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Urticarial Vasculitis Overview
Urticarial vasculitis is rare and the causes often go undiagnosed. A Medscape recent overview highlights key features in the diagnosis and management of this rare disorder.
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Immunomodulatory Prevention of Uveitis Relapse in Behçet's
The results of a randomised, open-label, head-to-head trial shows that adalimumab was superior to ciclosporin in preventing uveitis relapses in patients with severe Behçet's disease.
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Scleroderma Raynaud's May Worsen in Summer
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MedPage Today
Episodes of Raynaud's phenomenon, a common feature of systemic sclerosis (SSc, also known as scleroderma), were more severe not only at low temperatures, as one would expect, but also during summertime heat, a multinational study found.
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Good Clinical Practice Recommendations on Glucocorticoid Withdrawal and Adrenal Insufficiency
Glucocorticoids are widely prescribed as anti-inflammatory and immunosuppressive agents. This results in at least 1% of the population using chronic glucocorticoid therapy being at risk for glucocorticoid-induced adrenal insufficiency. This risk is dependent on the dose, duration and potency of the glucocorticoid, route of administration, and individual susceptibility.
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Sustained Hydroxychloroquine and Cardiovascular Outcomes
A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects agains cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).
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Metanalysis of Social determinants of health and lupus nephritis (31 studies) showed poor LN outcomes were 1.47-fold higher w/ any adverse SDoH. Also multiplicative impact of having two or more adverse SDoH on LN outcomes. https://t.co/4oEuAEgBx1 https://t.co/OkeRzrCXzQ
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Points to Consider when Managing Inflammatory Arthritis with Cancer
https://t.co/qLMPwDNMiy https://t.co/sL87mp0gd4
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Life Essential 8 (LE8) score studied in RA & SLE was neg. corrlated w/ DAS28 (r −0.96) & SLEDAI (r − 0.81) & assoc w/ 10 yr survival. LE8 score: smoking, sleep, physical activity, diet, BMI, non-HDL, BP, fasting glucose, & HgbA1c. https://t.co/DCpWKzmt80 https://t.co/eKqqEO1F65
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Biomarker subanalysis of a phase 3 RCT of SC Abatacept in 219 polyarticular JIA pts. Lower baseline levels of S100A8/9 & S100A12 predicted better response (JIA-ACR90 2.5) at 16 mos. Decr in S100A8/9 & S100A12 @4mos was >50% among responders https://t.co/TWx62EhRBl https://t.co/6uhoRowg3n
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Retrospective observational study of 96 stable #SLE pts compared maintenance on HCQ vs belimumab. There were no significant differences in Flare rate (18% HCQ vs 8.3% BLM; p=0.47), damage index increase, SLEDAI, Pred dose or adverse events https://t.co/sVPMugSHn3 https://t.co/6bdel6Kvs9
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Consumption of Alcohol and the Risk of Gout
Alcohol is a risk factor for gout and flares. While the inciting potential differs among alcohol types, are these differences sex specific?
https://t.co/CzE9ZSEN9f https://t.co/e4WBSBlNEo
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Scleroderma skin findings in pts w/ skin of colour (SOC) - Raynauds was common but SOC pts had fewer hallmark Sxs: telangiectasias, calcinosis, digital swelling (complicating Dx). SOC had more severe pulmonary Dz & increased mortality, Atypical skin findings… https://t.co/8XkelxqvYE https://t.co/JOw8OSNjzw
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It takes >3-4 weeks of steroids (@ any dose >5 mg pred/d) to pose risk of adrenal insufficiency – Hence, Endocrine Society Guideline says short-term glucocorticoid therapy of <3-4 wks, irrespective of dose, DOES NOT require GC tapering https://t.co/o7tz1Am9pe https://t.co/CndfCYRApj
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Birth Control Use in Lupus
Published guidelines on lupus mgmt urge that female patients plan and prepare carefully for pregnancy, and use contraceptives when it's not intended -- but these reco’s are rarely followed, a registry study suggested.
https://t.co/81mQbp5Sib https://t.co/NJmwxvtR44
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ANA's over time may be more dynamic than previously accepted. SLE & ANA+associated Dz tend to have higher titers, esp. higher in early disease, but decrease over time https://t.co/caUazl9U6S https://t.co/jBglFBJ886
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Renal Impairment in Rheumatoid Arthritis
Patients with highly active rheumatoid arthritis (RA) experienced faster declines in kidney function than those whose disease was under better control, analysis of a large registry indicated.
https://t.co/WaUDtJCitG https://t.co/RmPPLsihAG
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ACR Backs FDA Rule Change on Interchangeable Biosimilars
The ACR submitted comments to the FDA supporting their proposal to update the approval process for biosimilars’ interchangeability status.
https://t.co/YD11qZJxIr https://t.co/tVij0ebwz4
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ANCA-associated vasculitis analysis of 6 European registries, 3868 pts (2434 GPA, 1434 MPA), age ~57 yrs. Identified 5 clusters: 3 w/ renal dz a) variable ANCA, Hi CRP & Cr; b) MPO+; c) PR3+ & 2 extrarenal 1) PR3+ multisystem; 2) ENT w/ low CRP. Clusters better predicted outcomes… https://t.co/XZcSZ6lGjH https://t.co/yEg64YGTrA
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Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M
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Retrospective study of 58 pts w/ #SLE concurrent with PJP infx, showed that 39% died, with many of these having diabetes and invasive ventilation. A 4 fold incr Mortality seen risk factorsHyperglycemia/DM, decreased C3, & thrombocytopenia https://t.co/CqPpRXG8mN https://t.co/GyKbiU8GWY
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