Lupus

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. They divide myositis-ILD into three main prognostic groups with different treatment approaches:

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. A recent metanalysisi of the medical literature from 2002 to 2021, included studies with ≥50 patients reporting on causes of FUO/IUO (inflammation of unknown origin). This series included 16884 patients.

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.

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. DAMPs and pathogen-associated molecular patterns (PAMPs) are primary drivers of inflammasome activity.

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.

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on RheumNow.com 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://bit.ly/3RvPzDm

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. 

Whether exposure to ultraviolet (UV) radiation from the sun can cause new-onset systemic lupus erythematosus (SLE) wasn't settled by data from a large, long-running epidemiologic study, but the trends indicated that it could.

Annals of Internal Medicine reports that thiopurine toxcicity risk is associated with the "CC" genotype and that azathioprine discontinuation was associated with hematopoietic toxicity and lower thiopurine doses. 

A retrospective cohort study has shown that outcomes in pregnant systemic lupus erythematosus (SLE) patients has significantly improved in the last decade, but there still is a high risk of adverse pregnancy outcomes (APO). A retrospective Danish SLE cohort was used to identify pregnancies in SLE patients from a single center between January 2010 and October 2020.

In SLE, two targets that are increasingly used are the DORIS 2021 Remission and the Lupus Low Disease Activity (LLDAS). T2T is more likely to be successful if the treating clinicians and the patients set the treatment goals together. What do our patients think about T2T and do they have any say/concern?

Impressive data on novel treatment for SLE were presented at the EULAR22 Congress. A disease that is difficult to study due to its pleomorphic presentation, unpredictable disease course, and high mortality rates, SLE is considered the dragon of all autoimmune diseases. Here are highlights of four exciting abstracts presented at the meeting with emerging therapeutics designed to slay the beast. 

Bags are packed, ready to go, but wait there’s more abstracts to show. The big news today were the “late breaking” abstracts. This is usually a favorite session of many as this is where the newest of study data often is showcased.  Here are my favorite late-breakers from Day 4.

By now, those of us attending the meeting know how to find a free coffee or sprite, have found comfortable meeting nooks and know our way around! PAnd congrats to you virtual Rheums for mastering the multi-screen, multitask simultaneous consumption posters, tweets and oral abstract presentations.

A full day at EULAR with oral and poster presentations of abstracts in the morning and a plethora of scientific (review) sessions in the afternoon. The latter covering topics like sarcoidosis, Still’s disease, fibromyalgia, back pain, sarcopenia, APS, IgG4 and imaging in vasculitis.