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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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
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A retrospective VEXAS cohort study of 59 pts receiving 71 targeted Rx - 98%male, mean 71 yrs & 46% had myelodysplastic syndr. Treatments included tocilizumab(19), anakinra (13), azacitidine(13), baricitinib (11), & pred only (10). Best responses w/ azacitidine & tocilizumab https://t.co/fBdfrrZt1M
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Single-centre retrospective study, 27 children with refractory juvenile dermatomyositis (jDM) Rx with baricitinib (F/U of 25 mos)-- 77% (21/27) improved skin rashes (62% complete resolution) & Dz activity improved (6 vs 0.8, p<0.01) 70% (19/27) achieved inactive disease https://t.co/rRlhoY9O4q
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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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RA nodules respond to JAKi. Small case series of 7 established/refractory moderate-to-severe#RA pts w/ rheumatoid nodules who were treated w/ JAKi (tofacitinib, upadacitinib)-- 5/7 had complete resolution & 1 reduced nodules size (w/in 3-12 mos) on JAKi therapy. https://t.co/oQWHMBVQEi
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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
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RA nodules respond to JAKi. Small case series of 7 established/refractory moderate-to-severe#RA pts w/ rheumatoid nodules who were treated w/ JAKi (tofacitinib, upadacitinib)-- 5/7 had complete resolution & 1 reduced nodules size (w/in 3-12 mos) on JAKi therapy. https://t.co/YGK1EGiJiJ
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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/pBJDhXOgut
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Keys to Mastery (5.2.2025)
Dr. Jack Cush reviews the news, articles and drug approvals from the past week on RheumNow.com. This podcast marks the beginning of our Lupus Campaign called "Lupus Unlocked: Keys to Mastery". This month's campaign on Lupus is sponsored by Aurinia.
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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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FDA Approves Rinvoq for Giant Cell Arteritis
Based on the results of the SELECT-GCA study, the US FDA has approved upadacitinib (Rinvoq or UPA) for the treatment of adults with giant cell arteritis (GCA), also known as temporal arteritis. This is the 9th FDA approved indication for upadacitinib in the U.S. for use in rheumatology,
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2024 Management of Familial Mediterranean Fever Recommendations
A EULAR/PReS combined task force has developed recommendations for the management of Familial Mediterranean fever (FMF), the most common monogenic autoinflammatory disease worldwide. These evidence-based recommendations update the 2016 recommendations developed for rheumatologists and other HCPs
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Pairwise Network Metanalysis suggests that JAKi use may NOT be assoc w/ Gastrointestinal perforation (GIP), as suggested by the PI. 23 RCTs, (20,023 pts) followed for 24 wks. Incidence of JAKi GIP=0.19%. compared to csDMARDs this was not signif increased (RR 1.02; CI: 0.41-2.56). https://t.co/lLD9Tj6a9F
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Better Responses with Chronotherapy for Baricitinib
A nonrandomized, open-label, controlled trial has shown superior efficacy when baricitinib was given at night (instead of day); attesting to the benefits of chronotherapy - selective dosing meant to target the body's diurnal https://t.co/pEJIsJq0wE
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Rheumatology: Believe It or Not (4/25/2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Should we believe the reviews and metanalyses?
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Unmet Needs in Still’s disease
In February 2023, an expert consensus panel of pediatric and adult rheumatologists met to address challenges in Still’s disease (SD), including systemic juvenile idiopathic arthritis and adult-onset SD. They addressed four main topics: (1) early recognition and diagnosis of SD; (2) pathogenetic
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Better Responses with Chronotherapy for Baricitinib
A nonrandomized, open-label, controlled trial has shown superior efficacy when baricitinib was given at night (instead of day); attesting to the benefits of chronotherapy - selective dosing meant to target the body's diurnal variations.
Chronotherapy implies that we may selectively
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2025 BSR Guideline for Treatment of Axial Spondyloarthritis
The British Society of Rheumatology has published its 2025 Guidelines for the Treatment of Axial Spondyloarthritis (axSpA); addressing axial and extra-musculoskeletal manifestations including acute anterior uveitis, psoriasis and IBD. They address the effectiveness and safety of
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EMR Messaging Woes (4.11.2025)
Dr. Jack Cush reviews the news, journal reports and regulatory approvals from this past week on RheumNow.com
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Metanalysis showed no increased risk of serious infx (SIE) w/ JAK inhibitors use in pts w/ immune-mediated inflammatory skin diseases -- 32 RCTs, 11,917 pts found SIE in 0.62% on JAKi vs 0.51% controls. Meta-analysis found no significant increase in risk of serious infection https://t.co/ugH72nk8bZ
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JAK-pot Collaboration of 15 registries looked at MACE risk in RA pts and found NO incr CV risk during 1st 2 yrs of JAKi (vs TNFi) use. 51233 pts; 828 incident MACE; in 73008 Rx courses (16K JAKi, 35K TNFi, & 21K OMA bDMARDs). JAK adj IRR: 0.89;0.63 to 1.25 (vs TNFi); bDMARD-OMA https://t.co/MAZrGfCNrU
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An Epidural Letdown (4.4.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Upadacitinib for Giant-Cell Arteritis - A Phase 3 Trial
The NEJM has published a randomized controlled trial in giant-cell arteritis (GCA) patients, demonstrating significant efficacy and safety of upadacitinib (UPA), given as 15 mg daily, as compared to placebo.
1st Line Biologics vs csDMARDs in Adult Still's Disease
A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease and found biologic agents were significantly better with sustained, event-free remissions and fewer complications.
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