Eye

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non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.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non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.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treatment for JIA-associated uveitis and has been FDA approved for such use - but for how long and can the drug be withdrawn?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 )
RheumNow Podcast square

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 )
shingles_0.jpg

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 )
A#2650 MRI can show extent of vessel wall inflamm to guide severity of GCA Brain & orbital MRI performed Assessed 7 arteries bilaterally -> CAMRIS-GCA MRI score (0-10) 33 GCA (17 ocular), 41 not GCA CAMRIS-GCA ass w/ ocular GCA, higher severity. Improved w Rx @RheumNow #ACR24 https://t.co/19XCuZJXqF

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Eric Dein @ericdeinmd( View Tweet )
Low uveitis rates in patients with axial spondyloarthritis and psoriatic arthritis treated with bimekizumab (BKZ) over the long term. Key findings: - AxSpA: 3.7% incidence (1.3/100 PY) with BKZ. - PsA: Only 0.2% incidence (0.1/100 PY). - All events were mild/moderate, with no… https://t.co/jkUwHJk3FJ https://t.co/gTcCzeC88e

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Single cell TCR sequence study explores the limitations of TRBV9-depleting therapies in axial spondyloarthritis. Key findings: - Identified a clonally expanded TRBV5-5+ TCR in HLA-B27+ acute anterior uveitis. - Alternative TRBVs may retain pathogenicity and evade anti-TRBV9… https://t.co/Aj8oslsTNX

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )

Which subsets of GCA pt might benefit most from upadacitinib? Sub-analysis from SELECT-GCA presented today: 💥Both relapsing and refractory disease 💥Pt w hx of PMR 💥Non-smokers 💥No hx ischemic eye dz In general, most subgroups still favor UPA @RheumNow #ACR24 Abst 1695 https://t.co/pX5hcX4TmR

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Brian Jaros, MD @Dr_Brian_MD( View Tweet )
#Blinded by results? 😊 #Ocular #involvement in #GPA 👇 Helped by #rituximab 👁️ #GPA Difficult Proptosis Pseudotumour Conjunctivitis Scleritis Vasculitis Ocular muscles - diplopia Small case series ‘author defined’ remission in 80% 👍 #RTX #abst0726 @rheumnow #ACR24 https://t.co/GHptelOTyv

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Janet Pope @Janetbirdope( View Tweet )
back, LBP, spine, AS

Difficult to Manage Axial Spondyloarthritis

Adela Castro, MD

Studies show that patients with difficult-to-manage axSpA have a higher disease activity; however, the lack of a consensus definition led researchers and clinicians to utilize their own proposed definition, resulting in variability of the characteristics of non-responders.

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Systematic review suggests (although not provn) that audiovestibular dysfunction may be from APS. Anti-phospholipid & HSP-70 Abs found 25-33% w/idiopathic sudden sensorineural hearing loss,. ACL Abs seen in up to 27% w/ sensorineural hearing loss https://t.co/GTcLoM0SCZ https://t.co/afFntYnPPG

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Dr. John Cush @RheumNow( 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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