Follow the Money (4.23.2026)
Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif
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Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ
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Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/SyhK12KhHY
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R
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Top Four and More (4.10.2026)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
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5 yr Italian study of hospitalized autoimmune pts(2018-23) 4,896 IMID pts compared to 301,126 non-IMIM. IMID had signif higher risk cancer (adj OR 1.32) highest 1st yr. Decreased from 1.83 @ yr 1 to 1.2 @5+ yrs. IMID had more lung & bladder CA, leukemia lymphoma & melanoma https://t.co/UXqDHQtzv0
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/Ljr5maHZcr
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Korean Insurance claims nested case–control study of 27,410 RA pts - 5482 w/ > comorbid Dsx Vs 21,928 w/ < 10 comorbd Dz. Having >10 signif incr Serious infx (OR 1.44), opportunistic (21.9)& Hzoster (1.18); mainly skin & soft tissue infx - NOT fatal infx. https://t.co/qDrU3BXYzd
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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/0FjPyXygpz https://t.co/04J23AiqtK
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FDA has issued a drug safety warning for avacopan (Tavneos), dentifying 76 cases of drug-induced liver injury, including 7 cases of rare vanishing bile duct syndrome (VBDS). There were 8 deaths https://t.co/WkBhs1rNpf https://t.co/ZXdHsAJUOQ
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Review: Rheumatoid Arthritis–Associated Interstitial Lung Disease
RA-ILD represents the most severe extra-articular manifestation of rheumatoid arthritis, affecting an estimated 1% of the adult population in the US and Northern Europe. Prevalence estimates vary widely (up to 58%), reflecting different diagnostic criteria, imaging modalities, and study
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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/en4OnhWPda https://t.co/urwkjlVeg6
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Italian population study of 37996 RA (prevalence 0.54%) pts w/ and 12875 incident cases (incid rate 33.1/100K), there were 1288 deaths/8yrs (MR 21.3/1K), median age=83; SMR 1.28 (1.21 to 1.35), higher <45 yrs (2.15). Leading causes CV (37%), cancer (21%) & infxn (11%) https://t.co/wPx5iqW7Nl
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phase 3 VALOR trial of 6-valent OspA-based Lyme dz vaccine (LB6V) vs placebo; 4 doses given @ Mos 0, 2, 5-9, & 12 mos later. LB6V reduced Lyme Dz risk by 73.2% @28d after 4th dose. But it was only 15.8% effective (falling short of prespecified 20%) because of fewer than expected https://t.co/TcX0GV05gY
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Outcomes of 87 VEXAS pts in the AutoInflammatory Disease Alliance (AIDA) - 75% had recurrent fever episodes. Fever episodes assoc w/ mortality, organ involvement (CV, GI, Lung), but not with complete response to biologics. https://t.co/j9vzBJNMj0 https://t.co/YGsE7LH3ml
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ILD found in 3% of #PsA pts. Metanalysis of 6 studies, 14,272 pts found ILD pooled prevalence was 3% in PsA; highers ((6%) in studies w/ CT, HRCT. Smoking was a signif. risk factor for ILD in PsA (OR 2.94, 95% CI: 1.22–7.12; I2 = 1.8%). https://t.co/9mY4Eiqc9d
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Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early https://t.co/hYf6GiR6TN
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Rheumatic Immune-related Adverse Effects with Checkpoint Inhibitor Therapy
A retrospective study of patients who developed rheumatic immune-related adverse events (R-irAEs) after receiving immune checkpoint inhibitors (ICIs) at two oncology centers in Spain suggests that early https://t.co/jKCbIvfebm
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Full read review & update on Rhabdomyolysis. 26K cases/Yr in USA. Muscle damage leading to weakness, myalgias, swelling, myoglobinuria, electrolyte probs, AKI. Causes: 1) exogenous toxins (46%); 2) trauma; 3) myopathies/metabolic muscle dz (10%), infxn. AKI in 46%, & death in https://t.co/E2LcLeMls0
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RT @gibson_rheumPAC
Given rising resistance, effective first-line regimens and adequate duration (14 days) are critical. PPI-based quadruple regimens remain highly effective when patients can adhere.
#RNL26 https://t.co/bxqMbPFegt
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RT @ericdeinMD
#RNL26
Prosthetic joint infection vs flare?
- PJI risk 50-80% higher in RA (OR 1.47-1.8)
- Immunosuppressants, intra-artic injections, RA activity, BMI incr risk
- Delay in diagnosis https://t.co/XTozafDQyf
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RT @ericdeinMD
#RNL26
Inflammatory arthritis pts getting TKA:
- increased risk of RBC transfusion (OR 1.39), infection (1.64) and readmission (1.46)
- THA: also risk of mechanical complications (like dislocation) OR 1.3 https://t.co/ovW2C2EuXF
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RT @gibson_rheumPAC
Helicobacter pylori Update: H. Pylori remains the most common chronic bacterial infection worldwide, acquired in childhood and lifelong if untreated. Its clinical impact spans far beyond dyspepsia—from ulcers to malignancy. #RNL26 tis
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