Autoinflammatory

Pregnancy outcomes in autoinflammatory disease To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual https://t.co/oQ7A2bnDmO
Dr. John Cush @RheumNow( View Tweet )
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Nurse-Led Treat-to-Target Clinics

EurekAlert!

New studies shared at the 2025 annual EULAR congress in Barcelona highlight the benefits that nurse-led care can bring for both patients and healthcare systems.

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EULAR 2025 – Day 4 Report

Jack Cush, MD

Saturday was the final day of EULAR, and included several lectures, but mostly late breaking abstracts and new EULAR guidelines - notably on Rheumatoid Arthritis and another on Interstitial Lung disease in connective tissue disorders. My favorite presentations included the following.

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pregnant, pregnancy, mother, fertility

Pregnancy outcomes in autoinflammatory disease

EurekAlert!

To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual congress of EULAR – showcased findings from 97 women with an

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EULAR FMF recommendations 2025: still emphasis on colchicine adherence to maximal dose +/- bDMARDs if needed for control +/- csDMARDs for residual chronic MSK involvement new: consider tapering bDMARD if remission >6mo See the treatment algorithm below⬇️ #EULAR2025 @RheumNow https://t.co/Hy6DOKzfUL

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David Liew @drdavidliew( View Tweet )
FMF #Recommendations 🔺️Start Colchicine in All (& continue for confirmed pts) 🔺️Single or divided dose, depend on adherence & tolerance 🔺️Max dose 2 mg children, 3 mg adults 🔺️if failure: add IL1i (6 RCT) (2 for IL6i) 🔺️Add c or bDMARd if MSK #EULAR2025 @RheumNow https://t.co/fPyQrLbb6S

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
FMF #Recommendations During attack: 🔺️No use of increasing Colchicine 🔺️No use for corticosteroids and opioid 🔺️Use NSAIDs #EULAR2025 @RheumNow https://t.co/jJjWJra7yr

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
FMF #Recommendations #Colchicine can be fatal 🔺️Monitor regularly #EULAR2025 @RheumNow https://t.co/VJZYPaBrvE

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
FMF #Recommendations #Colchicine can be fatal 🔺️Beware of drug interactions 🔺️Mostly statins in adults 🔺️Macrolides in children #EULAR2025 @RheumNow https://t.co/SYGLpAJXFu

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
Procalcitonin can be used in the monitoring of infection, but is also high in Stills disease. 89 AOSD pts showed pts w high PCT had more pleuritis, MAS,^LFTs, & correlated w/ Dz activity, CRP, LDH, hi ferritin & normalized w bDMARD Rx. #EULAR2025 abstr #POS1118 https://t.co/NpRA9optd3
Dr. John Cush @RheumNow( View Tweet )
"H Syndrome" review of 23 French pts. Autoinflammatory dz due to variants of SLC29A3 gene. Multisystem histiocytic lymphoproliferative disorder of young adults- skin 2/3, sensorineural hearing loss, fever w/ endo & autoimmune dz. Best responses w IL6 inhib. #EULAR2025 Abst https://t.co/F7NGI4TkJS
Dr. John Cush @RheumNow( View Tweet )
The definition of MAS. MAS is secondary HLH. Other causes of secondary HLH are infections, malignancy and iatrogenic. Georgin-Lavialle S @RheumNow #EULAR2025 https://t.co/CpB78JBlVJ

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS Several monogentic mutations in primary HLH- these panels can be available.. #EULAR2025 @RheumNow

Bella Mehta @bella_mehta( View Tweet )

Age of onset is really important when thinking about #MAS Primary HLH more frequent in pediatric population. But can continue to adulthood. #EULAR2025 @RheumNow https://t.co/J7xmTiQiwr

Links:

Bella Mehta @bella_mehta( View Tweet )
MAS can be triggered by infections in VEXAS syndrome. The threshold is reached leading to a hyperinflammatory state Georgin-Lavialle S @rheumnow #EULAR2025 https://t.co/NKLL75rOgP

Links:

Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Management of HLH/MAS and modes of action of advanced therapies Jessica Manson @RheumNow #EULAR2025 https://t.co/Op3u53ZXeK

Links:

Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Stabilize the pts with HLH with steroids when still trying to figure out the diagnosis of #HLH/ #MAS Many drugs can be used...but important to balance infection risk with immunosuppression These are critical pts. Be vigilant.. #EULAR2025 @RheumNow https://t.co/id4ae3SWtj

Links:

Bella Mehta @bella_mehta( View Tweet )
Closing the care divide in #JIA treatment plenary session Overall theme in #EULAR2025 is everyone talking about AI and digital health on day 1 Biologics have changed the game! @RheumNow https://t.co/qDqbz8JApe

Links:

Bella Mehta @bella_mehta( View Tweet )
Treatment of MAS, or the bête noire in Still's disease, presented at the Plenary session by Peter Nigrovic #Plenary room #EULAR2025 @RheumNow https://t.co/S4SG2VflNg

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Nelly ZIADE 🍀 @Nellziade( View Tweet )
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/wYTNv50tqM
Dr. John Cush @RheumNow( View Tweet )
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MTX Fails Knee OA (6.6.2025)

Jack Cush, MD

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

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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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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/fBdfrrZt1M
Dr. John Cush @RheumNow( View Tweet )
Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/YbYPaJUEbz
Dr. John Cush @RheumNow( View Tweet )

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Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder. Read Post

Best of 2022: Myths & Misconceptions with Febrile Disorders

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Still’s disease and autoinflammatory disorders are rare conditions unified by recurrent fevers and inflammation of skin, joints, and other organs. While labs often support the diagnosis, these conditions are best diagnosed by genetic testing, or by specific criteria (in the absence of a genetic test). The following is a table that lists common misconceptions (myths) and their clarifying explanations. Read Post
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