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Chemokine CXCL10 a potential biomarker for ILD in systemic sclerosis (SSc)? Study of 165 SSc pts (41 w/ SSc-ILD) found higher serum CXCL10 in SSc-ILD (126 vs. 78.5 pg/ml). Hi levels incr risk of ILD 2.74-fold. Most CXCL10 from inflammed lung tissues
Study from British Columbia, Canada, showed between 2010 & 2020, they saw 31% more new pt rheum consults (149,902); 1st time consults for inflammatory arthritis incr 28% to 51%. While time to 1st visit decr. 35%, time to DMARD initiation was unchanged
NEW Health Policy—Diagnosis and investigation of suspected haemophagocytic lymphohistiocytosis in adults: 2023 Hyperinflammation and HLH Across Speciality Collaboration (HiHASC) consensus guideline Free to read with registration on

When should we be starting therapy in GCA and PMR?

Nov 28, 2023

The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind a shrug of the shoulders, or the ambiguity of therapeutic inadequacy. The question that follows the presence of a therapy is the question as to how to best use it.


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National pharmacovigilance database review (1992 to 2021) identified 2217 "Falls", most serious, most in women (61%), & 38% in 18–64 yr olds. Falls attributed to immunomodulators (17%), 24% Fxs & 1 in 7 classified as adverse drug rxns (343)
"Protein kinases: drug targets for immunological disorders". Great full-read review from J Shea et al. Reviews Hx, biology, clinical use and safetey of Kinase targeted therapy.
NEJM Clinical Images: Scleromyxedema (cutaneous mucinosis w/ a paraproteinemia).53-yoM w/ itchy rash, Raynauds, dysphagia, burning dysesthesia hands; Waxy papules across forehead & hands w/ skin thickening & finger contractures. Skin Bx & SPEP done
Are Rheumatologists doing Enough for Cervical Cancer? Should rheums be counseling patients on cervical cancer prevention and screening? The data from Abstract #1479 at #ACR23 suggests this should be an important conversation with our lupus patients.
Substudy of the ADVOCATE trial looked at 214 ANCA assoc vasculitis pts treated with #RTX; avacopan Rx showed improved recovery of renal function, faster reduction in albuminuria and lower glucocorticoid toxicity compared to a prednisone taper.

IgG4 disease- the WInS withdrawal study results

IgG4-related disease describes a group of fibroinflammatory diseases whose features may include autoimmune pancreatitis, swelling of or within an organ system, salivary gland disease, swollen lymph nodes, skin manifestations, and symptoms consistent with allergies or asthma. While remission

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Chikungunya - takeaway points 🪔Acute arthritis in large joints , polyarthritis and tenosynovitis in hands 🪔 Associated with travel history to Africa/Asia/Asia Pacific 🪔<5% develop chronic arthritis #ACR23 #ACRambassador
As per #ACR23 ABST0433, what % of RA patients on US Medicare are on a DMARD within 1y of diagnosis? I'm not talking your choice of b/tsDMARD. I'm talking any cs/b/tsDMARD of any sort. Hear from @JihaRheum to skip to the answer: Truly stunning. @RheumNow
INSIST trial: MMF vs Tac in SS-ILD N=25 pts 👉No significant diff between MMF & TAC in mean change in FVC at 24 weeks [2.52%, 95% CI (-10.3 to 5.18)p=0.500] 👉No SAEs noted in both grps Larger studies w/ longer ffup needed. #ACR23 ABST2595 @RheumNow
Nov 16, 2023
Dr. @Janetbirdope has the best quotes ever ‘ if its ain’t broke, don’t fix it, just leave it alone’ 🤷🏻‍♀️ IGg4 is very interesting , could just be reacting / secondary to an underlying phenomenon? @RheumNow #ACR23, Daily recap.
Nov 16, 2023

Here at Last: Treatment Options for VEXAS

We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been

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Are Rheumatologists doing Enough for Cervical Cancer?

Nov 15, 2023

Should rheumatologists be counseling patients on cervical cancer prevention and screening? The data from Abstract

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Is MSOT the New Ultrasound? Dr. Aurelie Najm reports on oral abstract 0750 presented at #ACR23
A randomised clinical trial show improvements in clinical outcomes CDAI, VAS for both the ITIS diet and the Med diet. Baseline differences in the microbiome between responders and non-responders were seen. Sala Climent M, Abst#2124 #ACR23 @RheumNow
Nov 15, 2023
Fecal transplant for treatment of GI complications of systemic sclerosis? No change in those who received transplant... Overall procedure safe @RheumNow #ACR23 Abs#2597
Nov 15, 2023
What's the long-term mainentance game plan in IgG4-RD? WInS IgG4-RD study China, n=146 IgG4-RD stable disease >12mo Withdrawing both IM+GC completely has much higher relapse rates vs at least keeping some IM IgG4-RD needs some steroid-sparing Rx ongoing #ACR23 L16 @RheumNow
L18 @ #ACR23 ⭐️Clinical Implications in Primary Sjögren's Syndrome (pSS) by Molecular classification of Salivary Glands (SGs) ➡️ transcriptomic profiling of SGs in Chinese cohort 👉 396 pSS, 87 non-pSS, & 44 early-pSS ➡️ 3 distinct sub-types: ⭐️Pacui-immune/C1…
Withdrawing immunosuppression and steroids in IgG4-RD Maintaining immunosuppression with or without steroids associated with low relapse rate 52% of pts who withdrew steroids +immunosuppression relapsed @RheumNow #ACR23 Abs#L16
Nov 15, 2023
Inflammation in interstitial fibrosis & tubular atrophy (i-IFTA) is assoc w/ GFR loss accdg to this study by Dr SMalvica et al. ✳️In pts w/ mod-to-severe IFTA, the degree of i-IFTA was assoc'd with higher risk of GFR loss #ACR23 ABST2552 @RheumNow
Nov 15, 2023
Beware of the « HOT stuff 🌶️ bias » In his very didactic catalogue of bias, Timothy McAlindon particularly warns us against the hot stuff, or the tendency to be less rigorous in the scientific approach when a topic is fashionable @RheumNow #ACR23
Nov 15, 2023
#ACR23 Abstr#2580 Could high-intensity resistance training improve outcomes in myositis? RCT showed 16 wks of training was tolerable, improved quality of life & functional capacity, without increasing disease activity/damage @RheumNow