ANA+ consult (10.18.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Study of AutoAbs in 141 pts w/ systemic sclerosis overlap syndrome (SSc OS). Most common Abs: Ro-52, centromere (ACA) & anti-Scl-70. Scl-70 was assoc w/ ILD & SSc renal crisis (SRC); while ACA is protective factor of ILD. SRC & pulm HTN assoc w/ incr mortality… https://t.co/sqQhIlZjdB https://t.co/noyaFbd3Z8
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Full read review on the detection & management of #ILD in Autoimmune Dz (AID).
- AID at risk for ILD should be screened with hi-res CT Scan
- ILD should be monitored closely w/ PFTs
- Multidisciplinary Rx includes immunosuppressives & antifibrotics https://t.co/bk7kc5Piyq https://t.co/ktvhS214gS
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Claims study presented at SASM mtg by HSS orthopedists found among >100k Hip/Knee replacement surgeries, the 19% who used CPAP (OSA) had significantly fewer ER visits and postop complications. https://t.co/kg7oCRndqH https://t.co/WRcxUD3c6V
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Cardiovascular health (CVH) is critical in arthritis care. NHANES study 5919 arthritis pts finds 10-point incr, in CVH score yielded significantly lower all-cause mortality risk (adj HR 0.72; 0.67–0.79); best results with OA/DJD, more than inflammatory arthritis.… https://t.co/etBbH7bH1D https://t.co/1is2VlT5sl
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Eu Heart J - Cardiometabolic risk factors in RA Pregancy rose in last 15 yrs. RA-Preg at higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, venous thromboembolism during hospitalizations. https://t.co/7SnjWFluCf https://t.co/H93ELPZWWz
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UK Biobank study of 391 481 individuals found that a high polygenic risk score (PRS) for Hidradenitis suppurativa (HS) was assoc w/ increased risk of incident coronary artery Dz, diabetes, High LDL/TG and CRP https://t.co/ZS4w4hooKB https://t.co/DUXoFHMBqR
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A CATCH study of 2052 early RA (ERA) pts found high incidence of hypertension (26%) with the highest risk in older patients with traditional cardiovascular risk factors. Those without HTN, at enrolment, 24% developed HTN after median follow-upof 5 years. https://t.co/8MmU60MK8v https://t.co/LyxSssXKLo
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Dot the "i", Cross the "t" (10.11.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.
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Screening to Prevent Multimorbidity in Rheumatic Patients
A population based screening program of patients with chronic inflammatory rheumatic diseases (IRD) demonstrates that systematic screening IRD patients for multimorbidity increased preventive interventions and reduced hospital admissions.
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Korean Claims analysis of 413 radiographic axial spondyloarthritis (TNFi exposed=75 ). Recurrent CV events = 32 per 1,000 person-years; but lower if TNFi Rx'd = 19/1000PYs. TNFi exposure significantly lowered risk of recurrent CV events https://t.co/f69SHpXZCx https://t.co/ofpg0JbrR1
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Full read review and metanalysis of 11 articles shows nearly 60% of #RA demonstrate an elevated Coronary Artery Calcification (CAC) score; RA pts have higher CAC scores (&CV risk) than their healthy counterparts. https://t.co/aWE2Ul6WDu https://t.co/QHFbRzytTZ
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Pooled data from #PsA (n=914) & #AS (n=372) RCTs looked at outcomes in smokers (37% & 48%). Current or past smoking had NO EFFECT on outcomes (MDA, ACR50, ASAS40, ASDAS), but incr odds of D/C & some SAE (SIE) but not MACE, HZ, VTE https://t.co/WRflSVO3Ig https://t.co/YMI5YCT0QK
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Which One is the Loneliest Number (9.27.2024)
Dr. Jack Cush reviews the regulatory approvals, announcements, guidelines and interesting journal articles from the past week on RheumNow.com. When not to use muscle relaxants, how frequent is loneliness in RA/PsA/SpA, and when to refer patients with Still's disease.
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Full read overview of ILD & its Clinical Course inRheumatoid Arthritis. Metanalysis of 22 reports shows 6-19% of RA have ILD on HRCT. Article discusses early onset, progression and the monitoring and management of RA-ILD https://t.co/mqexPcruni https://t.co/One7XYn4wX
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Treatment of Rheumatoid Arthritis (RA) associated Interstitial lung disease #ILD
2023 ACR/Chest Guideline
#Rheumatology #MedTwitter https://t.co/hoW88BL2E2
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Metanalysis of JAKi in ILD (7 studies, 183 pts) showed increases in FVC (2 %), DLCO (3.1%) & improved Thoracic HRCT of 11%; only 5% had worsening of their ILD. Risk of ILD w/ JAKi was low ( 0.20/1000 PY) w rates similar to abatacept & rituximab https://t.co/UDJ1ZvtGhh https://t.co/WTQS67yDyl
Links:
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Pipeline drugs and trials intended for Interstitial Lung Disease - including studies with nintedinib, Efzofitimod, BI 1015550, AD-214, Abatacept, ATYR1923, Pirfenidone inhalation, RO-0220912, Lung stem cells...Riociguat, Treprostinil and more https://t.co/fpMjjubPVx https://t.co/ketFP0N9jk
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I Can't Treat Ugly (9.20.2024)
Dr. Jack Cush reviews the news, journal articles and a new FDA approval for EGPA, this week on the Podcast.
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Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/uprHZbsqkR https://t.co/edjoN2vzc0
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Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.
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Sustained Hydroxychloroquine and Cardiovascular Outcomes
A national cohort study shows that continuous use of hydroxychloroquine (HCQ) protects against cardiovascular (CV) events in patients with systemic lupus erythematosus (SLE).
https://t.co/xqB2tyzzYQ https://t.co/dlFjbgbsep
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Norwegian Registry study compared risk of stroke in 2750 RA vs 158 879 w/o RA pts. 7.3 vs 5% (HR 1.36; 1.13, 1.62). RA pts with atrial fibrillation was also elevated (HR 1.25; 1.05, 1.5). RA pts less likely to Rx w/ oral anticoagulants (adj OR 0.88) than non-RA… https://t.co/s20wTKafR8 https://t.co/FPxc5VP4Xh
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Linger on the Fingers (9.6.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week with a focus on fingers and better prescriptive follow through.
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Study of 4370 RA pts (26534 PYs) saw 362 MACE (CV) events. RA activity & inflammatory markers assoc w/ MACE risk in bDMARD non-users (not those on bDMARDs). 515 bDMARD vs 3855 non-users (n=3855). Each DAS28-CRP unit incr MACE risk (HR 1.21)https://t.co/lRaHxTHzqe https://t.co/usEiJctVYk
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