The NEJM has published the results of a phase 2 randomized trial showing that the use of an interleukin-36 receptor inhibitor, spesolimab, resulted in rapid improvement of generalized pustular psoriasis (at 1 week), but that adverse events and infections were of concern with 12 weeks of foll
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Since the introduction of COVID-19 vaccines in January 2021, rheumatologists have fully advocated the protective benefits of their use - yet many have rarely noted flares and reactive side effects worrisome to patients. Now a multinational study shows that the use of COVID vaccination in rheumatic and musculoskeletal disease is safe, well-tolerated with very rare serious adverse events.
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It's great to be a rheumatologist, but boy, it's getting harder and harder. You have to be a jack of all trades. You have to be good at cardiovascular disease, osteoporosis, vaccination, inflammatory bowel disease - it just never ends. This and more, as Dr. Cush summarizes more than a dozen journal articles, news reports and questions + cases.
Of 173 autoimmune inflammatory rheumatic Dz pts w/ respiratory Sx, 46 had Pneumocystis jirovecii. Higher risk of PJP w/ high-dose steroids, recent immunosuppressives, combo w/ CsA, hx of chr lung dz, high LDH, ground glass CXR https://t.co/P8KtC2Hab8
Study of biologic/ts DMARD switching in 8,398 axial spondyloarthritis pts from 5 Nordic registries showed a low rate of multiple switches (refractory?) over 3 years; ≥3 DMARDs (8%), ≥4 (3%) & ≥ 5 (1%); more w/ women, comorbiditiy & psoriasis https://t.co/ZQDvl6AaZz
Best of 2021:Hydroxychloroquine related hyperpigmentation appears as blue/ black discoloration of skin or mucosa, occurs in 7-30%; Recent report says ~5%; Risk factors include steroids, bruising, anti-coagulants & trauma - theyr slow to resolve if you D/C https://t.co/IJDolwNyDx
Best of 2021: Comparison of oral and parenteral MTX shows oral MTX in RA is non inferior to subcutaneous MTX treatment (in 640 RA pts) with regard to disease activity, but oral MTX had fewer adverse events than SC ( 41% vs 52%, p= 0.005). https://t.co/4RB7SxuGx7
121 Sjögren’s pts dx w/ non-Hodgkin's lymphoma - 76% were MALT lymphoma (9% Diffuse Large B Cell, 7% Nodal Marginal Zone Lymphomas). MALT 10-yr survival was 79% MALT. Predictors were Cryoglobulinemia, focus score, ESSDAI at Dx https://t.co/EYsB06DU4s
Best of 2021:Danish Cohort study of 5310 cutaneous LE/SLE pts between 1995-2014 (7-8 yrs F/U & 40.724 PYs) shows overall increased cancer risk for CLE (SIR 1.35)and SLE (1.45), esp a 3-4 fold increased risk for NHL, hematological, pancreatic & lung cancers https://t.co/Lgbe2hwtNj https://t.co/NzjM5LCuaX
Are autonomous practices disappearing. With pandemic closures and big network buyouts of practices, less than 50% of practices are MD owned. This WSJ article (by the daughter of a Brooklyn Rheumatologist) explains why this is not good for patients. https://t.co/lVxBrhpHbh
Best of 2021: Seronegativity in RA studied using sera and microarrays from 559 RA (283 ACPA-) found 9 autoAbs w/ >90% specificity for seroneg RA. anti-PTX3 & anti-DUSP11 had best performance w/ sensitivity 38% & specificity 88% https://t.co/4ZQ7KmMszT
Best of 2021: Avacopan - Is it Really a Win for ANCA-Associated Vasculitis?
The NEJM has reported the results of a study showing that avacopan, a C5a receptor inhibitor, is as effective as steroids at treating patients with ANCA-AAV.
https://t.co/vaoTNLy6ts https://t.co/euv8u0ScGH
Best of 2021: Single center, 40 yr experience shows lupus psychosis to be rare. Among 709 SLE pts, 18 (2.5%) developed lupus psychosis. 2/3 remitted w/ antipsychotics & immunosuppressive Psychosis more likely w/ RNP and less likely w/ cardiolipin Abs. https://t.co/sKaZBqClyA https://t.co/i32kbIuEaX
Best of 2021: Jack of All Subspecialties
https://t.co/Nskfl0Y9qw https://t.co/BmMaoj2tuO
Best of 2021: Perspectives on CV safety: JAKi (Tofacitinib) and TNF inhibitors
https://t.co/pNBLklf6tY https://t.co/siJV8uhQOf
Best of 2021: A serious shortage of pediatric rheumatologists in the USA, where we need at least 1 ped rheum per 400,000 population. @RWCSmtg https://t.co/hUroLwclxz https://t.co/QHHNH99wJ0
Best of 2021:Synovial Tissue Signature Guiding Targeted IL-6 Therapy in RA
RNA sequencing-based stratification of rheumatoid arthritis synovial tissue showed stronger associations with clinical responses compared with histopathological classification.
https://t.co/SD8ceTmbnm https://t.co/D98XBLj1YY
Best of 2021: FDA Puts Boxed Warnings on JAK Inhibitors
https://t.co/O5RnyWcDQl https://t.co/EAiU7DRmBU


