MTX Fails Knee OA (6.6.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com
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#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 )
Muscle biopsies form 3 treatment-naïve juvenile dermatomyositis (JDM) finds transcriptomic evidence of mitochondrial dysfunction consistently in JDM muscle, independent of interferon-driven inflammation. Treating mitochondrial dysfunction may improve JDM outcomes https://t.co/u5tMhT23si
Dr. John Cush @RheumNow( View Tweet )
Environmental and Geographic Risks for SLE
Dr. Karen Costenbader, a rheumatologist at the Brigham and Women's Hospital and a Professor of Medicine at Harvard Medical School in Boston, discusses environmental and geographic risks for systemic lupus.
https://t.co/UDMgB8f0WZ https://t.co/ec5S5wGr9C
Dr. John Cush @RheumNow( View Tweet )
Autoimmunity Rising in Expectant Mothers
Lancet Rheumatology has published a UK study showing a significant increased in the number of expectant mothers beginning their pregnancies with autoimmune conditions.
The MuM-PreDiCT project run by the University of Birmingham, analyzed the electronic healthcare records from
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Genetic Link to CPPD
In a first-of-its-kind genome-wide association study (GWAS) researchers have discovered two genes, RNF144B and ENPP1, that cause calcium pyrophosphate deposition (CPPD) disease in Americans of European and African descent.
https://t.co/YSR6rEYzjG https://t.co/L7JyoxQp3K
Dr. John Cush @RheumNow( View Tweet )
Genetic Link to CPPD
EurekAlert!
In a first-of-its-kind genome-wide association study (GWAS) researchers have discovered two genes, RNF144B and ENPP1, that cause calcium pyrophosphate deposition (CPPD) disease in Americans of European and African descent. This crystalline arthritis is caused by calcium
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Lupus in an empty house
The full house immunofluorescence pattern is the classic histopathologic finding of lupus and lupus nephritis. Glomerular deposits staining for IgG, IgA, IgM, C3 and C1q can help confirm a suspected diagnosis of systemic lupus erythematosus (SLE). This https://t.co/Zcywc5r9q9
Dr. John Cush @RheumNow( View Tweet )
>200 genes 🧬 implicated in #SLE
Complex indeed!
And
▶️ 7 clusters of signalling pathways
So we have to have many Rx options
Ab patterns vary
LN flares can have v diff pathways between Pts
#LUPUS2025 @RheumNow
Unravelling #LUPUS2026 https://t.co/LEKN363194
Links:
Janet Pope @Janetbirdope( View Tweet )
The ANA pattern I hate
#DFS
Why
Dense fine speckled should R/O #SLE
But mimicking patterns that MAY Have #lupus
AC-2 pattern mimickers ex AC-4
Machine learning models to help
▶️improved accuracy
Fast saving hrs
#Artificial #intelligence
May Choi #LUPUS2025 @RheumNow https://t.co/9tk80ZOAWg
Janet Pope @Janetbirdope( View Tweet )
Who with +ANA will become #SLE
Mostly similar cytokine signature
But ⬆️IFN and
more innate immune changes
👇
In those who developed #lupus
? prediction & Prevention model in +#ANA people 🤷♀️
yr in review E Vital’s paper
#LUPUS2025 @RheumNow @ZahiTouma https://t.co/khpqRlH8Nk
Janet Pope @Janetbirdope( View Tweet )
Who does worse with #SLE
#nature vs #nurture
South American #lupus #registries
⬆️ activity
⬆️damage
⬇️age
⬇️SES
⬆️SLE #antibodies
#Gladel registry and others vs Europe
Environment >genetics 🤔
#LUPUS2025 #45poster @RheumNow
@gponsestel https://t.co/XjiXHAMuGm
Links:
Janet Pope @Janetbirdope( View Tweet )
Panacea of Prednisone & Cannabis (5.16.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com. Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!
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A brief history of familial Mediterranean fever - FMF is most common periodic fever syndr. an inherited polyserositis mainly affects Arabs, Armenians, Jews, & Turks. Hx may date back to 1802 & Heberden. Osler described 11 cases in 1895. 1st clear report 1945 by Siegal 10 pts. https://t.co/m20uO3bOoj
Dr. John Cush @RheumNow( 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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