Sjögren's Graduates (8.22.2025)
Dr. Jack Cush reviews the news, journal reports, FDA approvals, drug safety, and more from this week.
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Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/8GhoamkV4N
Dr. John Cush @RheumNow( View Tweet )
Systematic review of Rx options for #PMR (24 pubs, 10 RCTs, & 13 prognostic studies) concludes IL6-R inhibitors effective GC sparing agents; RTX & Tofa are promising. Quality trials needed to refine Rx & establish prognostic markers for decision-making. Fast-track clinics https://t.co/c3rI6u1aI6
Dr. John Cush @RheumNow( View Tweet )
Advances in Still's disease Rx:
- using IL-1 or IL-6 inhibitors 1st line
- New FDA approval of emapalumab (IFNg) for MAS
- unclear if biologics can cause lung probs in Stills https://t.co/zSqTcOSVGE https://t.co/qefCt5b7qh
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 35 studies, 887 participants, shows 3 consecutive nights of sleep deprivation (~4.3hr/hs) assoc w/ signif. increase in IL-6 (p < 0.01) and C-reactive protein (p = 0.03) in blood. This was not seen w/ a single night of total or partial sleep deprivation https://t.co/M60wPUbsch
Dr. John Cush @RheumNow( View Tweet )
Full read review of DMARD effects on CV Risks. Strongest CV protective effects for MTX & TNF inhibitors. Potentially beneficial are sulfasalazine, hydroxychloroquine, & leflunomide. More info needed on IL-6, IL-17/23 inhibitors. Concerns over NSAIDs & JAKi https://t.co/INEdCt0pxa
Dr. John Cush @RheumNow( View Tweet )
2025 BSR Recommendations for ANCA-associated Vasculitis
The British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) have published a guideline for the management of adults with ANCA-associated vasculitis (AAV); specifically three conditions: granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA)
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Rheums Speak - RA Treatment Survey
RheumNow's August 2025 “Live Vote” surveys examine Rheumatologist impressions, knowledge and practices over the last 20 years when treating rheumatoid arthritis.
The first survey on RA Treatment (7/28/2025) sheds light on evolving prescribing habits, use of biologics, and key frustrations in RA
Molecular profiling of RA synovium predicts biologic responses
Machine learning analysis of pre-treatment synovial tissue biopsy from rheumatoid arthritis (RA) patients starting either etanercept (ETN), tocilizumab (TCZ) and rituximab (RTX)
Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the
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Overview of the VEXAS Syndrome
A current systematic review in Rheumatology addresses the clinical features seen in the VEXAS syndrome.
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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs
A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (
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PCR: Prevalence, Cost, & Risk (6.27.2025)
Dr. Jack Cush reviews the news and journal reports from last week on RheumNow.com
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A Review of Intracranial GCA
A comprehensive review in Rheumatology on intracranial giant cell arteritis (icGCA) stresses that GCA is both an intracranial and extracranial large vessel vasculitis, with the former having unique presentations, and outcomes.
A systematic review included 102
Pregnancy outcomes in autoinflammatory disease
EurekAlert!
To address this, a French multi-centre prospective pregnancy observational cohort was set up, to analyse disease activity, treatment, pregnancy outcomes, delivery, and neonatal health. The work – presented at the 2025 annual congress of EULAR – showcased findings from 97 women with an
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In the United States, IL-6R inhibitors have continued to help PMR patients get off steroids.
Hopefully more use and more options mean that, in the future, PMR patients get no more steroids than PsA or RA patients
#EULAR2025 POS0948 @RheumNow https://t.co/JT7gFDC5rl
David Liew @drdavidliew( View Tweet )
-Difficult to treat RA is a heterogeneous concept
-Risk fx: younger onset, high disease activity,erosive disease, comorbidities, depression.
-Study in a Spanish cohort with D2T 2/2 inefficacy showed Rituximab, JAKis, and IL-6i had longer survival (hence better tx options).
-The https://t.co/ZCZcX9FRfb
Adela Castro @AdelaCastro222( View Tweet )
FMF #Recommendations
🔺️Start Colchicine in All (& continue for confirmed pts)
🔺️Single or divided dose, depend on adherence & tolerance
🔺️Max dose 2 mg children, 3 mg adults
🔺️if failure: add IL1i (6 RCT) (2 for IL6i)
🔺️Add c or bDMARd if MSK
#EULAR2025
@RheumNow https://t.co/fPyQrLbb6S
Nelly ZIADE 🍀 @Nellziade( View Tweet )
"H Syndrome" review of 23 French pts. Autoinflammatory dz due to variants of SLC29A3 gene. Multisystem histiocytic lymphoproliferative disorder of young adults- skin 2/3, sensorineural hearing loss, fever w/ endo & autoimmune dz. Best responses w IL6 inhib. #EULAR2025 Abst https://t.co/F7NGI4TkJS
Dr. John Cush @RheumNow( View Tweet )
Total serum IL 18 can help instead of CDC42 or NLCR4 genetic testing in #MAS
Several monogentic mutations in primary HLH- these panels can be available..
#EULAR2025 @RheumNow
Bella Mehta @bella_mehta( View Tweet )
Management of HLH/MAS and modes of action of advanced therapies
Jessica Manson @RheumNow #EULAR2025 https://t.co/Op3u53ZXeK
Links:
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Hepcidin detected in synovial membrane and fluid in RA, PsA, and OA. Monocytes were the main source. IL-6, IL-10, IL-17, M-CSF induced hepcidin via JAK-STAT pathway. Hepcidin reduced osteoclastogenesis but correlated with synovial neutrophils and CXCL1 induction. Functional dual https://t.co/ZjUtTYPre8
Antoni Chan MD (Prof) @synovialjoints( View Tweet )
Extract of purple sweet potato ANTHOCYANINS (PSPA) studied in CIA animal model of #RA; Rats Rx w PBO or PSPA (10, 20, or 40 mg/kg) x14days. 40mg/kg dose reduced synovitis, altered gut microbiota (Akkermansia, Lactobacillus) decr RF & cytokines TNF-α, IL-1β, IL-6, IL-18) https://t.co/UjPFEuTU1S
Dr. John Cush @RheumNow( View Tweet )
Tocilizumab vs. Methotrexate in Rheumatoid Arthritis
A large randomized rheumatoid arthritis (RA) clinical trial compared subcutaneous tocilizumab (TCZ) vs oral methotrexate (MTX) vs. the combination of subcutaneous TCZ and MTX, and showed that TCZ was superior to MTX, either given as TCZ monotherapy or in combination with MTX.
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EULAR Guidelines on Reproductive Health
MedPage Today
Rheumatology patients considering or actually having babies can safely take most of the medications currently used to treat their conditions, according to an updated guideline from the European Alliance of Associations for Rheumatology (EULAR).
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How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
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