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DPGN, lupus, nephritis, GN, glomerulonephritis, biopsy, kidney

Increasing Risk of Lupus Nephritis

Jack Cush, MD

Population based study from Minnesota shows that the incidence of lupus nephritis (LN) in the US has increased in the last four decades and that LN patients have poorer outcomes with high rates of ESRD and mortality rates six times that of the general population.

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ACR Award Winners (10.21.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Highlighted discussion of implantable stimulators, urine proteomics and gut-immune responses to Prevotella in RA.

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Prgnancy,outcome

Pregnancy Outcomes with Belimumab

Jack Cush, MD

Pregnancy in systemic lupus erythematosus (SLE) is fraught with problems of adverse pregnancy outcomes, more pregnancy loss and birth defects. Now a study of SLE pregnancies exposed to belimumab (BEL) shows and expected rate of pregnancy loss but a variable rate of birth defects.

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heart,CV,MI.cardia,

Predicting Cardiovascular Events in SLE

Jack Cush, MD

A study from the Georgia Lupus Registry shows that systemic lupus erythematosus patients are at greatest risk for cardiovascular disease events between years 2 and 11 after diagnosis and higher in Black people or those with a discoid rash.

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death

Causes of Death in Lupus

Jack Cush, MD

The California Lupus Surveillance Project has longitudinally followed included systemic lupus erythematosus (SLE) cases and shown that overall, the leading cause of death was cardiovascular disease (CVD), followed by rheumatic disease and hematologic/oncologic conditions.

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Will we see you there? #ACR2022 What are you most looking forward to on the agenda? https://t.co/KQGHJtwboe
Dr. John Cush RheumNow ( View Tweet)
1915 Rheumatic (RMD)pts w/ COVID (42% RA. 15% SLE, 1/2 comorbidities); Outcomes: 28% hospitalized, 8% to ICU & 4% died from COVID-19. Poor COVID-19 outcomes seen w/ age, male, Hi Dz activity, steroids & RTX, & 1+ comorbidity https://t.co/ztBiJc9nxV https://t.co/RVOKyjseFJ

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Pregnancy Outcomes with Belimumab A study of SLE pregnancies exposed to belimumab (BEL) shows and expected rate of pregnancy loss but a variable rate of birth defects. https://t.co/kybCgu3Rlp https://t.co/ckshcgDZbD

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Dr. John Cush RheumNow ( View Tweet)
Analysis of WHO Safety Vigibase found 625 cases of drug-induced SLE - mostly female (78%), 59 yrs old, w/ half suspecting only PPI. Most common was Omeprazole (30%). Another 800K French database ID 39 pts w/ PPI CLE, half SCLE, 5% DLE https://t.co/vfAArCfWW1 https://t.co/3xQc5NZhvQ

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Hydroxychloroquine Dosing and SLE Flares A cohort study examining HCQ dosing in patients with SLE suggests that HCQ doses of 5 mg/kg per day or less, was associated with a higher risk of lupus flares, including moderate or severe lupus flares. https://t.co/VCn4hOs1PY https://t.co/bbVeVlD1u0

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Dr. John Cush RheumNow ( View Tweet)
Spondyloenchondrodysplasia - Very rare genetic skeletal dysplasia w/ short stature, platyspondyly, short broad ilia and enchondromas in long bones or pelvis. Varied phenotype w/ CNS (spasticity, retardation) & autoimmune (ITP, SLE, AIHA, thyroiditis) https://t.co/4DHqohjb2Z https://t.co/Bafh1v0MOA

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Dr. John Cush RheumNow ( View Tweet)
Follow us for real time coverage #ACR2022 https://t.co/5CBdiKWdKM
Dr. John Cush RheumNow ( View Tweet)
Pregnancy Outcomes with Belimumab A study of SLE pregnancies exposed to belimumab (BEL) shows and expected rate of pregnancy loss but a variable rate of birth defects. https://t.co/cXm58iSmVc https://t.co/Hdg6Qg1uHE

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Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine Dosing and SLE Flares A cohort study examining HCQ dosing in patients with SLE suggests that HCQ doses of 5 mg/kg per day or less, was associated with a higher risk of lupus flares, including moderate or severe lupus flares. https://t.co/UeIZ70zRnt https://t.co/tGrBSydvKB

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Dr. John Cush RheumNow ( View Tweet)
Urine proteomics on 54 SLE pts in the Belimumab–Lupus Nephritis trial, compared responders (n 31) v non-responders (n 22), on BEL or SOC. Reduction in urinary CD163 was strongly associated with complete renal response @wk52 & CD23 @wk24 https://t.co/PrXaJq6h0E https://t.co/IWREF9VmZ8

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Dr. John Cush RheumNow ( View Tweet)
Do you renal Bx your #SLE pts? Study of 277 SLE pts w/ US-guided percutaneous renal bx showed bleeding complications post biopsy to be 19.9% (minor 13%; major 7%); risk higher w/ thrombocytopenia (OR 7.12)low eGFR (OR 3.5) https://t.co/vYYChuGdSN https://t.co/kULTEnNYC9

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Rheumatology Salaries and Career Choices A recent Doximity report shows how rheumatology salaries increase by years in practice. Rheumatologists tend to earn their highest salaries after gaining 30-39 years of experience. https://t.co/wxWQruIlu9 https://t.co/gUsIffoHn6

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Record a Question or Comment... Rheums: Have a Rheumatology question or case for Jack Cush? Record it here and we'll feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/rICbSJzPbk https://t.co/VIjlR6xlwQ

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20% of SLE pregnancies end w/ adverse preg outcome (APO). Use of LASSO & Machine learning of PROMISSE data (385 pt) before wk 12 could predict APO based on BP Meds, low Plts, Dz activity, and LAC (AUC=0.78) https://t.co/DZJ9UCpwCk https://t.co/5yYgj9g0dP

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Proposed modified SRI (SLE Responder Index) - Reduction in SLEDAI-2K ≥4 (w/ no worsening in MD global (PGA) ≥0.3). mSRI responders had signif lower Dz activity & pred dose, More LLDAS & remission, less damage accrual (p<0.001) https://t.co/lwsZpnRz3l https://t.co/V7pDYswM7b

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