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Lungs ILD

Approach to ILD in Myositis Syndromes

Jack Cush, MD

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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Rheumatic Causes for Fever of Unknown Origin

Jack Cush, MD

Fever of unknown origin (FUO) represents a diagnostic challenge to many physicians and while cancer and infectious causes need to be excluded, rheumatic disorders are amongst the most common causes of FUO.

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Nintedinib’s Durable Efficacy in Systemic Sclerosis

MedPage Today

Patients with interstitial lung disease (ILD) related to systemic sclerosis continued to see less progression when treated with nintedanib (Ofev) in the pivotal 100-week SENSCIS trial, researchers said.

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Mitochondria as Master Regulators of Inflammation

Jack Cush, MD

Mitochondrial constituents and metabolic products may give rise to immune activation; this is especially true for mitochondrial DNA, which can function as damage-associated molecular patterns (DAMPs) leading to inflammasome activation.

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Early, Aggressive and Seropositive (7.22.2022)

Jack Cush, MD

Dr. Jack Cush covers the news and journal reports from the past week on RheumNow.com. This week we have Insights NAFLD, overdose deaths, septic arthritis, refractory stills, & when MTX doesn’t work.

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Fever Pitch (7.15.2022)

Jack Cush, MD

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on RheumNow.com

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Can Antimalarials be Withdrawn in Quiescent Lupus?

Jack Cush, MD

Antimalaria (AM) therapy is a cornerstone to the management of systemic lupus erythematosus (SLE), yet a recent study suggests that slowly tapering AM yields a lower rate of SLE flares. 

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Japanese SLE registry looked at infection risk with Prednisolone (PSL). Among 509 SLE pts (47 yrs); 77% used immunosuppressants & 52 had hospitalized infxns. Signif higher SIE w/ PSL 5.0–7.5 mg (aHR 6.8) & PSL 7.6-15 mg (aHR 7.6) vs 0-2.5 mg/d https://t.co/xZ5Yx4X1uw https://t.co/FSfsTENeUx

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Study of 245 active SLE pts followed x 2 yrs shows low disease activity (LLDAS) achieved in 63%. By multivariate analysis, negative predictors of LLDAS were nephritis, heme involvement & low C3/C4. Early LLDAS predicted future LLDAS-50 https://t.co/IQaDFRtrZy https://t.co/G6MdBOMftX

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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/LCUFDpZM6j https://t.co/R2kA2DbxKy

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Have you checked out our new sister-site, Still's Now? A new site for Still's disease, autoinflammatory & febrile disorders. https://t.co/oWEugnOB6k https://t.co/5jwiP2Xqrz

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11.5% of Crohns pts have TNFi use contraindications (either MS, CHF, neoplasia, infx risk, TNFi AE, comorbidities, SLE. Alternatively GI survey respondents use ustekinumab (76%), vedolizumab (249%), or tofacitinib (0.5%) https://t.co/6ApUz93iS0 https://t.co/PTmnsTd2Wh

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213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/jRVXCj4MlV https://t.co/gamOOwkJ5R

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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/2TWmweS2wy https://t.co/0YzlU4vfXP

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Rheums: Got 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/QUTIbK3r89 https://t.co/FZcTLREida

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Rheumatologist Survey: What do you rely on MOST in diagnosing Still’s disease? Sxs? Labs? Both? Criteria? Fever? Vote here: https://t.co/oANKpKqJA5 https://t.co/LIjRSBHNBi

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Dr. John Cush RheumNow ( View Tweet)
213 #SLE pts were screened for Cryoglobulinemia (2013 -2017); CG is frequent in SLE (66%), but mostly asymptomatic. Mean levels 40mg/L (0-228). Cryo Vasculitis in 15% w/ purpura, ulcers, digit ischemia, arthritis, GN (5%) or CNS (19%) https://t.co/R6xUJldgC2 https://t.co/mwsSTI3ztk

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Dr. John Cush RheumNow ( View Tweet)
Can Antimalarials be Withdrawn in Quiescent Lupus? Antimalaria (AM) therapy is a cornerstone to the management of systemic lupus erythematosus (SLE), yet a recent study suggests that slowly tapering AM yields a lower rate of SLE flares. https://t.co/dYJy5BOKay https://t.co/pgz694ep2G

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Dr. John Cush RheumNow ( View Tweet)
Ustekinumab (IL-12/23i) phase 2 study was successful in #SLE; but the phase 3 LOTUS study of 512 pts, UST was NOT superior to PBO (SRI-4 44% v 56%) at 1 year. Study was halted for lack of efficacy (but no safety concerns). https://t.co/uMY5uPPabA https://t.co/nG2RO6oEJQ

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Li et al. Orelabrutinib in SLE. 60 patient phase 2 RCT. Week 12 SRI(4) 50.0%/61.5%/64.3% in orelabrutinib groups vs 35.7% PBO. @RheumNow #EULAR2022 LB0005 https://t.co/wWJhlY5IYW cc: @RichardPAConway : https://t.co/2IAURdfAOB

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