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Big Time Vasculitis (3.10.2023)

Jack Cush, MD

Dr. Jack Cush Reviews the News and Journal articles from the past week on RheumNow. This weeks highlights includes insights on scleroderma, myositis, vasculitis and answers the question - does aggressive biologic treatment of psoriasis prevent future psoriatic arthritis?

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Higher Rehospitalization Rates in Younger SLE Patients

Jack Cush, MD

A Medicare study shows that young adults with systemic lupus erythematosus (SLE) exhibit very high 30-day rehospitalization rates (36%) that are significantly higher than older SLE patients and age matched non-SLE patients.

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NSAIDs in Pregnancy (3.3.2023)

Jack Cush, MD

Dr. Jack Cush reviews the lastest journal articles, news, and FDA announcements from the past week on RheumNow.  This week, the importance of IFNa, Subclinical PsA and NSAID safety during Pregnancy.

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Phase 3 Trials of Baricitinib Disappoint in SLE

Jack Cush, MD

Despite the encouraging phase II trial results of baricitinib in systemic lupus erythematosus (SLE) patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE, thereby halting development of baricitinib in SLE. 

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Half the Experts are Wrong (2.17.2023)

Jack Cush, MD

Dr. Jack Cush reviews the news and tries to stump the expert panel this week on the podcast.

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New Laboratory Insights for the ANA+ Consult

Jack Cush, MD

A new study suggests that use of ELISA assays for CXCL-10 and IFN-α can predict which ANA+ individuals may progress to developing a systemic autoimmune rheumatic disease (SARD).

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Serum beta-2 microglobulin (B2M) in 100 #SLE pts - strong correlations betw B2M & 24 hr urinary protein, BUN, creatinine, disease activity, & damage score (p < 0.001), & negatively correlated with GFR, C3, C4 (p < 0.001). B2M predicted lupus LN https://t.co/XujdKvjjoS https://t.co/vl8XXQDhXM

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Dr. John Cush RheumNow ( View Tweet)
Phase 3 Trials of Baricitinib Disappoint in SL Despite the encouraging phase II trial results of baricitinib in SLE patients, two parallel phase III trials have failed to redemonstrate the efficacy of baricitinib in active SLE. https://t.co/SwU7ujZnsP https://t.co/IgpCTtyDNA

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Dr. John Cush RheumNow ( View Tweet)
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/nhqg0ky7RT https://t.co/kBuqvJYFYE

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Dr. John Cush RheumNow ( View Tweet)
51 Juvenile SLE (j-SLE) studied for neuropsychiatric Dz (j-NPSLE)- 39% presented with jNPSLE. While no clear biomarker/imaging of j-NPSLE identified, they found CSF neopterin (& IFN-α) levels signif higher w/ active j-NPSLE & CNS involvement (p=0.0008) https://t.co/QM8yJGrBJu https://t.co/4hj1eE2JIC

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Dr. John Cush RheumNow ( View Tweet)
While anifrolumab targets IFN alfa in SLE, its unclear how much IFNa is needed for Rx response. A study of 40 pts shows Rx naive SLE has signif higher serum IFN activity; this is assoc w/ fever, leukopenia, ALE rash and oral ulcers & more organ damage https://t.co/RtI9ulurB1 https://t.co/wMl5DOyGB6

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/WIXDXUCG60 https://t.co/s7W9gcd5dd

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Dr. John Cush RheumNow ( View Tweet)
A retrospective study from a Taiwan health insurance claims data analysis looked at the association between Hashimoto's thyroiditis and lupus. https://t.co/159JNLY6tf https://t.co/JxR88a84MN

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 25 studies, betw 1985 - 2021, showed US average annual visits for RA=5.25 for US rheums (vs 3.3 ex-US) & 4.8 US non-rheums. SLE=3.24 & 12.3 for US non-Rheums. FM=1.8 for US rheums & 0.4 vs ex-US Rheums. Rheum Visits Decreased 1982 to 2019 https://t.co/5ugk34MJ3b https://t.co/NDMYZT7pil

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Dr. John Cush RheumNow ( View Tweet)
Toxic Epiderman Necrolysis vs Acute Cutaneous Lupus Erythematosus https://t.co/wKX3v01RUb https://t.co/SWwnH7ph04

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Dr. John Cush RheumNow ( View Tweet)
Steroids assisting options - CTX, LEF or RTX @anisha_dua @RWCSmtg @RheumNow #RWCS23 https://t.co/gVw2tGKYNG https://t.co/ItIKB8MFTI

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Dr. John Cush RheumNow ( View Tweet)
Case reports of anifrolumab use in 2 pts w/ chronic, scarring discoid lupus unresponsive to steriods, HCQ, immunosuppressants & CTX. Case 1 SLEDAI from 13 to 2 in 24 weeks & CLASI-A from 26 to 3 in 20wks. Cs 2 CLASI-A decr 24 to 5 after 1 infusion https://t.co/Qe2rF4Avxe

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Dr. John Cush RheumNow ( View Tweet)

Deucravacitinib - Effective in Systemic Lupus Erythematosus A Phase II, multicenter study has demonstrated the efficacy and safety of deucravacitinib, an oral, selective, allosteric inhibitor of TYK2, in adults with active SLE. https://t.co/YS8n02BEsk https://t.co/4sBd88AhtK

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Dr. John Cush RheumNow ( View Tweet)
Have you heard of nipocalimab? It prevents IgG-FcRn by binding to the FcRn IgG binding site. This is one to watch in our diseases (RA, Sjogren’s, SLE, myopathies.) Dr. Postolova #RWCS23 ⁦@RheumNow⁩ ⁦@RWCSmtg⁩ https://t.co/qMGA6IdtUE
Dr. Rachel Tate uptoTate ( View Tweet)
Older Lupus Patients Need Follow-Up After Hospital Discharge Medicare beneficiaries 65 and older with lupus faced dramatically higher mortality when they received no follow-up care during the month after a hospital stay, researchers found. https://t.co/4mFctXGQH9 https://t.co/2Q1z03myud

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Dr. John Cush RheumNow ( View Tweet)
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