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Immunology

Dr. John Cush
@RheumNow
Monogenic Inflammatory Disorders Go Unrecognized Lancet Rheumatology published a large cohort analysis using a genome-first approach with whole-exome sequencing, finding a prevalence of 1 in 4026 (159/640092) for monogenic disorders, half with inflammatory features. Only one https://t.co/bItqMXIoUH
Dr. John Cush
@RheumNow
Joint Disease in SLE Reconsidered A new Frontiers in Immunology review from Ong, Wincup and colleagues, shows that lupus arthropathy is not a single uniform entity and it is biologically under-studied and clinically mismeasured, Moreover, the biology of lupus arthritis may https://t.co/M5m6TMZr3x

Impact of Myositis in Scleroderma Patients

Jack Cush, MD

Systemic sclerosis (SSc) may have overlap features such as myositis. When present, myositis in SSc is associated with an increased risk of cardiac involvement and a shift in mortality away from ILD towards a greater cardiac risk.

Joint Disease in SLE Reconsidered

Jack Cush, MD

A new Frontiers in Immunology review from Ong, Wincup and colleagues, shows that lupus arthropathy is not a single uniform entity and it is biologically under-studied and clinically mismeasured, Moreover, the biology of lupus arthritis may shed light on choosing the best therapy for MSK

Dr. John Cush
@RheumNow
Single center study of Probiotics in #PsA showed no benefit. 66 moderately active PsA pts (PASDAS>3.2) on stable Tx: Rx probiotic vs PBO x 12 wks. 56 pts analyzed, PASDAS <3 responders: 43% probiotic vs 65% PBO (P 0.167), w/ no change in gut permeability markers or stool https://t.co/g6icpjuQOU
Dr. John Cush
@RheumNow
92 early (<2 yrs) systemic sclerosis pts were treated with #MTX; 79% diffuse SSc. At 3 mos, 34% of dcSSc ≥25% reduction in mRSS - increasing to 612% a@ 24 mos (29% at 24 mos ITT w/ non-responder imputation). GC did not improve skin. Dz progression seen w/ 75% of MTX monoTx D/C https://t.co/WvqyI8GKjT
Dr. John Cush
@RheumNow
Singapore center study of 119 IIM pts (DM 57%; ASyS 23%, OM 15%), IMNM 4%). MDA5 Abs seen in 35% DM. Vs ASyS, MDA5-DM had signif more Skin Sxs (ulcers, papules, Gottrons, heliotrope, periungual erythema). MSK Sxs equal & higher CK levels in ASyS MDA5. 79% DM-ILD were MDA5+ https://t.co/hWaaeLUYkz
Dr. John Cush
@RheumNow
T-cell engager blinatumomab (CD3xCD19 TCE) was used for Deep B-cell depletion in 15 resistant RA pts (MDR-RA). @wk 12 9/15 CDAI LDA, 3/15 CDAI remission. Synovial B cells were depleted (4 of 5 biopsies) but not in lymph nodes. Later, 14/15 flared. No ICANs, 3/15 w/ CRS (gr 1) https://t.co/xLGZjkMmit
Dr. John Cush
@RheumNow
T-cell engager blinatumomab (CD3xCD19 TCE) was used for Deep B-cell depletion in 15 resistant RA pts (MDR-RA). @wk 12 9/15 CDAI LDA, 3/15 CDAI remission. Synovial B cells were depleted (4 of 5 biopsies) but not in lymph nodes. Later, 14/15 flared. No ICANs, 3/15 w/ CRS (gr 1) https://t.co/ddLb7lIHka
Dr. John Cush
@RheumNow
Cluster analysis of Spanish RELES #SLE SLE cohort reveals 3 groups. C1 (n 168) was younger, w/ lupus nephritis, low C3, intensive Rx, high infx & damage. C2 (175) w/ cytopenias, serositis, APL & dsDNA(+). C3 (452) mild skin-Jts, less serologic activity & complications https://t.co/N0XLUaegWc
Dr. John Cush
@RheumNow
Cluster analysis of Spanish RELES #SLE SLE cohort reveals 3 groups. C1 (n 168) was younger, w/ lupus nephritis, low C3, intensive Rx, high infx & damage. C2 (175) w/ cytopenias, serositis, APL & dsDNA(+). C3 (452) mild skin-Jts, less serologic activity & complications https://t.co/OYTXD4KV6O
Dr. John Cush
@RheumNow
Scleroderma-Specific Autoantibodies in Early Systemic Sclerosis Prognostication is tenous in early scleroderma, especially in those with dcSSc. dcSSc has associated with substantial morbidity and disease-specific mortality. Analysis of an early SSc registry shows that anti-RNA https://t.co/Qvu2vSShcg
Dr. John Cush
@RheumNow
EBR Journal Club: Obexelimab in IgG4-Related Disease (INDIGO) The EBR Journal Club Companion applies my adapted JAMA approach to critical appraisal to an important rheumatology RCT. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How https://t.co/rH7BY21FvF
Dr. John Cush
@RheumNow
Review of HLA-B27 What’s New? HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint https://t.co/13hbXlAvCr

Review of HLA-B27

Jack Cush, MD

HLA-B27 remains the dominant genetic link to spondyloarthritis (SpA) across the age spectrum, but B27 related clinical expression diverges between children and adults. New mechanistic data on autoreactive T cells, HLA-B27 misfolding, and gut-joint trafficking point to new plausible, targetable

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