NHANES, Numbers, & Risk (7.18.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".
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"FLAME" - machine learning model developed to predict SLE flares. Data from 28,433 SLE pts (2011-2022) looked at clinical & social determinants of health (SDoH) to predict 3 mo flare risk. AUROC = 0.67; SHAP analysis identified HA, OBS, & pyuria as predictors. Is this the https://t.co/6Eqqc9w2oV
Dr. John Cush @RheumNow( View Tweet )
PsA is worse in women--why? 100 PsA pts, serum study of differentially expressed proteins - 20 times more sex-specific DEPs in PsA males than females (PsA vs controls). In women leukotriene A-4; and in men IL-36, NEK7 & PIK3CA/PIK3R1 were significant predictors. https://t.co/JzI1n6Hf5G
Dr. John Cush @RheumNow( View Tweet )
Clinical Associations with Anti-RNA Polymerase III Antibodies
A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome https://t.co/p1KVUFPJvN
Dr. John Cush @RheumNow( View Tweet )
Pesticides and Rheumatoid Arthritis?
Women exposed to pesticides through farm work or as farmers' wives face increased risk for developing rheumatoid arthritis (RA), a new analysis of Agricultural Health Study (AHS) data indicated.
https://t.co/ISddKbnxMY https://t.co/E5tpX5D70X
Dr. John Cush @RheumNow( View Tweet )
Fibrosis in IgG4-related disease due to the overexpression of early growth response-1 (EGR-1) by Epithelial cells that facilitates tissue fibrosis https://t.co/PBMqjr0MVV https://t.co/d9b7k2zwYE https://t.co/25aIjIrYm3
Links:
Dr. John Cush @RheumNow( View Tweet )
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/hp7sFR6kLa
Dr. John Cush @RheumNow( View Tweet )
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/IDeEvitIrB
Dr. John Cush @RheumNow( View Tweet )
BMJ - UK population study of 1.5 million adults finds pts w/ autoimmune dz have twice the risk of affective disorders (depression, bipolar dz, anxiety) significantly higher (p<0.001) (28.8% vs 17.9% in gen. population. Signif regardless of age, sex, ethnicity, income, Fam Hx, https://t.co/dsJxkvD4Nu
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Axial Involvement in Psoriatic Arthritis
Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.
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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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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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Predictors and Outcomes in Systemic Sclerosis
The VEDOSS project has previously shown that 70% of patients with Raynaud’s phenomenon and at least one red flag – systemic sclerosis (SSc)-specific antibodies, puffy fingers, or an SSc pattern on nailfold capillaroscopy –will https://t.co/9dJn1qMQfy
Dr. John Cush @RheumNow( View Tweet )
#EULAR2025 Abstr#OP0265 Do we have convenient biomarkers to help predict new ANA+ referral who would progress to #SLE #Sjogren at 12 mths? Proteomics analysis identified IFN and B-cell markers. Validation is needed and to incorporate clinical items into prognostic model @RheumNow https://t.co/TWClLTKQ0b
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
What ‘CAR’ to drive?
#CAR-T buzz was at #EULAR2025
In multiple #rheumatic #diseases
#SLE
#Scleroderma
#Sjogrens
#myositis
Even #axial #SpA
Who - active, not a lot of damage
Which target 🎯
Which priming regiment
What will results be compared to?
Who will pay?
@RheumNow
Janet Pope @Janetbirdope( View Tweet )
E3N cohort 78000+ women >30yrs follow up
698 incident RA cases)
In non smokers, RA asso w/
-tall at birth HR=1.55
In smokers, RA risk associated w/
-prematurity HR=1.63
-in utero exposure to tobacco HR=1.83 (ns)
#EULAR2025 @RheumNow POS0226 https://t.co/xC3k3kiKsZ
Aurelie Najm @AurelieRheumo( View Tweet )
Acute Dactylitis in #Psoriatic_Arthritis
🔹️1216 patients Canada 🇨🇦
🔹️52% had at least one episode of acute dactylitis in a median 12 years
🔹️Positive association with HLA-B27 and HLA-B27/C02
🔹️No association with HLA-B51
#EULAR2025
@RheumNow
OP0180 by Kharouf et al. https://t.co/oNNMBcvVb4
Nelly ZIADE 🍀 @Nellziade( View Tweet )
Is RA just one disease?
No, & increasingly more efforts to subgroup RA on diff levels
Simple approach - derived phenotypes map (independent of ACPA):
- to broad histopath
- to MTX response
Omics is good, but still need to do the simple stuff better!
#EULAR2025 OP0328 @RheumNow https://t.co/a8Vl7Kcjso
David Liew @drdavidliew( View Tweet )
Study on the HLAs associated with the occurrence and course of acute/tender dactylitis in PsA patients.
Acute dactylitis genetics:
•HLA-B27 (OR 1.71), HLA-C12 (OR 1.43), B38/C12 & B27/C02 haplotypes.
•Resolution faster on b/tsDMARDs (HR 1.67); unaffected by HLA.
Abstract
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
29% of new-onset psoriasis pts in Stockholm cohort developed PsA over 9,255 person-years.
Two prediction models (AUC 0.804) identify:
➡ who to refer
➡ who will progress
Key predictors: HLA-B27, CRP, enthesitis, arthralgia.
@RheumNow #EULAR2025 #OP0178:
Jiha Lee @JihaRheum( View Tweet )
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS
Several monogentic mutations in primary HLH- these panels can be available..
#EULAR2025 @RheumNow
Bella Mehta @bella_mehta( View Tweet )
3 Fs of diagnosis of #HLH
-Fever
-Ferritin
-Falling blood count
Raising awareness is the key! Especially in rare diseases like this where the morbidity and mortality is super high!
Collaboration between specialists help
HLH networks will be helpful like this
@RheumNow #EULAR2025 https://t.co/HWbvIma3yx
Bella Mehta @bella_mehta( View Tweet )
Sex differences in biologic response in PsA.
DISCOVER-2 post hoc analysis showed:
•Radiographic progression at Week
♂️: 2.22 units
♀️: 1.10 units
•Early ACR-like response (cDAPSA LDA at 8wks) linked to less damage in men (0.39 vs 2.24)
Women less likely to progress https://t.co/NhBkXbuLjO
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Insights from the Gut-Joint Axis in axSpA: Findings from the DESIR cohort
-Baseline biomarkers of bacterial translocation: PLTP (phospholipid transfer protein) and LPS evaluated.
-In early axSpA baseline PLTP activity was associated with sacroiliac radiographic progression at 5
Adela Castro @AdelaCastro222( View Tweet )
RA polygenic risk ≠ MI risk. In >8,700 Swedes w/ or w/o RA, higher genetic risk for RA wasn’t linked to higher MI incidence. Familial clustering of RA & MI likely driven by non-genetic factors. Traditional CV risk still key in RA care.
@RheumNow #EULAR2025 #OP0072 https://t.co/KN6Dg0ekt2
Mrinalini Dey @DrMiniDey( View Tweet )
Recent Blogs
Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub! This is their light-hearted, gender biased debate on the best patients: Men vs. Women.
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