JAKi in inflammatory myositis?
Abstract 1731 is a small RCT of baricitinib in inflammatory myositis comparing early start baricitinib to later start.
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ACR24 take homes
➡️#Inflammatory #myositis
#Upadacitinib improved MDA5 ILD
#Baricitinib 4mg/d good in myositis delayed start #RCT
#Tofacitinb ➡️help for skin, calcinosis, rash in case series
➡️RCT ongoing
JAKi is ‘jacked’ in muscles 💪🏿
#ACR24 @RheumNow @ACRheum
1731 0348
Janet Pope @Janetbirdope( View Tweet )
The #scleroderma-like pattern on NVC is observed in pts with #dermatomyositis and MCTD
It consists of a combination of giant capillaries, some microhemorrhages, severe capillary loss and angiogenesis
@RheumNow #ACR24 @rheumarhyme https://t.co/WO9BOYn4ir
sheila @RHEUMarampa( View Tweet )
#MDA5 #dermatomyositis assoc #ILD
May do better w
#tofacitinib vs #CNI in 515 pts
Too bad they didn’t do a pragmatic RCT as we do t know the reasons for prescribing each #Rx
But impressive survival w #tofa
#ACR24 @ACRheum @RheumNow abst1736 https://t.co/HLJknSYcNJ
Janet Pope @Janetbirdope( View Tweet )
The 🫀is muscle‼️
💥From the maestro herself @JuliePaikMD underscores why cardiac involvement in myositis can't be overlooked.
🔥Crucial insights with major implications for patient care and outcomes
#acr24 @RheumNow @HopkinsMedicine @jhrheumatology
https://t.co/mw6BvkdF2w
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
Chinoy et al. Baricitinib in IIM. Delayed-start clinical trial. 15 patients. 14/15 improved at 24 weeks (the other withdrew). 50% vs 100% at week 12 (delayed start group initiation). Stats confuse me a bit here but promising. @RheumNow #ACR24 Abstr#1731 https://t.co/orewsxbPpL https://t.co/5AyRpYJdec
Links:
Richard Conway @RichardPAConway( View Tweet )
#1156
@DidemSayginMD et al finds that ~1/3 patients with myositis have comorbid fibromyalgia
➡️Presence of fibromyalgia significantly impacted patient global disease activity
#acr24 @RheumNow https://t.co/u1XfqrQU1H
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
#1165
📊 PBMCs of IIM patients with myocarditis(n=4) showed distinct gene expression v controls(n=4) v IIM alone(n=4)👇
💥 B-cell dysregulation may drive myocarditis in IIM
🎯Key immunological insights into🫀involvement in IIM
#ACR24 @RheumNow @JuliePaikMD @jhrheumatology https://t.co/PceZUS929S
Links:
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
ACR 2024 - Day 1 Report
ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings. The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.
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#0322🔬 Myocarditis in Myositis(IIM)
📊 26% new IIM pt had myocarditis (ESC,Lake Louise)
💥 Anti-Ku most common MSA
💥Myocarditis a/w ⬆️heart failure, arrhythmia (43 v 6%;p=0.02)
🎯 Myocarditis🟰poor outcomes
🎯Cardiac MRI🟰earlier detection
#ACR24 @RheumNow @JuliePaikMD https://t.co/yz0f2ozFVL
Caoilfhionn Connolly @CaoilfhionnMD( View Tweet )
#Baricitinib in refractory #myositis?
A ‘weak’ trial design comparing #Bari to #Bari Rx started 12 weeks later
in a small N =15
neat idea but NO answer
👇
looked like 👍 it worked
BUT
this is not the #RCT design that can show differences
#ACR24 @RheumNow abst#1731
@ACRheum
Janet Pope @Janetbirdope( View Tweet )
Study of 168 patients with MDA5-positive Dermatomyositis finds that elevated IL-6 (≥ 13.41pg/m), lymphopenia (< 0.5 × 109) older age and high LDH predicted 6-month all-cause mortality in DM https://t.co/eHYrUtvsI9 https://t.co/SAy27Om2zu
Dr. John Cush @RheumNow( View Tweet )
Happy Diwali (11.1.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.
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Blue Collar Arthritis (10.25.2024)
Dr. Jack Cush reviews the news and journal articles from this past week on RheumNow.com.
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Dot the "i", Cross the "t" (10.11.2024)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com. Today’s reports suggest where to look for help, especially with regard to pain.
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Medscapes Diagnostic evaluation of inflammatory myositis patients
Labs
Imaging
EMG/NCV
Muscle Bx
https://t.co/jDNlqypoq8 https://t.co/dBgMgex4Cw
Dr. John Cush @RheumNow( View Tweet )
Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.… https://t.co/4fgkNJeO4i https://t.co/Z2lDloBzrI
Dr. John Cush @RheumNow( View Tweet )
Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.… https://t.co/fHL14rXAQ6 https://t.co/ZagRU62joJ
Dr. John Cush @RheumNow( View Tweet )
Study of 65 myositis pts w/ PM/Scl Abs found ILD as a dominant feature, esp. if double pos. w/ myositis-specific Abs (MSAs 52%). PM/Scl+ more likely women (90 vs 68%), w/ sclerodactyly (16 vs 0%). Double ++ had more ILD (91%) & mortality (21% vs 0) https://t.co/grz7NW410N https://t.co/pdDilBabdf
Links:
Dr. John Cush @RheumNow( View Tweet )
Different Autoantibody Phenotypes in Juvenile and Adult Myositis
A Kyoto University study compared juvenile-idiopathic inflammatory myopathy (IIM) and adult-IIM patients, demonstrating different autoantibody profiles and a more favorable outcome for n juvenile-IIM patients.
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CA-125 & PET/CT screening in 1432 myositis. 125 pts had CA-125 w/in 5yrs of onset - 3.1% false-positives (fibroids, endometriosis) & 14.3% false-negatives. 139 had PET done- 5.5% false-positives (LN, lung nodules), 28.6% false-negatives (missed melanoma, breast or prostate CA)… https://t.co/16KSDmp9Kz https://t.co/6QFl4jhDxp
Dr. John Cush @RheumNow( View Tweet )
Myositis (IIM) pts w/ ILD have higher mortality. Study of IIM (n 190) vs myositis-mimics (414) shows ILD risk incr by myositis-specific antibody (MSA) 6 fold; Ro-52 8 fold; or 20 fold with dual positivity (MSA + Ro-52 antibodies) https://t.co/oLFflVjzOb https://t.co/uzqpfBP28M
Dr. John Cush @RheumNow( View Tweet )
Antibiotics May Increase Inflammatory Arthritis Risk
A Danish registry study has shown that amongst those patients who develop inflammatory arthritis (IA), antibiotics use was more frequent when compared to the background population (BP)
https://t.co/5CEewNqirM https://t.co/FSOFp4N6ks
Dr. John Cush @RheumNow( View Tweet )
Higher Cancer Rates (8.16.2024)
Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com, noting his concerns about diet, cancer, ILD, death and dosing challenges.
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Hispanic Patients With Dermatomyositis
JAMA Dermatology has published a review of dermatomyositis (DM), focusing on similar and different manifestations of DM.
DM affects all races, but it has been suggested that racial and ethnic minority patients may have more severe disease and a different autoantibody profile. This analysis
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