Location, Location, Location (7.26.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Location matters; Geo-rheumatology?
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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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NEJM Case: A 29-year-old woman with SLE presented to the dermatology clinic with 2-weeks of itchy, painful rash on her nose and hands that came on with cold weather. What do you think? https://t.co/NvaM4mVJWd https://t.co/QFtC47ZOv9
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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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Cross-sectional study of 154 adult DLE pts in the Philadelphia area assessed DLE Dz severity (by CLASI) & geoghraphic distribution to ID area deprivation (ADI). ADI > 5 (geospatial disadvantaged) was assoc w/ signif (4X) higher risk of mod-Severe Damage https://t.co/dgeGwzNTKm https://t.co/B3hmUE1G9U
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UK study of pneumococcal vaccination in UK, shows IMID pts had suboptimal vax against pneumococcus. In 32 277 pts (RA 14151, IBD 13631, SpA 3804, SLE 691) saw 57% vaccinated; lower if <45 yrs (32%), IBD (42%). Vax not associated w/ IMID flare https://t.co/y5JHYaEpA9 https://t.co/zUXfDoqyal
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SLE Topic Panel: EULAR 2024
Dr.Jack Cush moderates this topic panel on SLE with Drs. Yuz Yusof and Andrea Fava.
https://t.co/nBTiIeGd99 https://t.co/5BK72vbR5V
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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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268/279 SLE pts w/ kidney biopsy for proteinuria were Dx w/ lupus nephritis. Proliferative LN (III/IV+V) had higher levels of C1q, chromatin, dsDNA, ribosomal P Abs. C1q & dsDNA independently assoc w/ proliferative LN. AutoAbs decreased in proliferative LN https://t.co/oq3JhrFlz8 https://t.co/nxQBZvoOzP
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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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Ultraprocessed Foods Increase Lupus Risk
In a study spanning over 25 years, women who consumed high amounts of "ultraprocessed" foods had a 50% higher risk of developing SLE compared to those with low consumption.
https://t.co/7ICeAFRjRG https://t.co/Vi1lBe7neQ
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Intercurrent infections may be assoc w/ SLE flares. 203 Amsterdam SLE pts, incidence of major & minor infections were 5.3 & 64/100Pys. Intercurrent infections (major & minor) were assoc w/ SLE flares (HR 1.9); major infx lead to major SLE flares (HR 7.4) https://t.co/DSPgi9KrwT https://t.co/FI7ZYf3CPl
Dr. John Cush @RheumNow( View Tweet )
268/279 SLE pts w/ kidney biopsy for proteinuria were Dx w/ lupus nephritis. Proliferative LN (III/IV+V) had higher levels of C1q, chromatin, dsDNA, ribosomal P Abs. C1q & dsDNA independently assoc w/ proliferative LN. AutoAbs decreased in proliferative LN https://t.co/tRucgJRpDN https://t.co/DtgEmGhUzd
Dr. John Cush @RheumNow( View Tweet )
Study from the UK Biobank (n 459K) shows long-term exposure to air pollutants (PM2.5, PM10, NO2, and NOx) may increase the risk of #SLE. 399 SLE pts (F/U 11.8 yrs) found an 18027% incr SLE risk w/ pollutants; magnified in those with high genetic risk https://t.co/PI4rvKwfpj https://t.co/2CZ28rHVG2
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Progress in SLE with new mRNA CAR-T cell Trial
Cartesian Therapeutics, has announced their first-in-class mRNA CAR-T therapy has been given to the first SLE. patient in a Phase 2 open-label clinical trial.
https://t.co/7SYNtjIn9F https://t.co/a5LJn8QLT3
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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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PNAS & Nature Insights into Lupus Pathogenesis
Two prominent medical journals this week published new insights into the pathogenesis of systemic lupus erythematosus (SLE), with both inidicating promient roles for T cells in what is a classically viewed as a humoral (B cell) disorder.
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Ultraprocessed Foods Increase Lupus Risk
MedPage Today
Among women followed for upwards of 25 years, those who ate relatively large amounts of "ultraprocessed" foods -- such as soft drinks, frozen pizzas, and mass-produced baked goods -- developed systemic lupus erythematosus at more than 50% greater rates than those with relatively low consumption
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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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ICYMI: JAMA: SLE Review
https://t.co/GJJSOYZru2 https://t.co/mCgWy27yPr
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ICYMI: Can Mycophenolate be Stopped in Stable SLE?
In patients with clinically stable systemic lupus erythematosus (SLE) and lupus nephritis, the withdrawal of mycophenolate mofetil was not significantly inferior to mycophenolate maintenance, but MMF withdrawal had numerically more reactivations, while MMF maintenance had more infections.
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ICYMI: Dead Words Eulogy
The trouble with rheumatology may be the words we live by. Welcome to the eulogy for rheumatology 'dead words'. We're here today to celebrate the loss of rheumatology past. These are dead words in rheumatology, words fortified unfortunately by history and habit. The lexicon of rheumatology is
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RT @yuz6yusof
#EULAR2024 OP0180 Can we safely taper GC in #lupus patients who are in remission? Single study in Italy showed in pts with SLEDAI=0 + pred =<5mg/d + stable IS/HCQ, GC discontinuation after proper tapering appeared safe and was associated with a low risk of flare
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Factors Affecting Hydroxychloroquine Adherence
A study from the University of British Columbia has evaluated the trajectories of HCQ use in patients with incident RA and SLE between1997 and 2021, and identified factors associated with high adherence.
https://t.co/kDUxVCfRGt https://t.co/1v79Vqdqo8
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