Location, Location, Location (7.26.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Location matters; Geo-rheumatology?
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Digital Self Screening for Arthritis Diagnosis
A new study evaluates patient use of a mobile AI–based symptom checker for diagnoses, but demonstrated only modest accuracy when applied to a cohort of patients with joint symptoms.
https://t.co/YLkheDOrdI https://t.co/MFMEYifP3W
Dr. John Cush @RheumNow( View Tweet )
DBRPCT of Krill oil (4 g/d;KOC) vs PBO in 78 #SLE pts for 24 wks. KOC Rx pts had signif increase in Omega-3 Index 4.3% to 7.17% (4wks) to 8.05% (24wks) w/ no change SLEDAI-2K. But 9pts w/ hi activity (SLEDAI≥9) showed signif Dz activity improvements https://t.co/ODLqqZzGQx https://t.co/tehHk4MhbZ
Dr. John Cush @RheumNow( View Tweet )
Metformin Protects? TrinetX retrospective propensity matching study compared SLE pts on metformin (n 9,178) vs NOT (78,983). SLE NOT on metformin had signif higher risk of lupus nephritis (RR 1.70), CKD (1.27), & MACEs (1.21) & persited for 5yrs https://t.co/78VjEHs8dJ https://t.co/A6lz32fp0T
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PEXIVAS: Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis Patients
A secondary analysis of the PEXIVAS study showed antineutrophil cytoplasmic antibody–associated vasculitis (AAV) patients complicated by diffuse alveolar hemorrhage (DAH) may have improved with plasma exchange and glucocorticoids, the results did not achieve significance.
Diffuse
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UK Natl Early Inflammatory Arthritis Audit (5/18-10/22) compared 682 persistently active vs 1026 low activity RA pts. pactiveRA were younger, more women. pactiveRA assoc. w/ Age, gender, smoking, depression, lung dz, gastric ulcers, baseline steroids https://t.co/QGuUZmSBHD https://t.co/TDlPFmTQEn
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Biologics Prevent AA amyloidosis progression to ESRD
MedPage Today
One of the most serious complications of rheumat0logic and autoimmune diseases can be prevented with biologic drugs, a single-center chart review suggested, and some such products may be more effective than others.
Among 83 patients receiving biologic agents for their underlying
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3 yr German laboratory study of 71,597 laboratory tests, found 238 positive tests for 13 myositis autoAbs in 209 patients. Pos. results due to Idiopathic inflammatory myopathy in 37(18%), other inflammatory rheum Dz 90 (43%) or NO Rheum Dx 82 (39%) https://t.co/KKg0X1AyU1 https://t.co/FfVfufaUm4
Dr. John Cush @RheumNow( View Tweet )
Problems With Laboratory Tests in the Management of RA
https://t.co/kUYivP7SHW https://t.co/nFtB75N0jQ
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Best Rheumatologists (7.19.2024)
This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.
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174 Active RA pts not responding to MTX were started on TCZ. High GM-CSF (> 5 ng/ml and > 10 ng/ml) at baseline were the independent predictors of poor response to TCZ at Wk24. high GM-CSF had signif higher DAS28-ESR & cytokine levels at baseline https://t.co/vy7czYwv1Z https://t.co/R2cYdNZ3V0
Dr. John Cush @RheumNow( View Tweet )
268/279 SLE pts w/ kidney biopsy for proteinuria were Dx w/ lupus nephritis. Proliferative LN (III/IV+V) had higher levels of C1q, chromatin, dsDNA, ribosomal P Abs. C1q & dsDNA independently assoc w/ proliferative LN. AutoAbs decreased in proliferative LN https://t.co/tRucgJRpDN https://t.co/DtgEmGhUzd
Dr. John Cush @RheumNow( View Tweet )
Pollution and Autoimmunity (7.12.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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Efficacy of Biologics in Patients with Chronic KIdney Disease
A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis (RA) patients with chronic kidney disease (CKD), shows the 3 year survicval to be under 50% but that all studied biologics were nearly
In early arthritis (RA) pts there is no value in measuring for IgA-ACPA or IgA-RF, as there presence doesnt provide more than IgG-ACPA. In tREACH trial IgA-ACPA present in 23% & overlaped w/ IgG-ACPA in 94% (w/ IgM-RF in 90%). https://t.co/d8Xc4GBfEt https://t.co/qvujVx0RFf
Dr. John Cush @RheumNow( View Tweet )
PMR - a Risk Factor for Recalcitrant Giant Cell Arteritis?
Despite the clinical similarities and treatment differences between giant cell arteritis (GCA polymyalgia rheumatica (PMR), confusion exists regarding the impact of overlapping disorders. A large cohort study shows that GCA patients with PMR symptoms are
ICYMI: Enthesitis, Synovitis, and Tenosynovitis in Psoriatic Arthritis
An ultrasound study suggests that enthesitis is associated with both synovitis and tenosynovitis in patients with Psoriatic arthritis (PsA).
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ICYMI: JAMA: SLE Review
Drs. Caroline Siegel and Lisa Sammaritano (from HSS in NYC) have published an impressive overview of systemic lupus erythematosus (SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
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ICYMI: BSR Guideline on Management of Sjogren’s Syndrome
Sjögren disease (SD) is the most common of all autoimmune disease, yet little is know of its etiology and there are insufficient interventions for those affected with mucosal or systemic manifestations. The British Society of Rheumatology has updated its 2017 guidelines, with wider evidence and
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TARGET compared triple DMARD to TNFi in 122 RA pts and association with CV risk. In a subanalysis they found no correlation between change in lipid measurements and change in vascular inflammation by FDG-PET. https://t.co/0HKogmdRGH https://t.co/cD7UVTgTQ3
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The path to new technologies in rheumatology must be beset with caution
As we have incorporated technology into our workflows, and consequently saved lives and suffering, we have balanced our excitement about progress with proof that incremental advances can truly deliver benefit. it is easy to let promise carry our caution away - and while most of the time such
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Damage in Childhood Lupus
EurekAlert!
Childhood lupus (cSLE) is a rare multisystem disorder with significant associated morbidity, but evidence-based guidelines are sparse, and as such management is often based on clinical expertise. The EULAR/ACR-2019 criteria have shown sensitivity in cSLE patients, which could allow earlier
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Is a Biomarker for Adverse Pregnancy Outcomes on the Horizon?
With a better understanding of pathophysiology, improved management guidelines, available medications, and a multidisciplinary approach, pregnancy for lupus patients has become more feasible. Despite these improvements, some patients still experience poor outcomes, highlighting the need for
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Interpreting Hepatis B serology results. Hyrich K #EULAR2024 @RheumNow https://t.co/boXw2XCI2m
Dr. Antoni Chan @synovialjoints( View Tweet )
Dual seropositivity and shared epitopes in RA: friends or foes?
Dual seropositivity (rheumatoid factor and/or anti-citrullinated protein antibodies) as well as shared epitope are known to be associated with poor prognosis and structural damage in RA.
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