RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Sep 12, 2025 7:00 am

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD? Ro52 makes a big entrance with all our ILD coverage this month.

Metanalysis of 7 studies (1979-2023) shows RA pts on vegetarian or vegan diets achieved no improvement in disease activity or physical function, but did have a small significant improvement in pain. Insufficient Data on Fatigue. Overall, low certainty https://t.co/jeh6gN5Byg
Obstructive sleep apnea in USA is expected to rise from 34·3% in 2020 to 46·2%, resulting in 76·6 million OSA cases by 2050. By 2050 there will be more males w/ OSA (~46 milliion) than females (30·4 million), but greater growth in females over the next 30 years. https://t.co/6YZvSusTWf
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. https://t.co/HDnDWahuul
AI can Dx & predict HCQ retinopathy (HR). An International, Multi-center study used retrospective data from 409 pts (171 HR+, 238 HR-) & tested on 8251 SD-OCT scans. AI Dx 100% & predicted 98.7% mean 221 D before Dx. Sensitivity 100%; specificity 98%, PPV 94%; NPV 100% https://t.co/USABVO8Ss5
Cross-sectional study of 320 dermatomyositis (198 classic DM, 122 amyopathic DM/CADM) & compared myositis panels for ANA, MSA, MAA, etc. Comparing CDM vs CADM - ANA pos in 63% vs 49%, p<0.05; MSA+ 47% vs 40% (NS); MAA+ 29% vs 26%(NS); MSA&MAA neg 40% vs 48% (NS) https://buff.ly/lfaNdkS
Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Study of 111 TAKayasu arteritis pts Rx w/ 74 MMF+MTX vs 37 CYC/AZA. Response rates at 28 & 52 weeks were 58.1% and 55.4% in the MMF+MTX group, respectively, higher than 32.4% at both time points in the CYC/AZA group. https://t.co/wqlOLH0VEA
9 yr. study of anti-Ro52 & ILD pts -- 1,026 pts 15% Ro52+: interstitial pneumonia w/ autoimmune 48%, CTD-ILD 13%, idiopathic pulm fibrosis 10%, hypersens pneumonitis 6%, idiopathic ILD 24%. Ro52+ were younger w/ more autoimmune dz, +MSA Abs, ILD progression, death, & lung transplantation https://buff.ly/nCY6fFl
Single center study of 47 RA-ILD pts (Dx Age 64.7 yrs; 30 mos F/U). Median 100 mos from RA Dx to RA-ILD. Nearly half (49%) recv Rx for RA-ILD; few w/ TCZ, nintedanib, pirfenidone. ~90% had RA-ILD stability/improve @ 6 & 12 mos. Progression assoc w/ tobacco use (P .025) @ 6 mos https://t.co/AK4zYgcxeK
SSc-ILD ABs & LESSONS: 30% of won't progress. Triple negatives (ATA, ACA, ARA) wont progress. Males & diffuse dz > predictive than Abs. Great read on if Abs are biomarkers to predict Rx effect. https://t.co/YcZt4aAvL0
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/DbsJVZ16Zd
Anti-MDA5 DM is assoc w/ rapidly progr ILD & mortality risk. 26 MD5+ DM pts (age 56.6 yrs; 7/26 male) Sxs: Gottrón’s (81%), ILD (73%), periungual erythema (69%), heliotrope (61%), V-sign (42%), arthritis (42%), weakness (38%), mechanic’s (35%), Raynaud’s (19%). 7/19 RP-ILD died https://t.co/WFwavo32rB
ERS/EULAR guidelines for CTD-related interstitial lung disease
SMART study - Single vs. Split Dose Methotrexate in RA