Rheumatology: Believe It or Not (4/25/2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?
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67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/EZGgVYpxAl
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Pairwise Network Metanalysis suggests that JAKi use may NOT be assoc w/ Gastrointestinal perforation (GIP), as suggested by the PI. 23 RCTs, (20,023 pts) followed for 24 wks. Incidence of JAKi GIP=0.19%. compared to csDMARDs this was not signif increased (RR 1.02; CI: 0.41-2.56). https://t.co/lLD9Tj6a9F
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Osteoarthritis Risky Business (4.18.2025)
Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com. Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.
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In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/uAfInA5MAq https://t.co/3AjMRQnmts
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Anti-muscarinic 3 Abs are assoc w/ severe GI Dz in systemic Sclerosis. 132 SSc pts (enrich for GI Sxs) - 39% had anti-M3R Abs; 25% high-titer M3R+. Hi titer M3R+ pts had more diffuse Dz (44% vs 23%), GI severity (91% vs 70%), RNPC3+ (18% vs 6%), U1RNP+(21 vs 2%) https://t.co/j8ZWFY4fgx
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In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/Hnij8TWkYy https://t.co/wEuVcuAZ5j
Dr. John Cush @RheumNow( View Tweet )
An Epidural Letdown (4.4.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Korea National Health Insurance Database review shows that risk of mortality in Behcets patients is 28% higher than gen. population; highest in 1st 12 mos (OR 2.66). Major causes were CA, CVD, GI (viscus rupture), respiratory, & infections. Higher in younger pts. https://t.co/vWJrUN9C0H
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Predicting Premature Death with Multimorbidity
Machine learning (ML) models were used to predict premature death in inflammatory bowel disease (IBD) patients with multimorbidity, the co-occurrence of 2 or more chronic conditions.
ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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The FDA has approved guselkumab(Tremfya) for both subcutaneous (SC) and intravenous (IV) induction therapy treatment of adults with moderately to severely active Crohn’s disease (CD). It is the only IL-23 inhbitor available for SC and IV use in CD https://t.co/ekXRVOwNnS https://t.co/6zveRR5WjD
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Alpha-gal syndrome (AGS) is a (Lone Star) tick-borne allergy to the galactose-α-1,3-galactose carbohydrate, found in mammalian meat/products; Sxs (hives, itching, swelling, and GI issues) present 2-8 hrs after meat & be life-threatening. Time to Dx has dropped considerably, w/… https://t.co/p1M9Qaf1jz https://t.co/jTJzq7YtVJ
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A Case of IgA Vasculitis Presenting as Duodenal Perforation
Presentation by Dr. Audrey Liu, at the Rheumatology Winter Clinical Symposia - Feb 2025
https://t.co/kZWgy1S0Wh https://t.co/9mJAzVRVpl
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Are Combination Biologics Safe?
Although package inserts commonly warn against combining the use of biologic or targeted therapies, there is growing interest in such combination therapy for patients with problematic immune-mediated inflammatory diseases (IMID).
Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
Researchers at Weill Cornell Medicine found that people with Crohn’s disease and related joint inflammation have distinct gut bacteria, with Mediterraneibacter gnavus as a potential biomarker.
https://t.co/SI03wAJ3UU https://t.co/dlt3VxBDLw
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Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
EurekAlert!
People with Crohn’s disease and related joint inflammation linked to immune system dysfunction have distinct gut bacteria or microbiota, with the bacterium Mediterraneibacter gnavus being a potential biomarker, according to new study by Weill Cornell Medicine researchers.
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From Bellyache to Bloodstorm - a Mesenteric Sclerosis case with Macrophage Activation Syndrome
Presentation by Dr. Anjali Nidhaan at the Rheumatology Winter Clinical Symposia - Feb 2025
https://t.co/pXwav5f2BI https://t.co/0Faao7zhbV
Dr. John Cush @RheumNow( View Tweet )
UK MRCP exam makeup:
Cardio 15%
Pharm 15%
Resp 10%
GI 10%
Neuro 10%
ID 8%
Endo 8%
RHEUM 6%
Heme 5%
Renal 5%
Derm 4%
Eye 2%
Psych 2% https://t.co/WG7X3B8a0Y https://t.co/9VF5LkLJjs
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Do infections lead to Kawasaki Dz (KD)? Swedish registry study of 1774 KD vs 17 731 controls. +Hx of Infx incr risk of KD (OR 2.3; 2.0 to 2.5) - mostly Resp, skin, GU & GI Infx. Infxns usually clustered before KD Dx (OR 5.1 15–28d; OR 1.3 6-12 mos prior KD. More infx = more KD… https://t.co/V9zbcmJdKv https://t.co/Evl3rtCxUO
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Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/4JfUueF55o https://t.co/hBkgYU1Mye
Dr. John Cush @RheumNow( View Tweet )
Srudy of 558 #RA pts finds GERD symptoms were significantly w/ higher TJC28 and VAS scores and lower use of MTX (but not related to NSAID or steroid use). GERD Sxs may impact MTX dosing and Dz activity measures in RA https://t.co/2H8RUNywlG https://t.co/ZBSlTL1ZA3
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/29CG4bwlYR
Dr. John Cush @RheumNow( View Tweet )
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/KpdY1MEM1w https://t.co/vETGMJgHf3
Dr. John Cush @RheumNow( View Tweet )
The Cartel is Coming for Rheumatology
"What Do Blockbuster Drugs & The Black Market All Have in Common?" asked Dr. Madelaine Feldman at RheumNow Live 2025. They thrive, she explained, on market exclusivity "... until they don't." At first glance, the pharmaceutical marketplace may not appear like a crime drug ring, but Dr.
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