PCR: Prevalence, Cost, & Risk (6.27.2025)
Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com
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Metanalysis of Uveitis & JIA - 28 studies, 22,834 JIA pts w/ 3,381dx w/ uveitis - prevalence = 12.7%,, highest in Europeans (14.3%), lowest in Asian (6.5%). Uveitis risk factors included early age JIA onset, ANA-positive, and increased ESR. https://t.co/MxffJKvbik https://t.co/LDz60uwQTM
Dr. John Cush @RheumNow( View Tweet )
JAMA Patient Education Page on what is Interstitial Lung Disease https://t.co/BDbV6I53NH https://t.co/1OtTiJHkdt
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Dr. John Cush @RheumNow( View Tweet )
POCUS of the lung can detect subclinical ILD and can be a useful, inexpensive, easy to perform screening tool for CTD-ILD.
#EULAR2025 @RheumNow https://t.co/HC0skwUKQG
Dr. John Cush @RheumNow( View Tweet )
AI in Early Diagnosis of Giant Cell Arteritis
Dr. Bella Mehta reviews abstract OP0343 - THE CLAUDICAITIO MODEL: ULTRASOUND IMAGE CLASSIFICATION IN GIANT CELL ARTERITIS BY APPLICATION OF ARTIFICIAL INTELLIGENCE - at the 2025 EULAR meeting in Barcelona.
https://t.co/lJFuAgmSTH https://t.co/R1tbYpJ74o
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Dr. John Cush @RheumNow( View Tweet )
IL-17 inhibitors - Long-term Extensions and Uveitis
Dr. Peter Nash offers his perspective on data presented at the 2025 EULAR meeting in Barcelona.
https://t.co/eQd0TcQn76 https://t.co/6Zog4LC8Aj
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Dr. John Cush @RheumNow( View Tweet )
HLA-B27 Testing in Practice
A single center study shows HLA-B27 testing is often performed by both by rheumatologists and nonrheumatologists for a wide array of reasons and often along with other serologic tests. Optimal use of HLA-B27 testing has yet to be defined.
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A Review of Intracranial GCA
A comprehensive review in Rheumatology on intracranial giant cell arteritis (icGCA) stresses that GCA is both an intracranial and extracranial large vessel vasculitis, with the former having unique presentations, and outcomes.
A systematic review included 102
Lessons on Uveitis and AxSpA
Dr. Adela Castro reporting from the 2025 EULAR meeting in Barcelona
https://t.co/G0lDGDhpTh https://t.co/UWBSgTLyQm
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 )
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 golimumab and certolizumab pegol.
Other data have emerged for JAKi and
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
Dr. John Cush @RheumNow( View Tweet )
HLA-B27 Testing in Practice
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
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 )
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
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 )
Participation is Up! (1.31.2025)
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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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 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 )
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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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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