Eye

Putting IL17i into ‘focus’ for SpA-associated uveitis The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than https://t.co/xH12VigmUi
Dr. John Cush @RheumNow( View Tweet )
🚨Diagnostic delays are real in axSpA: -Can lead to more extra-msk manfieststions (EMMs) in PsA and axSpA. -Increases disease burden and productivity losses. -EMMs can present before articular sx -Uveitis and IBD associated with longer dx delays. -Diagnosis has improved since https://t.co/rWMwG7Ewwe

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Adela Castro @AdelaCastro222( View Tweet )
uveitis eye iritis

Putting IL17i into ‘focus’ for SpA-associated uveitis

Janet Pope, MD, MPH, FRCPC

The longest studied drug for uveitis in SpA has been monocolonal TNFi Abs. Reductions of acute anterior uveitis have been found with etanercept but less impressively than adalimumab, infliximab, and in my opinion less than golimumab and certolizumab pegol.

Other data have emerged for JAKi and

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While there are trials in progress, there is no RCT data on the use of JAK inhibitors in Noninfectious Uveitis (NIU). But there is this metanalysis of many small case reports suggesting their potential efficacy in NIU. https://t.co/pBNsSmVjOz https://t.co/JrIGQGZjHt

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Dr. John Cush @RheumNow( View Tweet )
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HLA-B27 Testing in Practice

Jack Cush, MD

Analysis of testing for human leukocyte antigen B27 (HLA-B27) in a teaching center shows HLA-B27 testing was frequently performed by rheumatologists and nonrheumatologists for a broad spectrum of indications and primarily as a screening test. 

Data

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JAMA -- Full read review "Uveitis in Adults:" - affects adults 20 to 50 years - noninfectious anterior uveitis: corticosteroids 1st line Rx - posterior noninfectious uveitis: DMARDs 1st line Rx; Biologics 2nd line https://t.co/BJQkPtK2z2 https://t.co/9zAntZK66Q

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Dr. John Cush @RheumNow( View Tweet )
Monitoring for #HCQ #retinal #toxicity 2 tests beyond visual fields are better than 1 OCT Etc But suggestion if low risk to do only every 5 yrs I don’t agree as risk ⬆️ w disease duration We do Annual fields and either OCT or retinal photography #LUPUS2025 @RheumNow https://t.co/TdPJ47jYEL

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Janet Pope @Janetbirdope( View Tweet )
Tuesday Night Rheumatology returns this month with the launch of Lupus Unlocked, starting with a special Journal Club session. Join authors Dr. Richard Furie and Dr. Brad Rovin as they walk us through their pivotal studies on lupus nephritis: 📄 Obinutuzumab in Active Lupus https://t.co/2zZOEzsnnI
Dr. John Cush @RheumNow( View Tweet )
Uveitis Risk with Slow Adalimumab Weaning Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated. https://t.co/KgQsK6fVnr
Dr. John Cush @RheumNow( View Tweet )
pediatric eye uveitis

Uveitis Risk with Slow Adalimumab Weaning

MedPage Today

Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.

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Retrospect. study of 77 RA pts w/ +ANCA (age 62 yrs, 79%F. 65% RF+. 45% p-ANCA+; 42% MPO+. Diagnoses included: AAV (29%); GPA (45%), MPA (36 %); EGPA (5%). Renal (41%) & upper Resp (36%) were most freq. Pts w/ RA+AAV had more RF, MPO+, nodules, inflam eye Dz… https://t.co/NTvAhZY2y8 https://t.co/IAkWHtcTCo
Dr. John Cush @RheumNow( View Tweet )
🆕 slide from @Official_ASAS HLA-B27 strongly associated with Anterior #Uveitis in #SpA #AAU #AxSpA #B27 https://t.co/lq19vIys9x

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Dr Gurdeep S Dulay @gurdeep_dulay( View Tweet )
Adalimumab Withdrawal in Uveitis Patients Adalimumab is an effective treatment for JIA-associated uveitis and has been FDA approved for such use - but for how long and can the drug be withdrawn? An adalimumab (ADA) withdrawal trial has shown recurrence of uveitis, arthritis, or… https://t.co/J1CRgC3GJz https://t.co/8eOSvl5zZm
Dr. John Cush @RheumNow( View Tweet )
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Participation is Up! (1.31.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. We also have two call-in cases on "Ask Cush Anything".

Be sure to join in the fun at RNL 2025 next weekend - Gong Show Karaoke; what will you sing?

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uveitis eye iritis

Adalimumab Withdrawal in Uveitis Patients

Jack Cush, MD

Adalimumab is an effective treatment for JIA-associated uveitis and has been FDA approved for such use - but for how long and can the drug be withdrawn? An adalimumab (ADA) withdrawal trial has shown recurrence of uveitis, arthritis, or both, when the disease was previously controlled on ADA.

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Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
Dr. John Cush @RheumNow( View Tweet )
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Anti-Zoster Drug Prevents Shingles in Lupus Patients on Anifrolumab

MedPage Today

The antiviral drug valaciclovir (Valtrex), given prophylactically, kept patients with systemic lupus erythematosus (SLE) under treatment with anifrolumab (Saphnelo) from having herpes zoster attacks, researchers said, offering a potential alternative to zoster vaccination.

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Overview of Uveitis management of adult & pediatric rheumatology. - Uveitis accounts for 10% of visual impairment globally - TNF inhib are effective; w/ IL-6 inhib as 2nd line options https://t.co/fwhTxEpVG0 https://t.co/cKGdcDbz3d

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Dr. John Cush @RheumNow( View Tweet )
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Off-Label Use of JAK Inhibitors in Orphan Diseases and Other Conditions?

Janet Pope, MD, MPH, FRCPC

When should you consider off-label use of JAKi?

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ANCA Vasculitis "Eye": Can rituximab help? Dr. Janet Pope discusses abstract 0726 at #ACR24 https://t.co/KzYcmjon8D https://t.co/KDIi1vJE4P

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Dr. John Cush @RheumNow( View Tweet )
PsA Potpourri Dr. Arthur Kavanaugh reviewed highlights on adult and pediatric sessions on uveitis, as well as interesting abstracts, at #ACR24 https://t.co/jsCMKHBFMk https://t.co/roZOZT3Mqd

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Dr. John Cush @RheumNow( View Tweet )
Biggest absence award at #ACR24 @ACRheum @RheumNow 🥇 Absence of discussion on 👇 #Oral #Surveillance Except for maybe Monitoring for mouth ulcers and cancers issues are not resolved but we are comfortable with ambiguity!

Janet Pope @Janetbirdope( View Tweet )

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A new score to quantify GCA inflammation?

Eric Dein, MD

The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. This approach is not well individualized to the patient as we do

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Risk stratification of GCA pts: who might lose vision? Cranial MRI with vessel wall enhancement used to calculate additive score... # of vessels affected Higher scores a/w ocular GCA > non-ocular GCA > no GCA and decreased w/ tx @RheumNow #ACRbest #ACR24 https://t.co/knDVrl84Qs

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
Yang et al. Cranial vessel wall MRI in GCA. Quantitated with PEG score. PEG score ocular GCA>non-ocular GCA>non-GCA. Decreases with treatment. @RheumNow #ACR24 Abstr#2650 https://t.co/e26urOpb7V https://t.co/eekQbzmKYm

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Richard Conway @RichardPAConway( View Tweet )

Recent Blogs

My Take on New Ocular Screening Guidelines for Plaquenil

Sergio Schwartzman, MD
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A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time). Read Post

The Role of Hydroxychloroquine Blood Levels in SLE

Michelle Petri, MD, MPH , Laura Durcan, MD

We review the available literature, with a particular focus on the recent findings in the Hopkins Lupus Cohort, regarding the clinical utility of hydroxychloroquine blood levels in helping to clarify some of the issues regarding retinopathy, how best to dose this medication, and medication adherence. 

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