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Best of 2022: Approach to ILD in Myositis Syndromes
Mehta et al have published a full read review of managing interstitial lung disease (ILD) in patients with inflammatory myopathies, a heterogeneous group of syndromes connected by ILD and and increased morbidity and mortality risk.
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CXCL5 Therapy in Lupus?
EurekAlert!
A new study has shown that restoring the balance of a protein in blood may be a promising treatment option for systemic lupus erythematosus.
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Study of 119 SLE pts (30 w CKD) shows urinary galectin-3 binding protein as a biomarker, increased w/ active LN, significantly (p<0.001)correlating w/ SLEDAI, SLICC RAS, histologic activity; higher in proliferative vs membranous LN (p=0.04) https://t.co/DlJzREdj0h https://t.co/peqZzpQrWk
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Leflunomide versus azathioprine in lupus nephritis? Study of 215 bx proven LN given either LEF or AZA - Renal flares were equal (15.7% v 17.8%), as was time to flare (16 mo vs AZA 14 mo); 24-hr proteinuria, creatinine, C3 and C4 improved similarly.
https://t.co/fbzhuFT3lh
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From the Hopkins Lupus cohort - Just one month of Prednisone 40 mg/d yields a FOUR fold increase in avascular necrosis risk #UTSWSLE2022 https://t.co/Kae2PMVgl7 https://t.co/XuhbkBwlCw
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Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies
Women of reproductive age comprise an overwhelming majority of patients with rheumatic and musculoskeletal disease.
https://t.co/x44GTLRtnT https://t.co/YlLgqeDRgP
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Dr. John Cush RheumNow ( View Tweet)
73-87% of autoimmune (RA, SLE, UCTD, APL) pts used HCQ during pregnancy. HCQ significantly reduced pre-eclampsia (20% vs 9%), early-onset pre-eclampsia (8% vs 2.5%), 2nd/3rd trimester pregnancy loss (3% vs. 0.6%) https://t.co/CF5ivHeCmY https://t.co/CYqaCCuZJz
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Review of the Rheumatic causes of Pericarditis and their management. Causes: SLE, RA, MCTD, Myositis, EGPA, GPA, IgG4-rel Dz, FMF, TRAPS, CAPS, AOSD, JIA, Sarcoidosis, Kawasakis, GCA, Takayasu's https://t.co/MQmkUe4Yey https://t.co/FSfrznoeBe
Dr. John Cush RheumNow ( View Tweet)
Lupus Research Alliance announced 2022 Distinguished Innovator Award recipients:
- Hongbo Chi, PhD, Exploring Metabolism of Follicular Helper T Cells & Lupus Progression
- Joseph Craft, MD: Processes Enabling T Cells to Be Destructive in Lupus Nephritis
https://t.co/yI2NlCHaBi https://t.co/fevBTkaxCY
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Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies
Women of reproductive age comprise an overwhelming majority of patients with rheumatic and musculoskeletal disease.
https://t.co/45ABQ0e2Qy https://t.co/dhLqzjf9uL
Links:
Dr. John Cush RheumNow ( View Tweet)
From a cohort of 689 SLE pts, prevalence of lupus pericarditis was 16.4% Pericarditis was signif assoc w/ renal dz (p 0.003), lymphopenia (p <.0001), thrombocytopenia (p 0.004), +APL Abs (p = 0.002) https://t.co/BndDu21aXF https://t.co/Umbq3rsF1y
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Dr. John Cush RheumNow ( View Tweet)
Review of the Rheumatic causes of Pericarditis and their management. Causes: SLE, RA, MCTD, Myositis, EGPA, GPA, IgG4-rel Dz, FMF, TRAPS, CAPS, AOSD, JIA, Sarcoidosis, Kawasakis, GCA, Takayasu's https://t.co/h6zpTOIuyu https://t.co/Gy3Eaqz8sM
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Study 119 SLE pts w/ SLEDAI-2K of 13.5 @Dx & 2.8 @ 1st birth. Half had 1+ flares at mean of 9 mos after birth. Pts in remission had less flares (37% vs 61%; p=0.008). SLE flares during pregnancy had more flares in F/U (76% vs 47%; p=0.019) https://t.co/3u3agu9wDj https://t.co/twj4YYclRz
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Tight control of proteinuria in newly diagnosed lupus nephritis
The last 3 years have been exciting times in the field of lupus nephritis (LN) with two new licensed therapies, belimumab (BAFF-inhibitor) and voclosporin (calcineurin-inhibitor).
https://t.co/InkX6I7qUm https://t.co/U1M1DtF8Id
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Inadequate Dosing of Hydroxychloroquine Leads to Hospitalizations in SLE
https://t.co/ZktIKo1eVl https://t.co/dtxVXZFXpk
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Review of 120 pts w/ Catastrophic antiphospholipid syndrome showed that 54% had skin involvement & was 1st APS sx in 35%. Findings: livedo racemosa (45%), necrosis/ulcers (42%), splinter hemorrhages (29%), distal edema (23%), purpura (14%). https://t.co/HsVWlebfL2 https://t.co/dixoeHNkFQ
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SLE preg delivery hospitalizations (77560) was associated with increased risk of CV complications, including preeclampsia [aOR 2.12] , peripartum cardiomyopathy (4.42), CHF (4), arrhythmias (2.2), AKI (7.7), stroke (4.8), VTE (6.9) w/ incr hosp costs https://t.co/PF6P8oDWZB https://t.co/jA2pHcciB1
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SLE: Variability in Racial Disparities in Pregnancy Outcomes
Significant disparities exist in pregnancy outcomes in women with SLE, w/previous cohorts identifying Black women as having a higher risk of maternal mortality compared to White women w/SLE.
https://t.co/1PrJYpMcHx https://t.co/YN7K0Gf5Jl
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Lupus Linked With Greater Risk of Cardiovascular Complications of Childbirth
Pregnant women with SLE were more prone to cardiovascular complications during delivery, and their risk seems to have increased over the past 15 years, according to data.
https://t.co/mRUOVrKbt2 https://t.co/m18DWxSV20
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Study of 294 SLE pts on HCQ (2005-2021): 37 (13%) developed CHF w/ low EF (HFrEF), arrhythmia or cardiac death. After adjustments, wt-based dosing of HCQ not assoc w/ cardiac events(sHR 0.62; 0.41,0.92) & may decrease risk in non-smokers https://t.co/11dneH04bv https://t.co/pp0ELe5mqV
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