Labs/Biomarkers

Sjogren,board

Interferon-α as an Immunologic Driver of Sjögren's Disease

Jack Cush, MD

Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and
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51 yoM w/ 2 yrs of FUO, unintentional 32-kg wt loss, LN, diffuse myalgias, but no GI Sxs or arthralgia. Neg MRIs, CT, PET scan, EGD, colonoscopy. Abnl labs: CRP 173 mg/L, ESR 46, anemia & ^ WBC. Cell-free DNA next-generation sequencing dx Tropheryma whipplei, & Whipple disease https://t.co/nJLa4l7Ers
Dr. John Cush @RheumNow( View Tweet )
Chondrocalcinosis

Expert Perspective on Calcium Pyrophosphate Deposition Disease

Jack Cush, MD

A recent perspective by Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments.

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Saliva and Uric Acid Testing A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing delivers smartphone-guided, enzyme-free gout screening at home for pennies per test. https://t.co/VtvJuPNEWA https://t.co/pdBmy5JoQd

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Dr. John Cush @RheumNow( View Tweet )
ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
Dr. John Cush @RheumNow( View Tweet )
Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/Go51MUOQlG
Dr. John Cush @RheumNow( View Tweet )
Congratulations to Dr. Chandra Mohan and Univ. of Houston for receiving a $4 million NIH grant for a 10-year longitudinal study to identify the earliest biological triggers of autoimmune disease https://t.co/6kMcv9PD5r https://t.co/CsY8QAxrXR

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Dr. John Cush @RheumNow( View Tweet )
Less than 10% of gout patients have crystal-proven gout. For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ,

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Dr. John Cush @RheumNow( View Tweet )

While not a validated Dx tool for gout, AI retinal scanning of digital fundus photography was tested on 107730 pts & showed high ROC - f NIDDM 0.833, Gout 0.832, OP 0.787, HTN 0.740, hyperlipidemia 0.736 & thyroid Dz 0.699 https://t.co/1yrlR04z4g https://t.co/c04YtVVERY

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Dr. John Cush @RheumNow( View Tweet )
RHEUMATOLOGIST SURVEY ON GOUT - In what percentage of your new Gout patients, do you do arthrocentesis and crystal ID? Answer here: https://t.co/jpebQev4VU

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Dr. John Cush @RheumNow( View Tweet )

New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/yFxwAYFPPb
Dr. John Cush @RheumNow( View Tweet )
uric.acid.test

Saliva and Uric Acid Testing

Jack Cush, MD

A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing  delivers smartphone-guided, enzyme-free gout screening at home for pennies per test.

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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/hrJoQXpAH8
Dr. John Cush @RheumNow( View Tweet )
JAMA HBV review - Worldwide, HBV affects ~254 million, causing 1.1 million deaths. In 2022, 14k new HBV infx in the US. HBsAg = ongoing infxn; HBsAb indicates immunity; HBcAg=ongoing or past infection. Do HBV DNA for virus-replication activity https://t.co/Yvdx09DrQ5 https://t.co/88VsTEgFev

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Dr. John Cush @RheumNow( View Tweet )
uric%20acid.crystals.gout_.JPG

Uric Acid: Is Lower Better?

Joshua Baker, MD, MSCE  Brian Coburn, MD, PhD

Lowering serum urate and urate crystals in the body is indispensable for long-term management of gout. The pathophysiology is simple and powerful: no urate crystals, no gout flares. However, this simplicity in goal belies a nuanced consideration in management: how low should serum

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RT @aurelierheumo A long release version of xanthine oxidase inhibitor in gout -442 pts 36 wks -HR091506 vs febuxostat -SUA <300 μmol/L: 63.8% vs 40.7% (Δ +22.9%, p<0.0001) -higher SUA reduction vs baseline -Similar overall TEAEs (~90%) A molecule to keep an eye on! #LB0008

Dr. John Cush @RheumNow( View Tweet )

ILD damage fibrosis path

EULAR26: ANCHOR-RA Study of RA-ILD

EurekAlert!

People with rheumatoid arthritis are at risk of developing interstitial lung disease (RA-ILD), which is associated with high mortality. ANCHOR-RA is a large, international cross-sectional prospective study that will enable the development of a multivariable model to help detect RA-ILD.5

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EULAR26: Vasculitis updates: Glucorticoid use in AAV and GCA

EurekAlert!

EULAR recommends a combination of glucocorticoids with either rituximab or cyclophosphamide for remission induction in life-threatening or organ-threatening AAV, followed by gradual tapering of glucocorticoids.

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uricacid.jpg

ICYMI: Worldwide Trends in Hyperuricemia

Jack Cush, MD

A Lancet Rheumatology systematic review shows the prevalence of hyperuricaemia has risen markedly over the past two decades in both men and women, owing to population growth, aging, and increasing age-specific rates

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Eosinophil

ICYMI: EGPA Review

Jack Cush, MD

A current review of eosinophilic granulomatosis with polyangiitis (EGPA) provides current recommendations on diagnosis and management.

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Prospective study of 6 newly Dx RA pts starting MTX shows MTX causes a decline in T follicular helper (Tfh) cells and plasmablasts (@ wk 3 before clin response), selectively in responders but not nonresponders. MTX shifts cellular & gene expression towards a more physiological https://t.co/scmfAAE9XA
Dr. John Cush @RheumNow( View Tweet )
Is there a path to precision medicine in #RA? Theres a substantial unmet need. Immunoengineering is possible thru nanotechnological delivery vectors, cellular therapeutics, & biomaterial scaffolds, with compelling preclinical and early clinical support. https://t.co/gL56EOlt7p https://t.co/31IRNXckym

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Dr. John Cush @RheumNow( View Tweet )
RA.vascular.cholesterol.plaque.jpg

EULAR26: Updates in SLE and APS

EurekAlert!

Severe refractory systemic lupus erythematosus (srSLE) is a clinical state conceptualised as persistent high disease activity despite standard care with glucocorticoids and immunosuppressants.

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2026 Guidelines for the Treatment of Axial Spondyloarthritis

ACR

New and updated clinical guidelines released today provide comprehensive, evidence-based recommendations for the management of axial spondyloarthritis (axSpA) for both adults and children. The effort includes an update to the 2019 ACR/SAA/SPARTAN treatment guidelines focusing on adults,

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Blood labs

2-Gene Blood Test for Kawasaki Disease in Febrile Children

Jack Cush, MD

JAMA Network Open has publshed that a simple 2-gene blood test may aid the earlier diagnosis of Kawasaki disease in children with febrile illnesses. 

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Therapeutic Updates

ILD Treatment and Guidelines

Hinze title card
Watch our 11-video series on ILD Treatment and Guidelines including videos on assessing ILD, guidelines caveats and concerns, and more.
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Biomarkers in RA

Augurex Front End Image
Rheumatologist Dr. Walter Maksymowych discusses the role of biomarkers in RA care, with a focus on 14-3-3eta as a modifiable marker for diagnosis and monitoring disease progression.
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Recent Blogs

ICYMI: Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
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Advanced Practice Rheum

Systemic Lupus Erythematosus

Jack Cush, MD
APR SLE VIDEO COVER
Dr. Cush reviews systemic lupus erythematosus.
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Autoantibodies Anonymous

Artie Kavanaugh, MD
AutoAb.Token
At first, it seemed similar to many other such sessions – a circle of folding chairs, a group of colleagues whose visages exuded understanding and acceptance – but this was special. I started the meeting…. “Hi, my name is Artie.”
Read Post
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