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Managing JDM with Calcinosis

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

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Malar,rash,SLE, Lupus

Low Dose IL-2 Therapy in SLE

Jack Cush, MD

A multicentre, proof-of-concept trial of suggests that low-dose IL-2 therapy may be effective in moderate-to-severe systemic lupus erythematosus (SLE).

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SCLE,DIL,PPI

Drug-Induced Lupus from Proton Pump Inhibitors

Jack Cush, MD

A wide range of therapies have been implicated in causing drug-induced lupus erythematosus (DIL); now it appears that proton pump inhibitors (PPIs) can be added to the list of causative drugs.

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lupus.jpg

Less Organ Damage with Remission in SLE

Jack Cush, MD

A cohort study of SLE patients shows that remission and low disease activity (LDA) are associated with less damage accrual over time.

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Utility of Repeat ENA Antibody Testing

Jack Cush, MD

Repeat serologic testing is not uncommon, but is it warranted? A retrospective study shows that repeated testing for autoantibodies to extractable nuclear antigens (ENA) rarely changes the result or adds a new diagnosis. 

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The Great Unknowns (8.5.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news, FDA approvals, journal articles from the past week on RheumNow; plus viewer questions. This week great hopes for vitamin D, the great unknows of CSA and the great big mess that is the gout.

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ACR guidance

ACR Updated Guideline on Vaccinations for Rheumatic Patients

Jack Cush, MD

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).

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DLE discoid lupus

Plasmacytoid Dendritic Cell Inhibitor in Cutaneous Lupus

Jack Cush, MD

Litifilimab, a humanized monoclonal antibody against BDCA2, targets the BDCA2 receptor on plasmacytoid dendritic cells. When administered to patients with cutaneous lupus erythematosus (CLE) was shown reducing disease activity in CLE patients.

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Medicare study of 10,868 Hospitalized lupus pts. Looking at age groups. 30 d rehospitalization higher in young adult LE (36%) - 40% higher than those without LE, 85% higher older LE. Rehospitalization higher with Longer hosp stay & higher comorbidity. https://t.co/Ul91DX6H8r https://t.co/t3plpQQ8qn

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/cvmbzknQqA https://t.co/6mX5eRUNuU

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Dr. John Cush RheumNow ( View Tweet)
Urine-soluble CD163 as a biomarker in #SLE: usCD163 significantly higher w/ active lupus nephritis & correlates w/ UPCR, disease activity, anti-dsDNA Ab levels and a higher chronic kidney disease stage. https://t.co/Mxe53pCnEF https://t.co/BOspodqpSE

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Dr. John Cush RheumNow ( View Tweet)
Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study https://t.co/1fiNgBQUbr looks like lower ab response and drops over 6 mths - boosters important in our patients

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Peter Nash drpnash ( View Tweet)

NEJM - Lupus Pernio in Sarcoidosis - 71 yoM w/ red nodules on his nose, ears, fingers, and toes. The lungs were clear on auscultation. Angiotensin-converting enzyme level of 102. https://t.co/Vy9XQlRVKl https://t.co/wlyx3D9FzC

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Dr. John Cush RheumNow ( View Tweet)
Utility of Repeat ENA Antibody Testing Repeat serologic testing is not uncommon, but is it warranted? A retrospective study shows that repeated testing for autoantibodies to extractable nuclear antigens rarely changes the result or adds a new diagnosis. https://t.co/ncXqSMz0Qo https://t.co/FxHKjJsga3

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Dr. John Cush RheumNow ( View Tweet)
Of 38 childhood SLE (12-25yrs) pts, 65% were non-adherent to meds. Those taking MMF, 33% had MPA drug level < 1 (nonadherent). 17% non-adherent by pharmacy refills rate. 46% pts c/o side effects; 33% remembering & 25% could not afford. https://t.co/vL6LtYzJWe https://t.co/RAwwg40Lfz

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Dr. John Cush RheumNow ( View Tweet)

Cogan's syndr is a rare autoimmune dz, all ages (20-30s) & races (whites) w/ ocular (interstitial keratitis) & audio/vestibular Sx (deafness, vertigo). Less: HA, fever, myalgias, aortitis, heart. No Dx test; 1/3 have another systemic dz. Rx: steroids https://t.co/e3sstsxO5R https://t.co/CQ3UfBqO0e

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Dr. John Cush RheumNow ( View Tweet)
NEJM - Lupus Pernio in Sarcoidosis - 71 yoM w/ red nodules on his nose, ears, fingers, and toes. The lungs were clear on auscultation. Angiotensin-converting enzyme level of 102. https://t.co/BUvO9Y0rzs https://t.co/AhK6VMVBlD

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Dr. John Cush RheumNow ( View Tweet)
Do not take antacids or PPI with mycophenolate. Magnesium & aluminium hydroxide antacids (Maalox) will lower MMF Cmax 33% & AUC 17% if given simultaneously. PPI also lowers AUC by ~33% https://t.co/IoWISgL3SY https://t.co/JV1Yv5Pg9d https://t.co/b8UoQ4zMUV https://t.co/VwNgVQ5End

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Dr. John Cush RheumNow ( View Tweet)
Plasmacytoid Dendritic Cell Inhibitor in Cutaneous Lupus Litifilimab, a humanized monoclonal antibody against BDCA2, targets the BDCA2 receptor on plasmacytoid dendritic cells. https://t.co/nmadPUhlyH https://t.co/4UbNPMtxIh

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Dr. John Cush RheumNow ( View Tweet)
Belimumab (Benlysta) has been FDA approved for use in pediatric patients with active lupus nephritis who are receiving standard lupus therapy. The approval in kids is for the IV formulation only; SC belimumab is for SLE and LN in adults https://t.co/TKyNDwIUQH https://t.co/6VaMOMfwYi

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Dr. John Cush RheumNow ( View Tweet)
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