphe https://t.co/qTZ4JYlJmW

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Dr. John Cush RheumNow ( View Tweet)
Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
Dr. John Cush RheumNow ( View Tweet)
🚨 Just 4 weeks until #RheumNowLive 2025! 🚨 📅 Feb 8-9 | Dallas, TX Don’t miss 1.5 days of cutting-edge #rheumatology education, interactive sessions, and unmatched networking! 🧠 Expert insights: 🔹 EGPA care innovations (Dr. Wechsler) 🔹 Vasculitis imaging… https://t.co/ObHBj1dQoK https://t.co/UuDZxBhdLr
Dr. John Cush RheumNow ( View Tweet)
Spanish registry ARTESER, looked at GCA outcomes from 2013 to 2019. In 1200 GCA pts ~ 2 yrs F/U, The 5-Yr mortality 37.9/1000 pt/yrs; higher in males vs females (59 vs 29 p<0.001), but was same as gen population . Incr mortality w/ age & male sex. HA & Hgb were protective… https://t.co/idnuUL9Kog https://t.co/2MsOxuTtCd
Dr. John Cush RheumNow ( View Tweet)
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV

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Dr. John Cush RheumNow ( View Tweet)
Upadacitinib in GCA. Merkel et al. SELECT-GCA study. Sustained remission week 52 Upa (+26 week steroid) 46% vs PBO (+52 week steroid) 29%. Reduced flare rates with UPA (see picture). Similar to GiACTA results. @RheumNow #ACR24 Abstr#0770 https://t.co/f7OwxAggaf… https://t.co/PUuwo0MLso https://t.co/JBzokT9icx

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Dr. John Cush RheumNow ( View Tweet)
TAPIR study of continuing vs stopping steroids in ANCA vasculitis in remission. Relapse at month 6 in 16% vs 4%. OR 4.22, but low rate in either group. If treated Rituximab, no difference! Merkel et al. @RheumNow #ACR24 Abstr#0774 #ACRbest https://t.co/F9DOBLrjVq https://t.co/BtphAuEopA

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Dr. John Cush RheumNow ( View Tweet)
To Behcet’s or not to Behcet’s? -Aphtous ulcers have unique features(broad ddx) -Oral+Genital ulcers=CAP not necessary BD. -Pathergy test ⬆️specific and not limited to skin! -Pulmonary arterial aneurysms=almost pathognomonic. -Do not get confused by HLAs. #ACR24 @RheumNow… https://t.co/3nWgILNVYw

Dr. John Cush RheumNow ( View Tweet)

Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated. https://t.co/8wvSy8555Z https://t.co/vaGt1AylBr

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Dr. John Cush RheumNow ( View Tweet)
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