How Does Your Garden Grow (9.26.2025)

Jack Cush, MD

Sep 26, 2025 12:30 pm

Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA.

Comparative Frequency of Systemic autoimmune rheumatic diseases (SARDs) in Australia: - SLE 57.9 per 100K - Lupus nephritis 11.2 per 100K - SSc 25.6 per 100K - ANCA-associated vasculitis 10.8 per million PYs IIM 9 per million https://t.co/cx9LvswQ2E
Should we be "scoring" comorbidity to predict outcomes? SLE metanalysis looked at Charlson Comorbidity index (CCI). JAPAN 3 RCTs, 1175 SLE pts show higher CCI scores predicts increased all-cause mortality (OR 3.92(95% CI: 2.74–5.60) https://t.co/LXfsGo9iJq
Inception SLE study of 674 pts (without LN), mean age 34 yrs - 154 (23%) developed new proteinuria (LN) after median of 3.6 yr. Cumulative antimalarial exposure did NOT lower risk of LN (HR 0.98; 0.94-1.02); same for those w/ serologically active SLE (HR 0.97) https://buff.ly/ZPvZDNp
Turkish study of 799 psoriasis pts - 30% had concurrent onset PsO & PsA & in 70% there was a long transition time (~13 yrs) from PsO-to-PsA. Factors assoc w/ prolonged interval included Depression, fatigue, scalp PsO(OR 7), nail PsO (3.2), +Fhx (2) & enthesitis ever (OR 2) https://t.co/wqtSbeQ2vz
Canakinumab in VEXAS - 47 males Rx w/ anakinra (44), canakinumab (9), or both(6). Response @1 mos: ANAK 34% vs CANK 100%; 22% vs 78% @ 3 mos. Drug survival was 54 mos CANK 300/m; 7 mo CANK 150/m; 1 mo ANAK. More ISR (47% v 0) & infx w/ ANAK https://t.co/Y3iSfajTal
Monthly survey - 351 ArthritisPower #RA Registry pts reported 523 nonserious infxns (31% ; most URI), few resulted in ED or hospitalization. But NSIA led to missed work (37%) or RA Rx interruptions (26%) and more fatigue. NSIE may contribute to more disease flares https://t.co/Al5B5oxvFg
Single-center retrospective study 49 pts w/ primary angiitis CNS (PACNS) stratified by vessel size. Vessel size dx by imaging & neuroradiologists. Small vessel involv(n  9) was significantly assoc w/ +Biopsies, CTX use, functional decline & more relapses. https://t.co/DF6DknoPxY
Systematic review of 139 RCTs(9644 pts) & 12 Rx options for knee OA (KOA) shows simple Rx is best. For pain and function, knee brace was best, followed by exercise, and US worst. For total WOMAC best was hydrotherapy, then exercise & LaserTx. (Short wave diathermy worst) https://t.co/sN9TxJGn6N
OL study of 60 pts w/ new idiopathic retroperitoneal fibrosis (GFR >30) Rx w/ low dose MTX+pred VS Pred only. @ 9 mos remission: 90% MTX+Pred vs 81% Pred (noninferior). Time-to-remission, RPF thickness & relapses were same; but pred use was lower w/ MTX+pred (p < 0.001) https://t.co/13cjnl4Ke4
Screening for RA-ILD: metanalysis of 9 studies, 1380 RA pts - RA-ILD prevalence ranged from 6.7-42.7%; 18.9% via HRCT. None examined risk factors. Male sex & smoking were ~12% higher in RA-ILD & RA disease onset age was 7 years higher in RA-ILD pts. DAS didnt matter. https://buff.ly/8Hz1ILn
Prospective French study of 101 RA-ILD (mean 66yrs) assessed for shorter WBC telomere length (LTL); short LTL seen in 43% & assoc w/ lower FVC (82% vs 93%pred) & TLCO (49% vs 63%) & greater FVC/DLCO decline & lung progression after 12 mos (47% vs 22%; p<0.001) https://t.co/ObVeon0riy
What is IPAF?
Polypharmacy Impairs Rheumatoid Arthritis Outcomes
DERM on RheumNow Podcast (September 2025) https://t.co/zZpheX1epS
TNR – Dx, Monitoring Screening Monitor of ILD. Tues. 9/30/25 at 7pm EST. buff.ly/R4OTnGQ