Alive in 2025 (1.10.2025)
Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com
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Systematic review of 208 pts w/ IgG4–related disease & pachymeningitis - mean age 52 yrs; 2/3 male. HA & cranial nerve dysfunctions were most common Sxs. nearly half had systemic Dz. Abnl imaging of cavernous sinus and middle fossa. Incr. IgG4 in 65% w/ CSF pleocytosis in 52%… https://t.co/0TberfIXsH https://t.co/6k5QgGTnkw
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🚨 Just 4 weeks until #RheumNowLive 2025! 🚨
📅 Feb 8-9 | Dallas, TX
Don’t miss 1.5 days of cutting-edge #rheumatology education, interactive sessions, and unmatched networking!
🧠 Expert insights:
🔹 EGPA care innovations (Dr. Wechsler)
🔹 Vasculitis imaging… https://t.co/ObHBj1dQoK https://t.co/UuDZxBhdLr
Dr. John Cush @RheumNow( View Tweet )
Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/s5v3XD8QmC https://t.co/iP5yFWkQwb
Dr. John Cush @RheumNow( View Tweet )
A re-evaluation of lupus arthritis. Old dogma is RA is erosive and SLE non-erosive. With better imaging, lupus arthritis can be erosive. Vivianne Malstrom. @RheumNow #ACR24 https://t.co/dFRnmGMGls https://t.co/LNoCtmtVuI
Links:
Dr. John Cush @RheumNow( View Tweet )
Full read JAMA ILD Review article. ILD= 33% idiopathic (IPF) + 15% hypersensitivity pneumonitis + 25% from CTD.
30% of ILD has cough
Chest CT 91% sensitive, 71% specific
5% decr in FVC/12 mos assoc w/ 2-fold incr in mortality
Rx options nintedanib or pirfenidone, TCZ, MMF, RTX… https://t.co/FKZyNU1s06 https://t.co/w5q0hOesEH
Dr. John Cush @RheumNow( View Tweet )
171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/XYeMl6ag9c https://t.co/ycM573lUGT
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women
A follow-up analysis of a randomized clinical trial found that the use of calcium and vitamin D supplements among postmenopausal women was associated with decreased risk for cancer mortality, but increased risk for cardiovascular disease mortality. The analysis is published in Annals of
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Best of 2024: 13 Risk Factors for RA-associated Interstitial Lung Disease
Interstitial lung disease (ILD) is the most widespread and fatal pulmonary complication of rheumatoid arthritis (RA). A recent metanalysis shows the pooled prevalence of RA-ILD was approximately 18.7%.
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Sarcoidosis is biopsy supported not proven”
-Dx is clinical with broad ddx.
-Assess organ involvement in all pts.
-Whole body PET can help assess disease activity (not in CNS disease)
-MR brain with pituitary cuts helpful in CNS sarcoid.
#ACR24 @ACRheum @RheumNow… https://t.co/Ka1cHtFOqj
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Best of 2024: Lung Cancer in Rheumatoid Arthritis and Interstitial Lung Disease
A matched cohort study from the Veterans Health Administration shows that rheumatoid arthritis patients have a >50% increased risk of lung cancer, and a 3-fold higher risk of lung cancer in RA-interstitial lung disease (ILD).
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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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Steroids do NOT hamper muscle Bx dx of ANCA vasculitis. Tokyo study of 126 pts w/ suspected vasculitis had Quad muscle Bx; 71 (+) w/ Dx of AAV. Bx yield in 56 and 15 pts w/ off or on steroids, respectively, was similar (59% vs 53%). https://t.co/Xpt01Wksd3 https://t.co/NSBclcEgwq
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Tocilizumab Efficacy in Giant Cell Arteritis Phenotypes
A Spanish Collaborative Group study of Tocilizumab (TCZ) in Giant Cell Arteritis (GCA) demonstrated high efficacy regardless of the different vascular phenotypes treated.
Multicentre study of 471 GCA patients treated with TCZ, assessed outcomes according to vascular
ICYMI: Beyond the Needle: Redefining the Assessment of Lupus Nephritis
Lupus nephritis is one of the most silent and severe manifestations of SLE. When not captured early, patients are at high risk of progressing to end-stage renal disease, which would require dialysis or transplantation. Renal biopsy remains the gold standard for diagnosis and disease
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JAMA FULL READ review and overview of Axial Spondyloarthritis by Drs. Deodhar & Bittar
- Dx often delayed 6-8 yrs
- Sensitivity/Specificity of: HLA-B27 (50%/90%), CRP (35%/91%), Xray sacroiliitis (66%/68%) or MRI (78%/88%). Great tables, figs, Xrays &Reference!… https://t.co/UbqVOr2iDx https://t.co/Ye5mYcbYX2
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Will the Robots Save Ultrasound?
Ultrasound has a lot going for it in rheumatoid arthritis and psoriatic arthritis. It is free of ionizing radiation, yet can deliver helpful insights to the bedside, educating our patients along the way. As we seek to prognosticate more and… https://t.co/2JL2be3RMj https://t.co/4oQy6gcQVS
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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
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ICYMI: Improving the Value of Musculoskeletal Ultrasound in Rheumatology Care
Unlike traditional imaging techniques, MSUS can be easily used at the point-of-care and offers high-resolution images of joints, tendons, and soft tissues, facilitating the early detection of inflammation and structural damage. On Saturday, November 16th at the ACR Convergence 2024, Dr. Veena
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Will the Robots Save Ultrasound?
Despite all its benefits, ultrasound’s daily clinical use remains the domain of only a subset of interested rheumatologists. If the benefits are so clear, then why is it not universal? In the late-breaking oral abstracts at ACR Convergence, the final abstract presentation was from the Danish
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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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How New Medications are Reframing Imaging Abnormalities in axSpA
Bimekizumab (BKZ), a monoclonal antibody targeting IL-17A and IL-17F, was evaluated in the BE MOBILE 1 and 2 trials for non-radiographic and radiographic axSpA, respectively. It showed significant clinical… https://t.co/wJYh5XCVfw https://t.co/qZ2MnGVXXG
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What Lies Beneath: Understanding Nailfold Capillaroscopy
Capillaroscopy is a non-invasive imaging technique used for the in vivo assessment of the microcirculation. kin capillaries at the nailfold are evaluated because the fingers are involved in pathological processes such as Raynaud’s phenomenon. Several abstracts and sessions on nailfold
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Maximizing DMARDs to Strive for Steroid-Free Remission in RA
In 1950, three scientists were awarded the Nobel Prize for their groundbreaking discovery of steroids, heralded at the time as a "miracle cure" for rheumatoid arthritis (RA). However, just a year after their introduction, evidence began to surface regarding the harmful side effects
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A new score to quantify GCA inflammation?
The treatment paradigm for Giant Cell Arteritis (GCA) has been a binary approach to the presence or absence of vasculitis. When GCA is present, we institute high doses of glucocorticoids for treatment of the inflammatory process. #ACR24… https://t.co/b5H7KOtZPC https://t.co/AvrwHcXI7r
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