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Labs/Biomarkers

HCQ Preserves Renal Function in Lupus Nephritis

MedPage Today

Lupus nephritis patients on long-term therapy with hydroxychloroquine showed significantly less decline in renal function, compared with patients treated otherwise, a 10-year retrospective study indicated.

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Systemic immune-inflammation index (SII), as a potential biomarker -- computed as platelet count × neutrophil count/lymphocyte count. SII has been shown to be useful in RA, PsA, SpA, SLE and vasculitis, reflecting disease activity, drug responses & supplements ESR & CRP levels https://t.co/LuFaYbWiWN
Dr. John Cush @RheumNow( View Tweet )

CKD & Osteoporosis Rx Revisited (7.25.2025)

Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.

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Practical management of rheumatic immune-related adverse events with immune checkpoint inhibitors

Joint Bone Spine has published a full read review of the management of immune-related adverse events (irAEs) in patients receiving Immune checkpoint inhibitors (ICIs) for cancer.
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New ICD-10 Diagnostic Code -- R76.81 -- for ’At-Risk RA’ (AKA Clinically suspect arthralgia or Pre-clinical RA); this applies to pts w/ abnormal RF or ACPA without having RA. Thanks to Dr. Kevin D. Deane for leading this effort. https://t.co/14I6RCZrXb https://t.co/YxTwPB0YDQ
Dr. John Cush @RheumNow( View Tweet )

Clinical Associations with Anti-RNA Polymerase III Antibodies

A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome outcomes.

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Retrospective review of 457 Autoimmune liver disease pts found 42.5% with Polyautoimmunity. Predictors included ANA positivity (78 vs 47%), ANA titers, dsDNA (12 vs 2%), RF+ (25 vs 9%), disease duration, low albumin, high ESRs. https://t.co/Socl6XWU9a https://t.co/8qomVBh3KP
Dr. John Cush @RheumNow( View Tweet )
La Paz study of 903 RA pts; 136 (14.5%) were D2T-RA, 96 for inefficacy. They define early vs Late D2T-RA=44.5 mos, & differed>> Early D2T-RA (1/3) pts more likely to have anxiety or depression (76% v 0), higher CRP @6mos, & time to develop D2TRA (35 vs 70 mos) https://t.co/KFG68y9Uq5
Dr. John Cush @RheumNow( View Tweet )
🧬 Myositis-Specific Autoantibodies (MSAs) – 2025 Update MSAs aren’t just diagnostic—they predict phenotype, prognosis, & treatment response. 👇 Infographic #RheumTwitter #Myositis #MedEd @IhabFathiSulima @DrAkhilX https://t.co/91U5s88AdB
Aravind Palraj @Rheumat_Aravind( View Tweet )
SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/rKDBovTOpl
Dr. John Cush @RheumNow( View Tweet )
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/hp7sFR6kLa
Dr. John Cush @RheumNow( View Tweet )

NHANES, Numbers, & Risk (7.18.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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SSB, > SSA, Abs are signif associated w/ abnormal DLCO (AUC 0.791) in Sjogrens syndrome, esp in assoc. w/ LIP- lymphocytic interstitial pneumonitis. These findings more likely in quadruple positive Sjogrens w/ RF/ANA/SSA/SSB positivity. https://t.co/s6IyRzfXiN https://t.co/J3bMowsrUQ
Dr. John Cush @RheumNow( View Tweet )
New download available on biomarkers https://t.co/rFeApBnHav https://t.co/vwjog6ILJU
Dr. John Cush @RheumNow( View Tweet )
Study of a Chinese systemic JIA cohort using scRNA-seq and Bulk RNA-seq, found a potential biomarker w. UBE2D1 expression closely related to Dz activity levels, reflecting enhanced monocyte activity in sJIA patients. UBE2D1 may complement others S100A8/A9, IL-18, ferritin https://t.co/IDeEvitIrB
Dr. John Cush @RheumNow( View Tweet )
NHANES study (1999–2018) of 38,272 participants looked at the neutrophil-to-albumin ratio (NPAR), & elevated NPAR significantly assoc w/ an increased risk of RA (ORtertile3vs1 = 1.27), esp if NPAR > 13.6. NPAR superior to SI), SIRI, PLR, MLR, & NLR. https://t.co/asLc6ghz7w https://t.co/2dAhIvekGA
Dr. John Cush @RheumNow( View Tweet )
NHANES study (2007 to 2020) of 19,904 participants (≥ 20 years), including 1,477 RA pts. Prevalence of kidney stones was higher in RA (17% vs. 8%, p < 0.001) (OR = 1.77) https://t.co/0NZKQdQWR8 https://t.co/BRZ1RTNh5W
Dr. John Cush @RheumNow( View Tweet )
MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/PXkEC3LO6n
Dr. John Cush @RheumNow( View Tweet )
Can you predict disease from serum biomarkers? Comparison of 5 controls, 36 individuals at risk, 74, RA, & 97 PsA pts finds RA w/ higher levels of sICAM-1, MMP1, MMP3, PP, c-Peptide, CRP SAA. Also CRP, SAA, GLP-1, GIP-1, Leptin, PP precede disease onset https://t.co/zqWxsbTSlC https://t.co/Kgv2ZAuzIR
Dr. John Cush @RheumNow( View Tweet )
MRI-detected erosions in clinically suspect arthralgia pts do not portend future Xray erosive disease or progression. Study of 405 CSA pts; 47% had MRI erosions that incr odds of Xray erosion [OR 5.2] but 96% of MRI-detected erosion had no assoc. Xray erosion. https://t.co/hvxJRv1r0R
Dr. John Cush @RheumNow( View Tweet )
1,494 Ehrlangen RA pts - machine learning used baseline variables to predict remission at 6 mos. Best/most predictive results w/ AdaBoost modelingdemonstrated strongest accuracy of 85.71% (based on DAS28, Age, VAS and swollen joints. https://t.co/h9UgUKUFo4

Dr. John Cush @RheumNow( View Tweet )

Japanese cohort study compared 12 pts w/ Stills Dz or intravascular lymphoma. Stills pt had significantly higher ferritin and IL-18 levels and IVL pts had significantly higher sIL-2R levels. https://t.co/Ecd6vNJTc4 https://t.co/KdEcpDeskA
Dr. John Cush @RheumNow( View Tweet )

Immunomodulators in the Treatment of Autoimmune Hepatitis

EurekAlert!

Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease driven by autoimmune mechanisms, characterized by elevated serum aminotransferases, hypergammaglobulinemia, and interface hepatitis on histology. With an annual global incidence of 1.37 per 100,000, AIH can lead

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ICYMI: Channeling Bias and Cancer Risk with Biologic or Targeted Synthetic DMARDs

A retrospective US administrative claims cohort study of RA patients on tumor necrosis factor inhibitors (TNFis), non-TNFi biologics, or Janus kinase inhibitors (JAKis) found a statistically significantly higher risk of incident cancer in patients receiving rituximab, abatacept, or JAKis (

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In >228k CTD patients across France, ILD increased mortality risk across all CTDs. Proportion of incident CTD with ILD highest in IIM (37%). Up to 34% of CTD-ILD pts had progressive pulm fibrosis. Supports earlier ILD screening & vigilance in CTDs. @RheumNow #EULAR2025 #OP0033 https://t.co/nEiTWQEqsP
Dr. John Cush @RheumNow( View Tweet )
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