GI/Liver

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

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Antoni Chan MD (Prof) @synovialjoints( View Tweet )
bathroom scale

Shedding Weight and Pain: The Promise of Anti-Obesity Medications in RA

Caoilfhionn Marie Connolly, MD

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

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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

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Janet Pope @Janetbirdope( View Tweet )
back, LBP, spine, AS

Difficult to Manage Axial Spondyloarthritis

Adela Castro, MD

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

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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

Links:

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

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sheila @RHEUMarampa( View Tweet )
Différent patterns of organ involvement in sarcoidosis @RheumNow #ACR24 #Sarcoidosis https://t.co/xigkS3vpUh

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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

Links:

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 )
Gut microbiome changes linked to onset of RA Changes in the make-up of the gut microbiome are linked to the onset of clinically evident rheumatoid arthritis in those at risk of the disease because of genetic, environmental, or immunological factors, suggests research published… https://t.co/gUgYLOKrI0 https://t.co/d75NmKup2U
Dr. John Cush @RheumNow( View Tweet )
colitis.jpg

No Increase in Cardiovascular Events with JAK Inhibitors in IBD Patients

Jack Cush, MD

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 cardiovascular events (MACE) in JAKi vs TNFi use in IBD.

Findings of an abstract presented at

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Peptic ulcer disease is still assoc w/ signif. hospitalization & mortality (10K deaths in USA/Yr). PUD affects 10% of outpts w/ Upper GI pain. 42% are due to H.pylori, 36% from ASA NSAIDs. Complications bleeding (73%), perforation (9%), pyloric obstruction (3%)- JAMA review… https://t.co/1bgagFVlYN https://t.co/8i2j3r1puf
Dr. John Cush @RheumNow( View Tweet )
Advances in the treatment of autoimmune hepatitis Autoimmune hepatitis (AIH) is a chronic, progressive liver disease caused by immune system dysregulation that targets the liver. If untreated, AIH can lead to severe complications, including cirrhosis and liver failure.… https://t.co/6GtWZ8tDDv https://t.co/YuJrcOyaGP
Dr. John Cush @RheumNow( View Tweet )
microbes.jpg

Gut microbiome changes linked to onset of RA

EurekAlert!

Changes in the make-up of the gut microbiome are linked to the onset of clinically evident rheumatoid arthritis in those at risk of the disease because of genetic, environmental, or immunological factors, suggests research published online in the 

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Liver.hepatitis.jpg

Advances in the treatment of autoimmune hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive liver disease caused by immune system dysregulation that targets the liver. If untreated, AIH can lead to severe complications, including cirrhosis and liver failure. 

An overview of AIH and treatment approaches was recently

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diet.healthy.keto.avocado

A Keto Diet for Autoimmune Disorders?

EurekAlert!

Scientists have long suspected the keto diet might be able to calm an overactive immune system and help some people with diseases like multiple sclerosis.

Now, they have reason to believe it could be true.

Scientists at UC San Francisco have discovered that the diet makes the gut

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RheumNow Podcast square

ANA+ consult (10.18.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.

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FDA has approved a 4th biosimilar to Stelara - the new agent, ustekinumab-srl (Imuldosa), is indicated for Rx of plaque psoriasis, psoriatic arthritis, Crohn’s disease and ulcerative colitis. Originator Stelara sales in 2023 were nearly $10.86 USD billion globally… https://t.co/MoNBj2UaVH https://t.co/3Tenkfq0KK
Dr. John Cush @RheumNow( View Tweet )
GI Abnormalities in Scleroderma A prospective Scleroderma Cohort Study found that gastrointestinal tract (GIT) involvement was common and negatively impacted quality of life, physical function, and employment, but had no effect on mortality. https://t.co/9z1ycWkCQt https://t.co/oE5RgjJ9tm

Links:

Dr. John Cush @RheumNow( View Tweet )
GI Abnormalities in Scleroderma A prospective Scleroderma Cohort Study found that gastrointestinal tract (GIT) involvement was common and negatively impacted quality of life, physical function, and employment, but had no effect on mortality. https://t.co/6jQvKz7nmm https://t.co/1IGPe6obyS

Links:

Dr. John Cush @RheumNow( View Tweet )

Recent Blogs

Best of 2022: The Contribution of the Gut Microbiome and Diet to Joint Inflammation in PsA

Christopher Ritchlin, MD, MPH
abdominal-pain-2821941_640.jpg
Interactions of the gut microbiota in humans promote the release of a variety of metabolites with profound effects on human health and immune regulation. Read Post

Best of 2022: Methotrexate in PsA

Philip Mease, MD
Methotrexate
Until the publication of the SEAM trial, evidence in the medical literature for the efficacy of the most commonly used drug for psoriatic arthritis worldwide, methotrexate, has been lukewarm at best. Yet we all employ it commonly, either as monotherapy or in combination with biologic or targeted synthetic DMARD treatment. It is inexpensive and widely available, and only modestly toxic. Read Post

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