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Immunology

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

Dr. John Cush
@RheumNow
Waist size matters! Using NHANES data (1999-2018) the weight-adjusted waist index (WWI) calculated on 5582 CKD pts. WWI was signif assoc w/ all-cause mortality (adj HR  1.17) & CV (1.24); these assoc partially mediated by NLR (inflammation) ~6.6%, showing both central adiposity https://t.co/kNf4nqiD2a
Dr. John Cush
@RheumNow
Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/JDvVZ1KEIY
Dr. John Cush
@RheumNow
Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/HTxOIxkezs
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