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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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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Bad News Coronary Artery Calcium in Rheumatic Patients
In the 2024 SCCT meeting, Dr. Brittany Weber presented findings showing that incidentally discovered CAC in patients with IMID can lead to worse outcomes, even without prior ASCVD.
https://t.co/aJhf0IL1WW https://t.co/uMl89rXjBK
Dr. John Cush @RheumNow( View Tweet )
Bad News Coronary Artery Calcium in Rheumatic Patients
A recent presentation at the 2024 Society of Cardiovascular Computed Tomography meeting by Brittany Weber MD, PhD (Brigham and Women’s Hospital) has shown that incidental findings of coronary artery calcium on chest CTs in patients with immune-mediated inflammatory diseases may be associated
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Full read overview of myositis associated - ILD (and treatments), including:
- Case examples
- Antisynthetase Syndrome
- Anti-MDA5 Amyopathic DM
- Interstitial Lung Disease in Myositis https://t.co/PhfuuBHOYf https://t.co/OC1GmWkYyO
Dr. John Cush @RheumNow( View Tweet )
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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Full read overview of myositis associated - ILD (and treatments), including:
- Case examples
- Antisynthetase Syndrome
- Anti-MDA5 Amyopathic DM
- Interstitial Lung Disease in Myositis https://t.co/zQpfstnGy8 https://t.co/XogyyxuVMk
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Community-Acquired Pneumonia (CAP)
https://t.co/geb8y2AK26 https://t.co/cB3y5vQoz1
Dr. John Cush @RheumNow( View Tweet )
CHANCE-3 DBR-PCT of 8343 adults (>40yrs) w/ CVA or TIA & hsCRP ≥2 mg/L showed that colchicine (0.5mg) x 90d did not prevent (6.3% vs 6.5%; HR 0.98; 0.83 to 1.16) subsequent stroke within 90 days compared with placebo https://t.co/APiMYVkBTV https://t.co/VgFiCKfMqB
Dr. John Cush @RheumNow( View Tweet )
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
Links:
Dr. John Cush @RheumNow( View Tweet )
How do you manage new progressive ILD?
Dr. John Cush @RheumNow( View Tweet )
No Risk of Interstitial Lung Disease with Methotrexate Use
JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM).
https://t.co/qauRelAkG0 https://t.co/bhSLYrfzlv
Dr. John Cush @RheumNow( View Tweet )
EUSTAr study of 4431 systemic sclerosis (SSc) pts - anti-SSA antibodies are detected in 15% of SSc-patients and represent an independent risk factor for the presence of lung fibrosis (OR 1.24) & more severe lung involvement. #EULA2024 OP0013 https://t.co/NcxReWk83n https://t.co/FSMx22XiNo
Dr. John Cush @RheumNow( View Tweet )
TARGET compared triple DMARD to TNFi in 122 RA pts and association with CV risk. In a subanalysis they found no correlation between change in lipid measurements and change in vascular inflammation by FDG-PET. https://t.co/0HKogmdRGH https://t.co/cD7UVTgTQ3
Dr. John Cush @RheumNow( View Tweet )
Protective Benefits of SGLT2 Inhibitors and Lupus Nephritis
A multicenter cohort study of systemic lupus erythematosus patients with type 2 diabetes has shown the use of sodium-glucose cotransporter-2 (SGLT2) inhibitors associated with a significantly reduced risk of lupus nephritis, dialysis, kidney transplant, heart failure, and all-cause mortality
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EUSTAr study of 4431 systemic sclerosis (SSc) pts - anti-SSA antibodies are detected in 15% of SSc-patients and represent an independent risk factor for the presence of lung fibrosis (OR 1.24) & more severe lung involvement. #EULA2024 OP0013 https://t.co/oW6NBjIG7E https://t.co/toyvHxJlr9
Dr. John Cush @RheumNow( View Tweet )
No Risk of Interstitial Lung Disease with Methotrexate Use
JAMA reports a cohort study that investigated the association between methotrexate (MTX) use and Interstitial lung disease (ILD) in patients with dermatomyositis (DM).
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Another proof (if needed) that controlling Dz Activity in RA is a very important preventive measure in RA!
179 pts
ILD newly developed 9.5%
progressed 12.3%
no change 74.9%
improved 4.5%
5.7% in the LDA group 28.0% non-LDA group (p=0.006)
#EULAR2024 POS0408 @AurelieRheumo https://t.co/lKUY32KFiX
Dr. John Cush @RheumNow( View Tweet )
Damage in Childhood Lupus
EurekAlert!
Childhood lupus (cSLE) is a rare multisystem disorder with significant associated morbidity, but evidence-based guidelines are sparse, and as such management is often based on clinical expertise. The EULAR/ACR-2019 criteria have shown sensitivity in cSLE patients, which could allow earlier
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Matters of the heart: cardiovascular disease and mortality in RA
Patients with RA have up to 2x higher risk of coronary artery disease, plus increased atrial fibrillation and stroke risk.
https://t.co/wFs7ds3tF2 https://t.co/GWyXJbeyIn
Dr. John Cush @RheumNow( View Tweet )
New Treatments for Systemic Sclerosis
EurekAlert!
Autologous hematopoietic stem cell transplantation (aHSCT) for SSc has been proven the most effective treatment strategy with regard to overall and event free survival in selected patients.2 But a key limitation is its toxicity, and new treatment options are needed. Two abstracts
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EULAR 2024 – Day 4 Report
The final day of EULAR 2024 was rich in posters, Late-breaking oral presentations and EULAR updates and recommendations. Below is a synopsis of the half-day's action.
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EULAR 2024 – Day 3 Report
EULAR treats its attendees to a wonderful lunch each day – Schnitzel, gnocchi, goulash at lunch after muffins and coffee in the morning. It's no wonder the meeting has been a lively one, well attended with a wealth of stimulating ideas, research and discussion. Here are a few of my favorite
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POS1035 FVC & risk of lung transplant & mortality in #RAILD
50% pts had FVC % predicted decline in ~6.5yrs
2/3 identified groups more strongly assoc w transplant or ILD-related death than INBUILD definition ➡️marked heterogeneity in ILD progression
#EULAR2024 @RheumNow
Mrinalini Dey @DrMiniDey( View Tweet )
📄 You can now read my article on #CardiovascularDisease, #Stroke & #Mortality @RheumNow!
🌟 Featuring 2 cohort studies from @MayoClinic, presented at #EULAR2024
🔗 https://t.co/b639vE5hSA
@MyasoedovaElena
Mrinalini Dey @DrMiniDey( View Tweet )
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