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Multimorbidity predicts flares in rheumatoid arthritis
A study from Olmstead county and the Mayo Clinic shows that multimorbidity and social factors predict higher rheumatoid arthritis (RA) flares and lower remission rates.
September to Remember (9.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.
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Rheumatoid Arthritis ILD Complications
I'm a pulmonologist at the University of Kansas in Kansas City, and I'm excited to talk about one of my favorite topics: treatment complications in rheumatoid arthritis- associated interstitial lung disease or RA-ILD. One of the reasons I think this is a pressing and important topic is what we're dealing with here is a group of patients who have really poor outcomes, even with the significant advances that the rheumatology community's been able to make in the management of the underlying synovial disease.
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Methotrexate significantly lowers Systolic BP
Australian researchers have shown that methotrexate (MTX) has another secondary, beneficial effect by significantly lowering systolic blood pressure, and contributes to its well docuented cardioprotive effecs.
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Abatacept and Methotrexate may Lower Risk of Interstitial Lung Disease in RA
A post hoc, pooled analysis of of rheumatoid arthritis (RA) clinical trials shows those received abatacept had a lower rate of Interstitial lung disease (ILD).
Long term outcomes of secukinumab in Children & Adolescents w/ Psoriasis (n=84). 80% completed 4 yrs of Rx w/ either low dose [N 31] & high dose [N 36]) with sustained PASI 75/90/100 results at week 208 [SEC LD: 96%/89%/52%; SEC HD: 88%/82%/73%]. No deaths; No dose-dependent https://t.co/y059SJTxP1
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Study of 607 systemic sclerosis (SSc) pts finds Pulm arterial HTN (PAH) in 77 (12.7%). While early immunosuppression didnt reduce odds of PAH (OR 0.74, p=0.495), early mycophenolate was protective(OR 0.12; p=0.048). Only HCQ use signif. improved survival (HR 0.04; p= 0.004). https://t.co/54m8btiMLy
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A case–time-control study of French National Health Insurance database w/ 34 241pts Rx w/ IL-17(R)A inhibitor (2016-2021) (for PsO, PsA, AS, JIA) found no significant association betw IL-17(R)A inhibitors & MACEs over 6 months compared to TNFi Rx pts. https://t.co/fJuPFYKnSr https://t.co/Vscnsq0DTA
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Prospective study of 171 suspected Sjogrens (130 dx w/ SjD) pts compared Dx accuracy - Labial gland Bx best Dx efficacy (AUC 0.90), followed Ro/SSA (AUC 0.79), Omeract score (AUC 0.78). Salv gland US grade 3 strongly predicted +Bx (AUC 0.77) & correlated w/ salivary flow ~-0.5
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6 yr study of Dutch #SLE pts (n 221) - unemployment was high (54%) & increased over time. Employ
ed assoc w/ supervisor support, regular working hrs, skill discretion, decision authority. Unemployment most from SLE Sxs (63%) & assoc w/ older, less education, Dz Dur, organ
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EHR analysis of Alaska Tribal Health System finds the prevalence of Sjögren's disease at 199 per 100K adults (primary SjD 129; secondary 70 (RA,SLE)). The age-adjusted incidence 16.6 per 100K Pt-Yrs. Only 5% had salivary gland Bx & 3% met 2016 ACR/EULAR or 2012 ACR criteria https://t.co/4tMdWIGTEi
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Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease A matched cohort study from the Veterans Health Administration shows that RA patients have a >50% increased risk of lung cancer, a 3-fold higher risk of lung cancer in RA-ILD. https://t.co/Gjn2M2CNAO https://t.co/F231nz57NY
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SMART study from India finally published. RCT compare split-dose to single-dose oral MTX, in 253 RA pts. Split dose was superior w/ significantly higher EULAR good response at 16 weeks; & reduced need for 2nd DMARD, but had more intolerance and transaminitis. https://t.co/4jBxP2GPZM
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LTBI risk in rheumatic pts is high (22%). Metanalysis 18 studies, 12,167 rheum pts shows LTBI signif. incr w/ current smoking (OR 1.50), golimumab(OR 2.90), Chloroquine (OR 1.27), age >40 (OR 1.84), prior TB OR 3.26). LTBI not increased w/ RF, ADA, ETN, BCG, Pred, smoking, DM https://t.co/0PayHJqwDn
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Retrospective French Health Data System Immune Checkpt inhibitor (ICI) study. Of 172,363 ICI-Rx adult pts, ICI myotoxicities at 6 months ranged from 0.7% -0.9%. ICI myocarditis & myositis incidence was 0.3%- 0.6%, co-occurring in ∼13–23%. ICI myotoxicity- 1-mo fatality was https://t.co/kOGKM8lC0H
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Connective tissue disease associated with interstitial lung disease (CTD-ILD) market is estimated to be $5.9 Billion USD in 2024 and is projected to grow to 9.3 billion, driven by increase in autoimmune Dz, adoption of biologics, ongoing clinical anti-fibrotic trials https://t.co/UqshQgNOau
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ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from https://t.co/V10S4oVFsv. This week news on vaccines, safety of acetaminophen and more.
https://t.co/YlOK3X4hkW https://t.co/9cgcDn0xab
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Combined Therapy in Rheumatoid Arthritis Interstitial Lung Disease
RA-ILD is a major therapeutic evidence gap in treatment, affecting 8% of patients. It was often under-diagnosed, leading to more severe cases and inflated mortality rates. Despite advancements, RA-ILD, https://t.co/Q8mMxtBgZZ
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Retrospective Korean study of #RA & ILD pts (n 151) - ILD duration & UIP pattern significantly affected prognosis. 62% were non-smokers, DAS28=4.9, UIP in 60%. @4 years, ILD progressed in 58%; mortality=21%. MTX did not affect progression or mortality. https://t.co/1XNcWsAuea https://t.co/hsUWi27OtQ
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Global prevalence of Hidradenitis suppurativa (HS) is 0.99%, but varies globally between 0.67% and 1.46%. HS is assoc w/ female sex. Based on a meta-analysis 22 743 participants, identifying 247 HS pts. https://t.co/TtKdfKiIn3 https://t.co/zOIVUlF5E8
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