Diagnosing Neuropsychiatric SLE (5.23.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com - including views on the vagus nerve, NPSLE and CAR-T mania.
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MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/CBUojpR3Q8
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Annals of Internal Medicine has published a CME review of LYME DISEASE. Most Lyme is Dx by onset of the erythema migrans rashes,. Lyme Ab testing is of low sensitivity at onset but more sensitive w/ time & CNS, CV complications. or Mono- or oligoarticular arthritis https://t.co/FMwQgcadik
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JAK inhibitors reduce inflammation while potentially exacerbating the propagation viral infections. They suppress transcription of IFN-stimulated genes in non-infected cells (usually triggered by type I IFNs produced by infected cells) Thus facilitating viral propagation https://t.co/BDzz8pHKxL
Dr. John Cush @RheumNow( View Tweet )
MMWR: 1994 the U.S. Vaccines for Children program has covered the cost of vaccines for US children. Since 1994 routine child vaccinations will have prevented ~508 million illness, 32 million hospitalizations, & 1,129,000 deaths,; direct savings of $540 billion & societal savings https://t.co/JCeSFmIgxV
Dr. John Cush @RheumNow( View Tweet )
Single center study of 1538 #SLE pts found 2.2% w/ lupus mesenteric vasculitis (LMV) - 39 LMV episodes in 31 pts - 2/3 had Nausea, vomiting, diarrhea & abdominal pain (~15% peritoneal irritation) & had active Dz (renal, Skin, Heme). LMV responded to steroids & https://t.co/AkuvCl6nG6
Dr. John Cush @RheumNow( View Tweet )
Annals of Internal Medicine has published a CME review of LYME DISEASE. Most Lyme is Dx by onset of the erythema migrans rashes,. Lyme Ab testing is of low sensitivity at onset but more sensitive w/ time & CNS, CV complications. or Mono- or oligoarticular arthritis https://t.co/NfL0dabeGe
Dr. John Cush @RheumNow( View Tweet )
Neutrophil alkaline phosphatase (NAP) elevated in active AOSD. 141 AOSD compared to Bcell lymphoma, SLE, aPL & controls. NAP pos. correl w/ Systemic Dz activity score (R=0.71), & 0.59 for CRP/ANC/ferritin. NAP scores higher in pre-MAS, but lower w/ MAS (w/lower WBC). NAP responds https://t.co/YbYPaJUEbz
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FDA approved the chikungunya virus vaccine (Ixchiq) in 11/23, but recently announced caution and pause use while it investigates Postmarketing Safety Reports of 17 SAE (cardiac & neurologic) & 2 deaths. 6 SAE in the USA, elderly w/ chronic med conditions. ~80K doses of Ixchiq https://t.co/RED8Xab0Ir
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Panacea of Prednisone & Cannabis (5.16.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this week on RheumNow.com. Interesting trends and results with prednisone in lupus, cannabis in RA and opioid deaths too!
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FDA approved the chikungunya virus vaccine (Ixchiq) in 11/23, but recently announced caution and pause use while it investigates Postmarketing Safety Reports of 17 SAE (cardiac & neurologic) & 2 deaths. 6 SAE in the USA, elderly w/ chronic med conditions. ~80K doses of Ixchiq https://t.co/XadqMEmSuD
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Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/2bKY9NtnCD
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Managing CKD in Lupus Nephritis
Dr. Hans-Joachim Anders explores how to treat LN patients with chronic kidney disease, balancing disease control and renal preservation.
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Dr. John Cush @RheumNow( View Tweet )
Soluble CD13 (sCD13) has pro-inflammatory effects & is elevated in severe COVID-19. sCD13 is chemotactic, angiogenic, & arthritogenic. In COVID-19, sCD13 was assoc w/ sCD13 severity, ethnicity, inflammation markers, NETosis, & vascular injury/thrombosis. https://t.co/dTT9X49DIt
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/Rf6c2gidpK
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Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/5V0yrctaFI
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Vitamin D Headlines (5.9.2025)
Dr. Jack Cush reviews the news, journal reports and lupus highlights from the past week on RheumNow.com. Triple positivity, the gut and CRPS, and hope for better outcomes with Vitamin D therapy.
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single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/JfaBtfvujU
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of ANCA-associated vasculitis with interstitial lung disease (8 studies, 654 pts shows the following significan mortality risk factors: age (HR 1.06), ever smoker (HR 1.61), UIP pattern (HR 2.07), acute exacerbation (HR 2.73) & microscopic polyangiitis (HR 4.03). https://t.co/z4zfDq9Wf9
Dr. John Cush @RheumNow( View Tweet )
Arterial or venous thrombotic events (AVTEs) are common w/ new forms of monogenic vasculitis (DADA2 & VEXAS), resulting from pathogenetic mechanisms of endothelial dysfunction, immune complex deposition and pro-inflammatory cytokines. Reviewed here. https://t.co/Nw9wNYssg3 https://t.co/1PoPWPWNec
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Study of 42 pts w/ long standing RA-LD undergoing Lung Transplant (LTx) betw 2004 -2020. Median survival was 5.3 yrs (1-yr survival 88%) - same survival as LTx in other CTD & non-CTD ILD LTx. Mortality was 43%, higher w/ UIP. RA/CTD is not a contraindication to LTx. https://t.co/JcTug1wsTZ
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Prophylaxis Against PJP in SLE: I'll Pass with @EBRheum
https://t.co/tUGwziEYCg https://t.co/VqTa9jG8oj
Dr. John Cush @RheumNow( View Tweet )
single-centre study of 469 consecutive RA pts - 15 had VTE (3%). Strongest risk factor of VTE was the history of previous VTE (OR 44.7), recent hospitalisation (OR 6.82), diabetes (OR 11.23), and JAKi (OR 5.54) (Other studies show inflammation incr VTE risk) https://t.co/pBJDhXOgut
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Prophylaxis Against PJP in SLE: I'll Pass
I think we're all somewhat familiar with PJP prophylaxis. This is the thing we do to stop the scary, opportunistic infection that affects people who are immunocompromised. I'm going to start by actually steelmanning the case for doing PJP prophylaxis before I explain why I think you probably
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67 systemic sclerosis pts w/ mod-to-severe lower GI Sxs were Rx in phase 2, RDBPCT of placebo or fecal transplants at wks 0 and 2, with no signif change in GI sxs by week 12 (bloating or diarrhoea). https://t.co/vWq2c8d4Kn https://t.co/PpPsAQbj5M
Dr. John Cush @RheumNow( View Tweet )
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