Fallen Angels (1.17.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com; and pays homage to colleagues who passed away in 2024.
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Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/Va9Z0NWHj9 https://t.co/ciM7QtEF5S
Dr. John Cush @RheumNow( View Tweet )
Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/rbYMCl1FcO https://t.co/LWqppg36cn
Dr. John Cush @RheumNow( View Tweet )
Retrospectively review of 165 #EGPA pts, GI manifestations were assoc w/ Eosinophils > 19.5%, weight loss, & myalgia; & included abdominal pain (78%), diarrhea (40%), N/V (33%); GI hemorrhage (27%), ulcers (17%), obstruction (10%), & pancreatitis (6%) https://t.co/EzsGcFs2l2 https://t.co/mQrgjTG6NV
Dr. John Cush @RheumNow( View Tweet )
54K Peptic Ulcers Annually (12.13.2024)
https://t.co/18FiQx1YQA https://t.co/32UZi9XafS
Dr. John Cush @RheumNow( View Tweet )
If high +ANA and NO #rheumatic #disease
LOOK 👀 at #LIVER
#Autoimmune #hepatitis
And
#alcoholic #liver #dx
#ACRBest #ACR24 @rheumnow abst#0627 https://t.co/0bwfgNnB0e
Links:
Dr. John Cush @RheumNow( View Tweet )
To Behcet’s or not to Behcet’s?
-Aphtous ulcers have unique features(broad ddx)
-Oral+Genital ulcers=CAP not necessary BD.
-Pathergy test ⬆️specific and not limited to skin!
-Pulmonary arterial aneurysms=almost pathognomonic.
-Do not get confused by HLAs. #ACR24 @RheumNow… https://t.co/3nWgILNVYw
Dr. John Cush @RheumNow( View Tweet )
95 IBD pts had Magnetic resonance enterography (MRE). While 6/95 (6.3%) developed IBD-arthritis (mean 11 mos), finding Sacroiliitison MRE did not increase this risk. IBD arthritis risk was linked to arthralgia (OR 84) & extraintestinal manifestations (OR 7.4)… https://t.co/NGWGKn75jG https://t.co/IqY6XHWqqy
Dr. John Cush @RheumNow( View Tweet )
Bah Humbug Vitamin D (12.20.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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54K Peptic Ulcers Annually (12.13.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on https://t.co/V10S4oVFsv
https://t.co/rHw1qgxzIP https://t.co/cOdGQ5cAPD
Dr. John Cush @RheumNow( View Tweet )
Avacopan, a C5aR antagonist, for Rx of ANCA-Assoc GPA & MPA. Main warning for liver AE. In RCTs, abnl LFTs seen in 11.6-13.3% and 4.2% D/C drug for liver probs. Recent Japanese report of 22 AAV pts with AVACO Liver injury seen in 9 pts - Severe, incr total bilirubin in 4, 1 pt… https://t.co/LyuIQhwOoQ https://t.co/TAmQ9vph4V
Dr. John Cush @RheumNow( View Tweet )
Safety of Acetaminophen in the Elderly
New research, led by experts at the University of Nottingham, has found that repeated doses of paracetamol in people aged 65 and over, can lead to an increased risk of gastrointestinal, cardiovascular and renal complications.… https://t.co/rLchNTh6C8 https://t.co/y2DUx6TQR0
Dr. John Cush @RheumNow( View Tweet )
54K Peptic Ulcers Annually (12.13.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com
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In US, peptic ulcer disease affects 1% of population w/ ~ 54 000admitted to hospital annually w/ bleeding peptic ulcers. But only 10% of PUD pts present w/ upper abdominal pain. Prime causes are Helicobacter pylori infection (42%) & NSAID use (36%) https://t.co/0VvA7lI0MQ https://t.co/YWv4SDNVLC
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Dr. John Cush @RheumNow( View Tweet )
JAMA Images in Dermatology - Palmar Fasciitis and Polyarthritis Syndrome -- 50yoM w/ 6 mo. hx of hand/finger swelling, stiffness, thickening, and erythema, impairing mobility. Also found to have hepato-/splenomegaly, WBC 151K, LDH 889; abnl BM Bx. Pt dx w/ palmar fasciitis & CML… https://t.co/1Z9Oz0sRa7 https://t.co/HRSJcv4lzZ
Dr. John Cush @RheumNow( View Tweet )
ACR24: Rheumatology Roundup
Join Drs. Jack Cush and Artie Kavanaugh as they review 15+ presentations and abstracts from the 2024 ACR Convergence meeting in Washington, DC.
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ANA+ and no Autoimmune Disease? Check the liver
Dr. Janet Pope discusses abstract 0627, presented at #ACR24.
https://t.co/4HV2kqjibL https://t.co/kmVcvUZtRQ
Dr. John Cush @RheumNow( View Tweet )
Differential diagnosis of ACA+
1. SSc
2. Sjogren Syndrome
3. PBC
4. Overalp syndrome https://t.co/JmqDaaZerJ
Dr. Dinesh Khanna @sclerodermaUM( View Tweet )
A#2647
DADA2 cohort 101 pts in India
Median delay dx 5 years - 5 pts of >20 yr
- 39 pts w GI involvement- bad outcomes
Skin most common - largely livedo, then ulcers/nodules
CNS common w ischemia
Many Rx before dx
12 deaths (11.8%) - 8 GI, 3 CVA, 1 suicide
#ACR24 @RheumNow https://t.co/Q8kiVbJq8I
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Eric Dein @ericdeinmd( View Tweet )
The precise mechanism of action of GIOP is not known. Decrease in osteocyte LCN is observed. Abstr#2528 @RheumNow #ACR24 https://t.co/fazUUy03fQ
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA
With the advent of FDA-approved anti-obesity medications such as semaglutide and tirzepatide, a new avenue for managing this challenging patient population has emerged. But how might these drugs impact the trajectory of RA, and are we on the cusp of a paradigm shift?
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Abstract 1686: Urinary proteomics reveals potential markers (MMP-13, M-CSF receptor, CD163, ALCAM, FOLR2) and pathways (neutrophil degranulation, ECM, tissue remodeling) involved in lupus nephritis Class II.
@RheumNow #ACR24 https://t.co/kufd2zl9yc
Akhil Sood MD @AkhilSoodMD( View Tweet )
#1330
🔬F-Calprotectin in Early RA
➡️ New-onset RA pts(n=104) had ⬆️ F-calprotectin vs controls(n=50)(71 v. 17µg/g; p<0.001)
🔑Higher F-calprotectin linked to ⬆️ DAS28 & NSAID use
⬇️levels @ 6 months Rx
❓Role of subclinical gut inflammation in early RA
#ACR24 @RheumNow
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
If high +ANA and NO #rheumatic #disease LOOK 👀 at #LIVER #Autoimmune #hepatitis And #alcoholic #liver #dx #ACRBest #ACR24 @rheumnow abst#0627 https://t.co/EVLUyvpBfD
Links:
Janet Pope @Janetbirdope( View Tweet )
Difficult to Manage Axial Spondyloarthritis
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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