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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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 )
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
Links:
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
Links:
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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Yokose et al. Population study using NHANES. Gout patients had 1.6 higher fold risk of gallstone disease. What? Why do we care? Well, GLP-1s associated with higher risk gallstones also... @RheumNow #ACR24 Abstr#0133 https://t.co/nf4R0hQe50 https://t.co/wDrEDeNbpT
Links:
Richard Conway @RichardPAConway( View Tweet )
Pharmacologics:
Cannabis absorption and metabolism is variable
Inhaled absorption 10-35%
THC is 97% protein bound, lipophilic and deposits in fat and spleen
Liver function is critical for THC metabolism
16S18 @BharatKumarMD
#ACR24 @RheumNow
Eric Dein @ericdeinmd( View Tweet )
The METEOR study reveals distinct clinical features in spondyloarthritis (SpA) patients with vs. without IBD.
Key features of those with IBD:
- Lower male prevalence
- Higher uveitis rates
- Lower psoriasis rates
- More structural damage in SI joints
Mirroring gut… https://t.co/EyBZQ91DDn
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Data from the EISER study show that IBD was significantly more prevalent in pts with r-axSpA than nr-axSpA.
Makes sense in a way since longer dse duration may play a role.
🔶️THM - screen SpA pts for IBD; ask for GI symptoms
@RheumNow #ACR24 abs554 https://t.co/Q6jeDUFa8Z
sheila @RHEUMarampa( View Tweet )
Différent patterns of organ involvement in sarcoidosis @RheumNow #ACR24 #Sarcoidosis https://t.co/xigkS3vpUh
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Sarcoid - diagnosis of probability!
Biopsy not required! Can be bx-supported, not confirmed!
Calcium in Sarcoid
10-20% hypercalcemic
30-50% hypercalcuria
Sc: polyuria, dehydration, confusion, depression, fatigue, n/v, anorexia, abd pain, hematuria
@RheumNow
#ACR24 Rev Course https://t.co/B1srD3saij
Eric Dein @ericdeinmd( View Tweet )
No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients
UMKC researchers have compared the use of JAK inhibitors versus tumor necrosis factor (TNF) blockers in inflammatory bowel disease (IBD) patients, but failed to see an increase in major adverse… https://t.co/XY0UVDTAI6 https://t.co/b09FB3niNP
Dr. John Cush @RheumNow( View Tweet )
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