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Myositis

Dr. John Cush
@RheumNow
Singapore center study of 119 IIM pts (DM 57%; ASyS 23%, OM 15%), IMNM 4%). MDA5 Abs seen in 35% DM. Vs ASyS, MDA5-DM had signif more Skin Sxs (ulcers, papules, Gottrons, heliotrope, periungual erythema). MSK Sxs equal & higher CK levels in ASyS MDA5. 79% DM-ILD were MDA5+ https://t.co/hWaaeLUYkz

Treatment Landscape for Dermatomyositis Is Evolving

MedPage Today

After years of inactivity, therapeutic development for dermatomyositis has begun to move forward with several new therapies and therapeutic strategies.

"This is a very exciting time for the field because we're finally going to get some new treatments, and I think it will be helpful in

Dr. John Cush
@RheumNow
EBR Journal Club: Brepocitinib in Dermatomyositis (VALOR) The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits https://t.co/UoCQM4GtwL
Dr. John Cush
@RheumNow
EBR Journal Club: Brepocitinib in Dermatomyositis (VALOR) The EBR Journal Club Companion applies my adapted version of the JAMA approach to critical appraisal. Each review covers four domains: Does this apply to my patients? What is the risk of bias? How great are the benefits https://t.co/KUB7fpmdbf
Dr. John Cush
@RheumNow
Leeds study of 44 patients idiopathic inflamm myopathy (IIM) pts Rx w/ rituximab showed a 70% response 4-6 mos post RTX. Responders had higher TIS (50·0 vs 17·5). Using highly sensitive flow cytometry, @ 2 wks responders had lower #s memory B cells & Plasmablasts. Is there a role https://t.co/HTxOIxkezs
Dr. John Cush
@RheumNow
FDA Approves Brepocitinib to Treat Dermatomyositis The FDA and Priovant recently announced approval of brepocitinib (Lisraya), a JAK1/TYK2 inhibitor, for the indication of adults with dermatomyositis (DM). This is the first oral (once daily) agent approved for DM. https://t.co/blsl1365XS
Dr. John Cush
@RheumNow
FDA Approves Brepocitinib to Treat Dermatomyositis The FDA and Priovant recently announced approval of brepocitinib (Lisraya), a JAK1/TYK2 inhibitor, for the indication of adults with dermatomyositis (DM). This is the first oral (once daily) agent approved for DM. https://t.co/JoE0p3UfSf
Dr. John Cush
@RheumNow
39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/PYuvyaPdxA
Dr. John Cush
@RheumNow
39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower https://t.co/vflarmwSyv
Dr. John Cush
@RheumNow
SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/DIe2OJhZIc

Misdiagnosis of Still's Disease

Jack Cush, MD

High fever, strange rashes, scary labs often lead to a consideration of Still's disease (AOSD or systemic JIA). Yet the dramatic onset of a systemic disorder may overlap with another, and possibly as rare, systemic disorder that should not be misdiagnosed or mistreated. A current case review by

Dr. John Cush
@RheumNow
Study of 154 anti-Ku Ab+ pts (51 IMMM, 46 SLE, 30 Sjögrens, 27 Sc) = 60 (39%) had ILD - 75% progressed; more rapidly in males. BUT Ku+ is rare <4%, not specific, without clear clinical implications. Ku is a myositis-assoc Ab (like Ro52/Ro60, U1-RNP, PM/Scl) https://t.co/s1VFhaOYgn
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