MTX Fails Knee OA (6.6.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

  1. 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/CBUojpR3Q8
  2. CMAJ reminds us that w/ parvovirus B19 infection, Arthropathy seen in ~60% of adolescents & adults, but the classic “slapped cheek rash” is uncommon. Symmetric, polyarticular inflamm arthralgias/itis affects PIPs, MCPS mostly. Sxs resolve w/in 3 wks. ~20% can last mos-yrs https://t.co/2SuL5igcnz
  3. Systematic review of JAK inhibitor use in systemic sclerosis - 18 articles/87 SSc pts (80%F; ages 13–78 yrs). JAKi (83% tofa) mostly used for ILD & Skin Dz (45%) or GI+Skin Dz (39%). 87.5% improved, w/ 6% relapsed. Adverse events in 50% (20% infx). We need RCTs! This could be a reporting bias.  https://t.co/VXFuHGpDjB
  4. Blau syndrome -a rare autoinflammatory Dz w/ triad of granulomatous dermatitis, arthritis, & uveitis (may cause blindness); from a NOD2 gain-of-function mutations. Onset age 2-4 yrs. Early biologics (esp TNFi) may prevent joint complications; but metanalysis shows no preferred https://t.co/IIJbJ7x2WB
  5. IL-40 is elevated in systemic sclerosis (SSc). Study of serum (90 SSc vs controls/HCs), Skin Bx (5 SSc v 5 HCs). IL-40 signific. upregulated in the skin & correl. w/ ESSG (r = 0.37), GI dz; also w/ serum IL-8, TGF-β1. IL-40 functionally linked to activated B cells, PMNs, T https://t.co/2sIgMYK7xo
  6. Sacroiliitis is a rare adverse reaction of isotretinoin. Review of 67 pts finds median age 21 yrs, onset median 2.5 mos (0-24) post isotretinoin. Sxs: LBP 70%) & hip pain 45%. Dx by MRI (73%) w BME. Full recovery 81% isoretinoin D/C & NSAIDs (< 10% biologics)
  7. Are PSO pts also Rx for PSA? Registry study of 17,310 PSO pts (19% also w PsA). @ baseline Biologics used in 44% of PSO, but higher rate in PSO+PsA (66% vs 39% PSO). 9.4% of PSO+PsA pts on Rx approved for PSO, but not explicitly for PsA. https://t.co/jMqk6gm1RR
  8. 5 year cohort study showed that obese T2D (diabetes) pts, semaglutide significantly lowered risk of osteoporosis (HR 0. 61), & gout (HR 0. 63) vs sitagliptin. Semaglutided did not lower the risk of Knee (HR 1. 05) or hip osteoarthritis (HR 0. 88). https://t.co/MqMBKdsXlu
  9. A retrospective VEXAS cohort study of 59 pts receiving 71 targeted Rx - 98%male, mean 71 yrs & 46% had myelodysplastic syndr. Treatments included tocilizumab(19), anakinra (13), azacitidine(13), baricitinib (11), & pred only (10). Best responses w/ azacitidine & tocilizumab https://t.co/jqDmKinPDt
  10. Genetic Link to CPPD In a first-of-its-kind genome-wide association study (GWAS) researchers have discovered two genes, RNF144B and ENPP1, that cause calcium pyrophosphate deposition (CPPD) disease in Americans of European and African descent. https://t.co/YSR6rEYzjG https://t.co/L7JyoxQp3K
  11. Review of Emerging Treatments for Vitiligo an immune mediated dz that affects QOL & has psychosocial impact. JAKi only ruxolitinib is FDA-approved, but Tofa & Bari show promise. Emerging therapies include simvastatin, afamelanotide, and metformin https://t.co/Rp2yYx6SyZ
  12. Global incidence of alopecia areata increased betw 1990 - 2021; from 20.43 million (19.77-21.09 million) in 1990 to 30.89 million in 2021 ( range of 29.95-31.82 million) - highest in USA 550/100,000. High in N.America, S.America, Southeast Asia, Australia. Lowest in Africa, Middle East https://t.co/d3WA3CRFRC
  13. Autoimmunity Rising in Expectant Mothers 
  14. Methotrexate Fails in Knee Osteoarthritis 
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