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Cardio/Pulmonary

RA-ILD at Higher Risk for Serious Infection and Death

A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.

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Burnout or Retire (4.12.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?

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ILD Onset in MDA-5 Dermatomyositis

Anti–melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM) is a rare, aggressive and progressive subtype of DM. Its' severity is dependent on the development of progressive interstitial lung disease (ILD), manifesting as either rapidly progressive ILD (RPILD

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13 Risk Factors for RA-associated Interstitial Lung Disease (ILD) ILD is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%. https://t.co/x1YFv0ZlL9 https://t.co/XGeilz2tus
Dr. John Cush @RheumNow( View Tweet )
Pearl: Three "S" Rule (Smoking, Seropositivity, Sex/Male): if present the risk of RA-UIP (ILD) goes up nearly 13 fold (ACR23 Abstract 1269) https://t.co/2YFosInpGs https://t.co/rOVN79JJRz
Dr. John Cush @RheumNow( View Tweet )

Serious Infections in Takayasu arteritis

The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.

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13 Risk Factors for RA-associated Interstitial Lung Disease

Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%. 

This systematic review included 56 studies with 11,851 RA-ILD patients. The

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Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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CV Risk Early with Rheumatic Disease Diagnosis

A Finnish populaton study shows that the temporal relationship between cardiovascular (CV) comorbidities in rheumatic diseases (RMD) is seen early after the RMD diagnosis.

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MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children

CDC

Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.  The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021.

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Sniffles & Arthritis (3.1.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual?  You decide....





  1. No clear link between weather & MSK symptoms

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Excess Cardiovascular Risk in Gout

A UK population cohort study has shown that gout carries an increased risk for a wide variety of cardiovascular disorders.



A matched case–control study examined the electronic health records from the UK Clinical Practice Research Datalink and compared gout (one to five) with controls

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Can Biomarkers Improve Cardiovascular Risk Assessments in RA?

The TARGET (Treatments Against RA and Effect on FDG PET/CT) trial showed that different treatment strategies equally benefited arterial inflammation (by FDG-PET) in rheumatoid arthritis. A subsequent analysis of these patients showed several candidate biomarkers that may correlate with

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MMPs play pathogenic role in RA-ILD. Multicenter VA study of 2,312 RA pts, 96 had prevalent ILD & Incident ILD developed in 130 (IR 7.5/1,000PY). High MMP-7 increased ILD (adj OR 3.78) & incident ILD (adj HR 2.33). Higher MMP-9 did same https://t.co/3i49TsAQbt https://t.co/RA6Fu2jPeE
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Gabapentinoid use in COPD pts assoc w/ signif increased risk of severe exacerbation. Compared with nonuse, GABA use incr risk of COPD exacerbation when used for epilepsy (HR 1.58), neuropathic pain (HR 1.35), chronic pain (HR 1.49) https://t.co/EyONh9sASh https://t.co/Sr2FyJQzBj
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But MTX does not prevent CV events in cardiac rush pts (without rheum dz). Results of the CIRT trial. #RWCS24 https://t.co/45aLt6qf27
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Steroids are associated with MACE events in RA. #RWCS24 @RheumNow @RWCSmtg https://t.co/U6ssALNspe
Dr. Rachel Tate @uptoTate( View Tweet )

Favorable Survival w/ MDA-5 Ab+. 154 pts w/ MDA5+DM; 40 died (26%) Rx induction (mostly resp. failure). 114 survived, w/ 5-yr survival of 97% & relapse-free survival 77%. Survival improved w/ JAKi use (P=.03). 8% achieved complete drug-free remission. https://t.co/QkqM9IztEG https://t.co/yBCH85CpUN

Dr. John Cush @RheumNow( View Tweet )
Prevalence of Cardiovascular Disease in Rheumatoid Arthritis A prospective study of the BioSTAR registry estimates the prevalence of cardiovascular disease in rheumatoid arthritis (RA) to be 4.6%. https://t.co/NRn0DrYoBX https://t.co/qOoTmBNB1p
Dr. John Cush @RheumNow( View Tweet )
How Dr. P Seo manages #vasculitis patients with nonrespiratory manifestations #RNL2024 @rheumnow https://t.co/sjTXulDZ3a
TheDaoIndex @KDAO2011( View Tweet )
JAK toxicity of interest. Eric Ruderman #RNL2024 @RheumNow https://t.co/qdlJFKTUR8
Nouf Al hemmadi @NoufAhmedAlham2( View Tweet )
Dr. Winthrop avoid JAKi and TNFi in pts with chronic lung infections like MAI. #RNL2024 @rheumnow https://t.co/TfMa7hktL9
TheDaoIndex @KDAO2011( View Tweet )
Dr. M Guma noted @ACRheum 2022 Guidelines on RA recommend the #MediterraneanDiet; studies have shown this diet reduces CV risk, RA disease activity #RNL2024 @RheumNow https://t.co/AdKWgME4nD
TheDaoIndex @KDAO2011( View Tweet )
Nuclear imaging assesses cardiac function, anatomy & microvascular dysfunction (MD). MD is underrecognized but can be measured by coronary flow reserve. MD is associated with worse longterm outcomes in systemic inflammatory disease – Dr. Weber #RNL2024 @rheumnow https://t.co/Bv22UKi6mM
TheDaoIndex @KDAO2011( View Tweet )
Coronary Microvascular Dysfunction is associated with poor prognosis/outcomes in our systemic inflammatory disease patients. What is the gold standard for evaluating microvascular dysfunction? Coronary Flow Reserve (CRF) This is only one component to fully understand and assess… https://t.co/bMV5npkFwm https://t.co/ZYBXpQLPIF
Dr. Rachel Tate @uptoTate( View Tweet )