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RheumNow Podcast – High Science and Future Treatments (9.10.2021)

d Jack Cush, MD

This week: high science that affect future treatments; breakthrough infections in our patients, and what's up with that; and soon your radiologist is going to be replaced by AI. This and more in our review of the news and journal articles from the past week.

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FDA Review of Vaping Products Extended

d Jack Cush, MD

The FDA has again extended its decision on whether the manufacturers of vaping products can market their e-cigarettes in the United States.

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Risk Factors Associated with Systemic Sclerosis Hospitalization

d Jack Cush, MD

A retrospective study of systemic sclerosis patients shows that acute hospitalization and mortality were not uncommon and were often linked to SSc-related lung disease.

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Lymphoma in RA: Disease Activity Matters

d MedPage Today

Among patients with rheumatoid arthritis (RA), the strongest risk factors for the development of lymphoma were disease activity and severity, French researchers found.

In a multivariate analysis, having a high Disease Activity Score in 28 joints (DAS28) at baseline conferred twice the risk for lymphoma, with an odds ratio of 2.09 (95% CI 1.41-3.38), according to Gaetane Nocturne, MD, of Hôpital Bicêtre in Ile-de-France, and colleagues.

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J Hopkins study of 524 myositis-specific Ab positive pts shows that while 91% met 2017 EULAR/ACR criteria for Dx of myositis, 20% of HMGCR+ & 50% anti-PL7 did not classify as myositis; ~10% anti-SRP & HMGCR were dx as inclusion body myositis https://t.co/jcIn6SzbGG

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NOVEL: CRISPR-Cas9 genome editing of stem cells allows sensing of local inflammation & proportionally secrete a programmed anti-inflammatory biologic drug. Stem cells implanted in cartilage can prevent pain and inflammatory damage https://t.co/VNIgnvDU2C

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MMP13 is one of several key contributors to #OA. Novel research showing the IA depot of nanoparticles w/ small interfering RNAs targeting MMP13 (breaks down type II collagen) can reduce cartilage damage/loss in mouse model of post-traumatic OA https://t.co/3wy6Bdk4o0

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Differential Dx of immune-mediated necrotizing myopathies (IMNM) - HMGCR & Signal recognition particle Abs; checkpoint inhibitors, anti-Mi2 dermatomyositis, antisynthetase syndr. antimitochondrial Abs, GVHD, SARS-CoV-2 infection https://t.co/hhizx5gAet

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Among patients with rheumatoid arthritis (RA), the strongest risk factors for the development of lymphoma were disease activity and severity, French researchers found. #RheumNow https://t.co/mEYtTl2WRs https://t.co/KTluamv9gj

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Dr. John Cush RheumNow ( View Tweet)
Analysis of records from the Mass General Brigham healthcare system in the Boston area, shows that breakthrough infections (after receiving SARS-CoV-2 vaccines) in patients with SARDs are not uncommon, and may be severe or fatal. https://t.co/Ri5QipR7YY https://t.co/TaTFTKfAzm

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Cardiac coronary Ca score (CCS) in 20 asymptomatic systemic sclerosis (SSc) pts vs controls.CCS incr (& higher scores) in 45% SSc vs 10% controls. CCS values higher in Limited vs diffuse SSc. CCS > 100 assoc w/ age, dz duration obesity https://t.co/aDWpoePqXK

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When MGUS isn't MGUS! (MGCS, C = Clinical) Literally, every MGUS consult I consult this https://t.co/JymQ8A8V2U + urticaria = Schnitzler's + ataxic neuropathy+opthalmoplegia= CANOMAD +⬆️RBC+pulm shunt+telangiectas = TEMPI + bleed = aVWD, amyloid (⬇️X) + cap leak = Clarkson ... https://t.co/m1qpWo4xjh

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Aaron Goodman - “Papa Heme” AaronGoodman33 ( View Tweet)
Among patients with acute #gout flare, early vs late initiation of #allopurinol did not show significant changes in time to resolution, flare recurrence, or inflammatory makers. #Rheumatology https://t.co/PhJNbOjWbp

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Rheumatology Advisor RheumAdvisor ( View Tweet)

Confused by all the different types of #COVID 19 tests? They are broken down in an easy-to-use tool here: https://t.co/P5jHhnzFej #Antigen #Antibody #PCR @CreakyJoints @IFAiArthritis @US_Pain @IAFaccess @colorofcci @patientaccess @aimedalliance @patientsrising @AARDATweets

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Lupus Association LADAOrg ( View Tweet)

3 of 4 COVID hospitalized in NJ are unvaccinated. - 5.6 mill fully Vax; 2.7 mill unvaccinated, - COVID hosp. rate of 4.33/100,000 fully vaccinated & 26.33/100,000 for unvaccinated. - Unvaccinated are nearly 6 times more likely to be COVID hospitalized https://t.co/nvDNODBlRW https://t.co/h3CcLXGLXG

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Telephone survey of 278 Rheumatic Pts during COVID (July 2020) showed 22% reduced/interrupted treatments, only 11 (4%) stopped. Decisions made by half (49%). Stop Reasons: anxiety (48%), IV Rx access (45%), Rx unavailability (6.5%) https://t.co/XgJ1TJsHJG

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Two cohorts from the Nurses’ Health Study (1984–2014 & 1991–2013) showed no association between diet & increased risk of incident #SLE; but that a high nut/legume diet may be associated with a reduced SLE risk https://t.co/mbBs7KZA6A

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What's your prediction when the Pandemic will end and we can travel, vacation, hug & handshake?

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JAMA: In women with spontaneous abortions, COVID-19 vaccine exposure was not increased compared with women without Spont Ab (ongoing pregnancy). COVID-19 vax given to 8.0% ongoing pregnancy vs 8.6% spont ab (adj OR 1.02) https://t.co/wEeaMR98Mf

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UK study shows PreClin RA, Establ #RA 1) have increased bowel permeability; 2) gut permeability worsens w/ activity; 3) gut-permeability markers not affected by treatment; 4) in a RA Mouse model-blocking gut permeability ameliorates arthritis https://t.co/HZNl56cQnn

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