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Anti-Rheumatic Rx

DBRPCT of Krill oil (4 g/d;KOC) vs PBO in 78 #SLE pts for 24 wks. KOC Rx pts had signif increase in Omega-3 Index 4.3% to 7.17% (4wks) to 8.05% (24wks) w/ no change SLEDAI-2K. But 9pts w/ hi activity (SLEDAI≥9) showed signif Dz activity improvements https://t.co/ODLqqZzGQx https://t.co/tehHk4MhbZ
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Metformin Protects? TrinetX retrospective propensity matching study compared SLE pts on metformin (n 9,178) vs NOT (78,983). SLE NOT on metformin had signif higher risk of lupus nephritis (RR 1.70), CKD (1.27), & MACEs (1.21) & persited for 5yrs https://t.co/78VjEHs8dJ https://t.co/A6lz32fp0T
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PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients

A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance. 

Diffuse

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Drug Safety Update, from UK MHRA, shows impt interaction between tramadol and warfarin. Tramadol may increase the INR with risk of major bruising and bleeding when warfarin and tramadol are taken concomitantly. https://t.co/mgmeMJzdLa

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Digital Self Screening for Arthritis Diagnosis

There are numerous impediments to diagnosis or referral; and a new study evaluates patient use of a mobile artificial intelligence (AI)–based symptom checker for diagnoses, but demonstrated only modest accuracy when applied to a cohort of patients with joint symptoms.

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RA & OA: Nearly 40% have Anxiety, Depression or Fibromyalgia

Researchers at Rush University analyzed clinic MDHAQ data and found between 36-40% of osteoarthritis and rheumatoid arthritis patients screen positive comorbid anxiety, depression, or fibromyalgia.

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Biologics Prevent AA amyloidosis progression to ESRD

MedPage Today

One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.

Among 83 patients receiving biologic agents for their underlying

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Patients with Financial Limits Struggle with Medication Adherence

Analysis of the National Health Interview Survey shows that nearly 1 in 5 patients with rheumatologic disease in the United States struggled economically, suffering from food insecurity and cost related medication (CRM) nonadherence.

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Earlier RA Diagnosis Leads to Lower Costs of Care

A study from the Leiden Early Arthritis Clinic shows that is rheumatoid arthritis (RA) is diagnosed within 12 weeks after symptom onset, treatment costs were lower in both autoantibody-negative and autoantibody-positive RA. 

The rheumatologist

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Retrospective study, biopsy-proven Lupus Nephritis pts - 35 of 115 pts (30%) were ANCA positive. ANCA+ LN pts had higher dz activity, predominantly proliferative LN, require more immunosuppressives (CTX, MMF) to achieve remission. https://t.co/jzU8fPYHps https://t.co/E7pMDWJmKt
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174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/AreLBseJDq https://t.co/OyIOkiUOT1
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Best Rheumatologists (7.19.2024)

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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JAK Inhibitors Reduce Macular Degeneration

Mepage Today

Insurance claims data showed that patients with autoimmune disorders who took Janus kinase (JAK) inhibitors had lower rates of age-related macular degeneration (AMD), hinting that the drugs might treat the common eye disease.

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Geography of Arthritis-attributable Pain in the USA

The journal Pain has shown geographic differences in arthritis-attributable pain, arthritis-related outcomes mostly clustered in the Deep South and Appalachia, while severe arthritis pain is more prevalent in the Southwest, Pacific Northwest, Georgia, Florida, and Maine.  

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192 RA pts on MTX: GI Sxs studied w/ MISS (MTX intolerance severity score). GI intolerance seen in 56%, Nausea & pain post-MTX most common. More in afro-descendants, w/ FM, Steroids, or JAKi. MISS results unrelated to Route, Gi Dz, age, MTX dose https://t.co/EROmZQo1Zs https://t.co/SOMzzXXj0b
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Updated EULAR Recommendations on the Treatment of Systemic Sclerosis

Medscape

Medscape has published an overview to the 2024 updated recommendations for the treatment of systemic sclerosis (SSc) presented in Vienna at EULAR 2024 by Professor Francesco Del Galdo, MD, PhD on behalf of a 27 member task force.

The new recommendations (n=20)

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Systemic sclerosis sine scleroderma

Systemic sclerosis sine scleroderma (ssSSc), which accounts for nearly 10% of systemic sclerosis (SSc) patients and was first described in 1962, is a subset of SSc.

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Efficacy of Biologics in Patients with CKD A retrospective cohort study of biological bDMARDs persistence in RA patients w/CKD, shows the 3 year survival to be > 50% but all studied biologics were nearly equivalents with regard to safety and efficacy. https://t.co/rL2ZondUsE https://t.co/1hM237Jl83
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European Research Council has awarded a Proof of Concept Grant to Institute of Bioengineering of Catalonia and their OrthoBots project, to study the treatment of joint diseases using nanorobots to deliver nanoparticle based therapy to synovial tissues https://t.co/JmYQ1727rf https://t.co/k5uZoSwJPo
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Pollution and Autoimmunity (7.12.2024)

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

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MTX was tapered or D/C in 30% of RA pts w/in 2 yrs of b/tsDMARD Rx. Of 889 pts, MTX (19 mg/wk) tapered in 13.8% & D/C 16.5% (planned taper(37%); pt decision (27.2%). In 582 (66%) MTX unchanged, 4.25 increased MTX after b/tsDMARD initiation https://t.co/yc8exMbeD1 https://t.co/b3L3Fha7xU
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ICYMI: Can Mycophenolate be Stopped in Stable SLE? https://t.co/WJv2CajgW9 https://t.co/AU8X5bVSJQ
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Progress in SLE with new mRNA CAR-T cell Trial

Cartesian Therapeutics, has announced their first-in-class mRNA-engineered chimeric antigen receptor T-cell therapy (mRNA CAR-T) therapy has been given to the first systematic lupus erythematosus (SLE). patient in a Phase 2 open-label clinical trial. 

The investigational drug,

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Efficacy of Biologics in Patients with Chronic KIdney Disease

A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly

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CT angio in 75 pts w/ Takayasu arteritis (40 w/ cDMARDs, 35 biologics) showed reduced arterial thickness in 73% (31% w/ >25% decr in wall thickness). 1st immunosuppressives (p= 0.012) & bDMARDs(p= 0.026) reduced art. wall thickness (relative to cDMARDs) https://t.co/16eGmgVoWr https://t.co/AyNyT7FsYZ
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