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Moneyball Rheumatology (5.30.2025)
Dr. Jack Cush reviews the book/movie, "Moneyball" and a suggests moneyball strategy is needed to find next level responses for our patients.
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Do SGLT2 and GLP-1 therapies have a role in Lupus?
Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i) and Glucagon-like peptide-1 receptor agonists (GLP1-RA) were initially developed as glucose-lowering agents for the treatment of Type 2 Diabetes. Since their introduction, they have been noted to have a myriad of other benefits, including cardiovascular and renal protective effects in patients both with and without diabetes. Here, we will review the evidence for SGLT2i and GLP1-RA in lupus.
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Belimumab in SLE with Mucocutaneous or Vasculitis Findings
A post hoc analysis of a belimumab (BEL) inn systemic lupus erythematosus (SLE) study showed lupus mucocutaneous and vasculitic manifestations improve with BEL and standard care.
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Valves Gone Wild in SLE
Lupus valvulitis is a rare cardiac manifestation of active systemic lupus erythematosus (SLE) and is defined by inflammation of one or more cardiac valves. It is often associated with Libman-Sacks endocarditis, which is characterized by the presence of sterile vegetations on the heart valves.
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Early RA or undiff. arthritis (UA) shows initial hi-dose steroids have significantly better earlier outcomes, but lower doses have fewer early side effects. IMPROVED used high dose GC (60 mg/d tapered to 7.5 mg in 7wks). tREACH used lower dose GC (15 mg/d tapered in 10 wks to https://t.co/TkrGPb6EBZ
Dr. John Cush RheumNow ( View Tweet)
JAMA CME review of Immune Thrombotic Thrombocytopenic Purpura (iTTP) - thrombotic microangiopathy w/ hemolytic anemia (MAHA) & thrombocytopenia. iTTP incidence is 2-6 per million. Caused by Abs to ADAMTS13), w/ low ADAMTS13 activity vWF multimers bind platelets https://t.co/bvCexDPBmq
Dr. John Cush RheumNow ( View Tweet)
Annals of Internal Medicine has published a CME review of LYME DISEASE. Most Lyme is Dx by onset of the erythema migrans rashes,. Lyme Ab testing is of low sensitivity at onset but more sensitive w/ time & CNS, CV complications. or Mono- or oligoarticular arthritis https://t.co/FMwQgcadik
Dr. John Cush RheumNow ( View Tweet)
2025 ACR Guideline for the Treatment of SLE
The ACR has released its 2025 Systemic Lupus Erythematosus (SLE) treatment guidelines and consensus-based good practice statements, applicable to children and adults with SLE.
https://t.co/2NFwTllLZa https://t.co/i5Q5UfE9v3
Dr. John Cush RheumNow ( View Tweet)
How Living With Childhood-Onset Lupus Impacts Mental Health
Children, teens, and young adults with childhood-onset systemic lupus erythematosus (cSLE) require intense immunosuppressive treatments to prevent organ damage. Recently, the mental health burden for cSLE patients has https://t.co/JXkdYiAO9o
Dr. John Cush RheumNow ( View Tweet)
Emulation Trials in SLE: Real or Fake
Dr. Janet Pope, Ontario, Canada, discusses emulation trials in systemic lupus erythematosus.
https://t.co/wVmMfLVAuQ https://t.co/V4VGVncSE9
Dr. John Cush RheumNow ( View Tweet)
2024 ACR Lupus Nephritis Guidelines: The Controversies
Drs. Maria Dall’Era & Michelle Petri discuss the sticking points in the latest lupus nephritis recommendations.
🗣️ Insightful, honest, and essential for your practice.
📍Full update on RheumNow: https://t.co/KPjyCrMTBr https://t.co/VoOslSqs99
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Dr. John Cush RheumNow ( View Tweet)
IMPACT Study - Certolizumab Efficacy in APS Pregnancies
A pilot trial assessed the safety and value of tumour necrosis factor α inhibitor treatment with certolizumab in patients with high-risk pregnancies with antiphospholipid syndrome (APS). Certolizumab (CZP) was shown to https://t.co/sbXW6vNX5y
Dr. John Cush RheumNow ( View Tweet)
Moving Targets in Lupus and Lupus Trials
In the 1990s, developing lupus treatments became a priority, but success was elusive for 20 years. Belimumab was approved by showing only small differences from placebo in trials with 867 patients globally. Its efficacy was confirmed by https://t.co/TekxzTJjwC
Dr. John Cush RheumNow ( View Tweet)
Steroids in Lupus Nephritis: No Free Lunch
https://t.co/yPQuZcnRLH https://t.co/V8GZoslSqV
Dr. John Cush RheumNow ( View Tweet)
NEW for #LUPUS2025—@ern_reconnet–SLICC–@SLEuroSociety expert consensus on the therapeutic management of rare systemic #lupus erythematosus manifestations https://t.co/XwAHpsho57
Free to read with registration on https://t.co/28wkm5ab69 (also free)
@Lupusreference #SLE https://t.co/73K0DKTHye
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The Lancet Rheumatology TheLancetRheum ( View Tweet)
🔺CTD-ILD radiological signs to look out for 👀
#CTD #ILD #UIP #NSIP #Fibrosis #scleroderma #systemicsclerosis #Sjogrens #Lupus
By @IlliasulK https://t.co/hHupTz0bCy
Dr Gurdeep S Dulay gurdeep_dulay ( View Tweet)
JAK inhibitors reduce inflammation while potentially exacerbating the propagation viral infections. They suppress transcription of IFN-stimulated genes in non-infected cells (usually triggered by type I IFNs produced by infected cells) Thus facilitating viral propagation https://t.co/BDzz8pHKxL
Dr. John Cush RheumNow ( View Tweet)
MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/JCeSFmIgxV
Dr. John Cush RheumNow ( View Tweet)
Biologics in Pregnancy Patients With Autoimmune Disease
A large cohort, claims data study shows that among pregnant women receiving biologic therapies for autoimmune conditions, 72% continued their biologics pregnancy, more so among inflammatory bowel disease (IBD) patients https://t.co/fjtUNaYtp9
Dr. John Cush RheumNow ( View Tweet)
Hydroxychloroquine: Are Your Patients Taking It?
Dr. Nathalie Costedoat-Chalumeau dives into monitoring HCQ levels and what they tell us about patient adherence.
💡Learn how to spot non-compliance early.
👉 Now live on RheumNow: https://t.co/KPjyCrMTBr
#LupusCare https://t.co/8ZiJcFZyKD
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Dr. John Cush RheumNow ( View Tweet)