ERA, APPs, & Alpha GAL (3.21.2025)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Listen in for 2 new case questions - Ask Cush Anything.
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Adrenal Dysfunction after Steroids in PMR and GCA Patients
JAMA has published a study of PMR and GCA patients who stopped glucocorticoid (GC) therapy and noted a low (1.2%) risk of GC-induced adrenal insufficiency after planned cessation.
GC are widespreadly and chronically used in rheumatology, often with the
PAFLAR Guidelines for Polyarticular Juvenile Idiopathic Arthritis
The Pediatric African League against Rheumatism (PAFLAR) initiative has published its guidelines for the diagnosis and treatment of polyarticular juvenile idiopathic arthritis (pJIA
Axial Involvement in Psoriatic Arthritis
Analysis of a Greek Psoriatic Arthritis (PsA) cohort shows that nearly one quarter of patients have axial involvement, and among them, ∼30% have isolated spinal axPsA and nr-axSpA, respectively.
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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Crohn’s Microbiome may Predispose to Axial Spondyloarthritis
EurekAlert!
People with Crohn’s disease and related joint inflammation linked to immune system dysfunction have distinct gut bacteria or microbiota, with the bacterium Mediterraneibacter gnavus being a potential biomarker, according to new study by Weill Cornell Medicine researchers.
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SOCS1 Insufficiency - a Rare Inborn Error of Immunity
Lancet Rheumatology has published a population study of the rare suppressor of cytokine signalling 1 (SOCS1) insufficiency - an inborn error of immunity affecting the negative regulation of cytokine and growth factor signalling.
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Diagnoses via Immune ‘Fingerprints’
Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors (BCRs and TCRs) sequences from human blood, showing the ability to predict health… https://t.co/nqyf4iaD10 https://t.co/wt5V6uxLYf
Dr. John Cush @RheumNow( View Tweet )
JAMA Case: A Woman With Painful Digital Ulcers - What would you order next?
- chest CT w/ myositis-specific autoAb panel
- dsDNA
- SCL-70 & Centromere Abs
- muscle biopsy https://t.co/t0WCIMtZg2 https://t.co/M1jBhnclLl
Dr. John Cush @RheumNow( View Tweet )
Opioid Deaths are Down (2.28.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Opioid deaths are down, IL-33 levels are up and Weight loss is in the news again this week!
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Diagnoses via Immune ‘Fingerprints’
Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors (BCRs and TCRs) sequences from human blood, showing the ability to predict health… https://t.co/ni09ssCYSv https://t.co/4HWui3XxfE
Dr. John Cush @RheumNow( View Tweet )
RNA-seq analysis of human chondrocytes (HTC) shows Osteoarthritis has more HTC-1 (w/ more cell apoptosis & PD-1 genes) & proliferate fibrochondrocytes (ProFC2) w/ heightened inflammatory response, & increased cytokine signalling https://t.co/FZ72CnWk20 https://t.co/sx4NB2C8h3
Dr. John Cush @RheumNow( View Tweet )
Misdiagnosis of Dermatomyositis
JAMA Dermatology reports a retrospective cohort study from Johns Hopkins reviewing mimic of dermatomyositis (DM), suggesting that DM and especially clinically amyopathic DM (CADM) are commonly and initially misdiagnosed as inflammatory skin disease (ISD).
The study was undertaken to
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TNF Inhibitor Drug-Induced Lupus
A study from the FDA's adverse event reporting system (FAERS or Medwatch) database identified cases of drug induced systemic lupus erythematosus (SLE) in patients receiving tumor necrosis factor-α (TNF-α) inhibitors - a paradoxical reaction to common antiinflammatory biologic agents.
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Diagnoses via Immune ‘Fingerprints’
Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors sequences from human blood, showing the ability to predict health status (healthy vs diseased) and discriminate between distinct
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JAMA Case: A Woman With Painful Digital Ulcers - What would you order next?
- chest CT w/ myositis-specific autoAb panel
- dsDNA
- SCL-70 & Centromere Abs
- muscle biopsy https://t.co/9T8mNDdJTs https://t.co/pTphzcuZKF
Dr. John Cush @RheumNow( View Tweet )
Increased L-33 linked to SLE. Study of 120 #SLE vs 60 controls. IL-33 levels signif higher in SLE (258.7 vs 78.3, p < 0.001) & correlated w/ SLEDAI (r = 0.68, p < 0.001) & organ damage (r = 0.45, p < 0.01) & renal dz (p < 0.01). https://t.co/8dbH6u2s1r https://t.co/SzKWy5Xbv1
Dr. John Cush @RheumNow( View Tweet )
A common clinical phenotype arising from diverse pathogenic mechanisms. Study of PBMC transcriptomes (ACPA+ at-risk vs early ACPA+ RA vs controls). A TF signature was enriched in early RA & at-risk individuals (involving SUMOylation, RUNX2, YAP1, NOTCH3, β-Catenin). Cells w/… https://t.co/vCDEjIMXWa https://t.co/mizo7AXWvr
Dr. John Cush @RheumNow( View Tweet )
B Cell Depleters (2.21.2025)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.
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CRP and Hidradenitis Supprativa
A post hoc analysis of 2 phase 3 randomized clinical trials (PIONEER I and II) of adalimumab vs Placebo in patients with active Hidradenitis suppurativa (HS) demonstrated more severe HS that was associated with elevated CRP had a higher BMI. Adalimumab was equally effective in patients
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Risk Prediction Modeling in MDA5 Dermatomyositis
Patients with Melanoma differentiation-associated gene 5 (MDA5) positive dermatomyositis (DM) are complicated and prone to interstitial lung disease, poor prognosis, and a high
Janet Pope @Janetbirdope
#Disease #activity in #axSpA
#ASDAS - a crude measure of activity in
#ankylosing #spondylitis
Is related to #radiographic #progression
👇
⬆️ CRP May be more predictive
#ClinicalPearl #RNL2025 https://t.co/34wrMuz9mO
Dr. John Cush @RheumNow( View Tweet )
MDA5 + Pts with #ILD in #dermatomyositis can improve!
@RheumNow @ACRheum #RNL2025
Data from Christina Charles-Schoeman
#ClinicalPearl
Her pearls
👇
#DM is a #vascular #disease
#CK is not reliable in chronic DM
Neg Abs don’t r/o #myositis https://t.co/hxomz70aq5
Janet Pope @Janetbirdope( View Tweet )
#RNL2025 @RheumNow
Dermatomyositis is VASCULAR disease
-IVIG may help DM by blocking complement deposition on endomysial capillaries
-CK levels not reliable
Pruritus common in up to 86% of DM patients
Dr. Charles-Schoeman, UCLA
Eric Dein @ericdeinmd( View Tweet )
QD Clinic - dsDNA without Lupus
Insufficient Sxs to Dx SLE, but persistent dsDNA positivity - what to do?
Features Dr. Jack Cush.
QD Clinics - lessons from the clinic, sponsored by RNL2025 in Dallas, TX; Feb 8 & 9, 2025
Register at https://t.co/2dcFVgu8z6… https://t.co/hCXRhTJB7G https://t.co/y3Tzh5bRLJ
Links:
Dr. John Cush @RheumNow( View Tweet )
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