ILD Begins (8.29.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com. This week news on vaccines, safety of acetaminophen and more.
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Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Dr. John Cush @RheumNow( View Tweet )
Interesting data shared by Dr. Sandhya Pulukool on Asian pts with SjD vs. Caucasians:
- Younger age of onset except in Japan
- Higher female to male ratio
@RheumNow #APLAR25 https://t.co/RPM9zI4tVQ
sheila @RHEUMarampa( View Tweet )
Peter Taylor on Pre-RA:
If Pre-RA is too late for interception, shall we start screening general population?
We have to remember RA is a RARE disease
Pre-test of RA per year per person would be 0.00025% for primary prevention:
A needle in a haystack?
@RheumNow @APLAR_org https://t.co/LKGtz1P7sl
Aurelie Najm @AurelieRheumo( View Tweet )
Prof Takeuchi on DMARDs treatment and regional disparities
For similar dose, serum concentration of the polyglutamate (active) form of MTX is much higher in Japanese than US patients
And also high levels achieved much quicker in Japanese than US patients
This is strong https://t.co/ikp63wWifj
Aurelie Najm @AurelieRheumo( View Tweet )
MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/eu1IpaXGL8
Dr. John Cush @RheumNow( View Tweet )
Antibiotics are not linked to Autoimmune disease in kids
The global incidence of autoimmune diseases among children has increased over the past few decades. A study published August 21st in the open-access journal PLOS Medicine by Ju-Young Shin at Sungkyunkwan University, https://t.co/46Q0GFZQiw
Dr. John Cush @RheumNow( View Tweet )
MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/QdUzra1fnj
Dr. John Cush @RheumNow( View Tweet )
Rheums Speak: Future of Rheumatoid Arthritis
The third survey in this series addressed clinician views on future trends (AI), future therapies and lessons learned.
This survey captured 233 responses from rheumatologists (91), most (61%) from the USA. US respondents were from the Southeast (17.5%), Southwest (11.4%), Mid-Atlantic (
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2025 ACR Guidance on Diagnosis and Management of VEXAS
The ACR has published a formal international consensus guidance on VEXAS as a resource for clinicians seeking to understand the disease and its management.
VEXAS is a rare genetic disorder; the acronym stands for Vacuoles E1 enzyme X-linked
Aging Quiets Lupus
UCSF researchers have found that epigentic changes in interferon genes over time may lead to lupus being less active as they age.
https://t.co/MLBFLXnXOQ https://t.co/9aacdZPoED
Dr. John Cush @RheumNow( View Tweet )
Juvenile Idiopathic Arthritis - NEJM Review
Sandborg et al. has published an overview of juvenile idiopathic arthritis (JIA) - its classification, biology, genetics, , clinical presentations and treatment advances in the New England Journal of Medicine (NEJM). https://t.co/ykI9zAUXaF
Dr. John Cush @RheumNow( View Tweet )
DID YOU KNOW? >30% of Systemic Sclerosis pts present without Raynauds!. Data from 2 large US cohorts, of SSc dx with puffy fingers/hands or other symptoms. Such patients presented with more severe skin and musculoskeletal disease. https://t.co/NP3KeUL5iX https://t.co/XWiAIljujL
Dr. John Cush @RheumNow( View Tweet )
Repurposing & Pipeline (8.8.2025)
Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.
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RA leads to ILD: but ILD does not lead to RA
Rheumatoid arthritis is a common autoimmune disease, and approximately 30%-40% of patients develop pulmonary complications such as idiopathic pulmonary fibrosis (IPF), but the causal relationship between the two has long been unclear.
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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:
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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 )
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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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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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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