Fallen Angels (1.17.2025)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com; and pays homage to colleagues who passed away in 2024.
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RheumThoughts: Overlap Syndrome with ILD
How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
https://t.co/4RyV1zkphe https://t.co/qTZ4JYlJmW
Dr. John Cush @RheumNow( View Tweet )
Dazukibart Effective in Adults with Dermatomyositis
Lancet reports that the use of dazukibart, a selective monoclonal antibody against interferon B (IFNβ), was clinically effective in reducing disease activity in adults with active dermatomyositis (DM).
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Eltrombopag, a Potential New Treatment for ITP
A pilot trial has shown a thrombopoietin receptor agonist, eltrombopag (Promacta), to be effective in connective tissue disease-related (CTD), refractory immune thrombocytopenia (ITP).
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Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/Va9Z0NWHj9 https://t.co/ciM7QtEF5S
Dr. John Cush @RheumNow( View Tweet )
In #RA, Higher levels of ESR and CRP, but not DAS28, joint counts or global assessments, were significantly associated with the risk of incident ILD in RA. German biologics (RABBIT) registry study compared 139 RA-ILD vs vs 686 controls. https://t.co/IB7aS6IKgT https://t.co/0zN5N7w65l
Dr. John Cush @RheumNow( View Tweet )
Alive in 2025 (1.10.2025)
Dr. Jack Cush brings in the new year with a review of the latest from RheumNow.com
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Leeds study of 19 pts at-risk for RA (ACPA+ & arthralgia) finds low-diversity gut microbiome & in the 10 mos preceding the transition to RA, microbiome becomes more unstable w/ accumulation of Prevotellaceae, particularly Prevotella copri https://t.co/rbYMCl1FcO https://t.co/LWqppg36cn
Dr. John Cush @RheumNow( View Tweet )
Prevalence of Autoimmune Diseases in the United States
An epidemiologic assessment of the prevalence of autoimmune diseases in the United States (US) finds that nearly 5% of the population has an autoimmune disorder, twice as many in women compared to men.
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Data from Psoriasis Atherosclerosis and Cardiometabolic Disease Initiative & Stockholm Psoriasis Cohort (n=769 Pso Pts) finds that PsO severity (PASI) PASI assoc w/ GlycA levels (syst inflammation) & GlycA levels assoc w/ CVD risk (OR=1.23) https://t.co/IwUHILMpnI https://t.co/DnEF3yuTvg
Dr. John Cush @RheumNow( View Tweet )
Benefit of Achieving Target Serum Urate Levels in Gout with Chronic Kidney Disease
A cohort study of gout patients with CKD stage 3 found that lowering serum urate (SUA) level to less than 6 mg/dL, lowered the risk for severe or end-stage kidney disease progression.
The study included patients drawn from a general practice database (IQVIA Medical Database) between
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post-hoc analysis 48 pts w/ SSc-ILD in the DESIRES trial (DBRPCT) showed that RTX efficacy on lung outcomes (FVC change) at 24 weeks was only seen in those with CRP levels ≥0.055 mg/dl, ΔppFVC was significantly higher w RTX vs PBO [difference 8%) https://t.co/92yfWEU1d8 https://t.co/tB9sd9VS1K
Dr. John Cush @RheumNow( View Tweet )
ICYMI: VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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Sedentary Behavior Increases the Risk of Gout
NHANES national survey study shows that sedentary behavior is an independent risk factor for gout, especially in those without hyperuricemia.
The increasing prevalence of
171 SSc pts w/ hand Xrays and US found 20% w/ Joint involvement. Active Synovitis & tenosynovitis predicted by CRP>10mg/L (p = 0.013), fibrotic tenosynovitis on US (p = 0.005), anti-RNA polymerase III antibodies (p = 0.043) https://t.co/XYeMl6ag9c https://t.co/ycM573lUGT
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women
A follow-up analysis of a randomized clinical trial found that the use of calcium and vitamin D supplements among postmenopausal women was associated with decreased risk for cancer mortality, but increased risk for cardiovascular disease mortality. The analysis is published in Annals of
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ANA neg, but ENA pos
should we care about that result?
PPV 5.5% here
(similar to 6% prev @EricFMorand: https://t.co/7Lo0DgHtXT)
and how many really needed the serology? Anxiety?
Surely pos ENA w neg ANA might be more hassle than help. So what to do?⬇️
#ACR24 ABST1930 @RheumNow… https://t.co/lZ1TJxTqhs https://t.co/itx0TCFFjl
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Efficacy of Biologics in Patients with Chronic Kidney Disease
A retrospective cohort study of biological disease-modifying antirheumatic drugs (bDMARDs) persistence in rheumatoid arthritis patients with chronic kidney disease, shows the 3 year survival to be under 50% but that all studied biologics were nearly equivalents with regard to safety and efficacy
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Best of 2024: Consensus Statements on Vitamin D
The “Controversies in Vitamin D” International Conference has published their proceedings on vitamin D metabolism, assessment, actions, and supplementation. Interestingly, optimal levels of 25-hydroxy vitamin D (25(OH)D) are still being debated.
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Biomarker Study of 171 synovial fluid samples (54 primary OA, 57 RA, 30 Crystal,30 septic arthritis) examined the cartilage oligomeric matrix protein (COMP) to IL-8 ratio and found it can differentiate primary OA and inflamm arthritis w/ sensitivity 87% and specificity 89%… https://t.co/UH77DFgAlJ https://t.co/MfXQcl0BhW
Dr. John Cush @RheumNow( View Tweet )
Bah Humbug Vitamin D (12.20.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com.
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Best of 2024: Diagnosing Seronegative Sjogren's Disease
Sjögren disease (SjD) is highly prevalent, but diagnosis may be challenged if anti-SSA antibodies or a labial salivary gland biopsy are negative. A recent cohort analysis suggests a novel autoantibody profile has predictive value SSA negative SjD and also in those with a positive labial biopsy
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41 "Rhupus" pts were compared to 160 SLE and 709 RA pts. Rhupus pts have a younger onset age than RA (P=0.032), but older than SLE (P=0.008). ~20% initially presented w/ SLE Sxs. Rhupus commonly has ILD, hyperglobulinemia & Lab abnormalities (61%), but seldom renal or CNS dz… https://t.co/pqfmFGT0D6 https://t.co/zo0APuAcQS
Dr. John Cush @RheumNow( View Tweet )
ICYMI: Beyond the Needle: Redefining the Assessment of Lupus Nephritis
Lupus nephritis is one of the most silent and severe manifestations of systemic lupus erythematosus (SLE). When not captured early, patients are at high risk of progressing to end-stage renal disease, which… https://t.co/ctngE0bMkX https://t.co/koDBZaPc19
Dr. John Cush @RheumNow( View Tweet )
Best of 2024: Determinants of Gout Flares
Approximately 12 million US adults in the US have gout. Two recent literature reports in JAMA and Arthritis Care & Research highlight contributors to gout flares.
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