ERA, APPs, & Alpha GAL (3.21.2025) Save

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.  Listen in for 2 new case questions - Ask Cush Anything.

1. Single Center study of 112 RA pts from Morocco used machine learning (ML) logistic regression model & identified #Depression in 48% (HADS score >8) w/ 76.5% accuracy, 72.2% precision, 81.2% recall, and an area under the receiver operating characteristic curve (ROC AUC) of 0.767. https://buff.ly/9MKKXuL
2. 617 seropos ARTHRALGIA pts - 34% got inflamm. arthritis (avg time ~20mos). Arthritis risk factors: high ACPA (HR 4.7) or double positive(HR 6.8); 1st degree relative (1.5); intermittent Sxs(1.6); <12 mos Sxs (HR 0.71); AM stiff ≥1hr (1.6); joint swelling (1.5). IF > 2 variables, 58% developed arthritis https://buff.ly/VsWiJ6g
3. Spatial transcriptomic profiling on pre- and post-Rx synovial tissue Bxs from RA - Tx naive pts on DMARDs or adalimumab. Rx refractory patients had high expression of COMP, and fibroblast TGFβ signaling driving synovial tissue fibrosis https://t.co/1xFVvoddCD
4. Systematic review of colchicine and pregnancy in #FMF pts included 25 studies. Miscarriage was not increased w/ colchicine in FMF (RR 0.87). Birth defects were similar to unexposed pts (range 0.6% to 4.0%). Colchicine showed no effects (men/women) on fertility. 1 study reported… https://t.co/axiH9jhEJr
5. Systematic literature review of sleep Rx in Fibromyalgia - 47 RCTs, 11094 pts, found cognitive behavioral Tx (CBT) significantly benefitted insomnia, but not pain. Pregabalin & sodium oxybate had small effect, but Amitriptyline, milnacipran, & duloxetine showed no benefit for… https://t.co/ReommvC5qO
6. J&J announced the FDA jas granted the investigational drug, nipocalimab (FcRn recpt Ab), with Fast Track designation for its study in adult patients with moderate-to-severe Sjögren’s disease https://t.co/TB2cESMLQi
7. Ontario study of 11 641 older psoriasis pts & hospitalized serious infx in those on b/tsDMARDs. IL-12, IL-23, and IL-17 inhibitors were assoc w/ 35% lower rates of SIE, while MTX, other older systemic meds, TNFi were not incr/decr. But JAK inhibitors had signif 3 fold incr in SIE https://t.co/ffFdHjme65
8. Study of 26 Enthesitis-related arthritis (ERA) pts (mean Dx age 12 yrs; 77% male; 58% B27+). These were later assessed as adults (20yrs age, <35yrs). Most were in remission/LDAS, but ~20% had synovitis or enthesitis, 73% SI Dz, 15% hip & 8% spinal damage https://t.co/FFEhyA5I6A
9. Alpha-gal syndrome (AGS) is a (Lone Star) tick-borne allergy to the galactose-α-1,3-galactose, found in mammalian meat/products; Sxs (hives, itching, swelling, and GI issues) present 2-8 hrs after meat & be life-threatening. Time to Dx has dropped considerably, w/… https://t.co/p1M9Qaf1jz
10. Mizoribine Effective in Lupus Nephritis 
11. Axial Involvement in Psoriatic Arthritis   
12. NP and PA Growth in the USA  
13. Disease activity during Pregnancy in Rheumatoid arthritis and Spondyloarthritis   
14. ASK CUSH ANYTHING
    1. Refractory Stills – Dr. Mary Guane
    2. HBV Testing in RA – Dr. R Udell