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Pediatric Rheum


ACR22 Presents New Data on JIA Clinical Remission with Combo DMARDSs

Nov 09, 2022

New research being presented this week at ACR Convergence 2022, demonstrated that polyarticular juvenile idiopathic arthritis patients were more likely to achieve clinical remission with a combination of conventional and biologic DMARDs compared with other consensus treatment plans by the

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QD Clinic - 1st Line Anakinra New-onset systemic JIA - how will you treat? #ACR22

Transitioning JIA to Adult Care is Problematic

Oct 04, 2022

Juvenile idiopathic arthritis (JIA) may start in adolescence and extend into adulthood. This report of the Nordic experience shows that both pediatric and adulty rheumatologists need to develop "transition" practices; without such an approach considerable gaps in healthcare will befall these

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Causes of Death in Lupus

Oct 03, 2022

The California Lupus Surveillance Project has longitudinally followed included systemic lupus erythematosus (SLE) cases and shown that overall, the leading cause of death was cardiovascular disease (CVD), followed by rheumatic disease and hematologic/oncologic conditions.

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Great and Not So Great (9.30.2022)

Sep 30, 2022

This week it's the great and not-so-great on gout, chondrocalcinosis, osteoporosis and misdiagnosis. We are good at many of those things - what's not so great? Let's review the news and journal reports from the past week on RheumNow.

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Joint Flares extend disease & show joint specific memory. Study of 95 JIA pts, 12.5 yrs F/U: 95% got to inactive dz, 81% flared 1+ times. 74% flares in prior joints, usual side 83%, contralateral 17%, 40% new Jt; more likely off meds

2022 Lasker Award Winners

Sep 29, 2022

The Lasker Foundation has announced the winners of its 2022 Lasker Awards, widely regarded as America’s top biomedical research prize since its creation more than 75 years ago. Here's a look at the award winners and their important contributions to biomedical research.

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Retrospective study of PFAPA < 18yrs, 336 pts, Boys=Girls, peak onset ~age 1 yrs (less w/ yrs); 90% 1st Sxs under 5 yrs & <3% after age 10 yrs, Common Sxs: pharyngitis w fever, Cx adenitis, aphthous stomatitis, atyp skin rash. Incidence 0.86/10K/Yr

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Does Fibromyalgia Need B12? (9.9.2022)

Sep 09, 2022

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from

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Genetic Testing for Autoinflammatory Disease

Sep 01, 2022

Not all patients with periodic fevers fit neatly into diagnostic categories. Some can be diagnosed as Still’s disease (based on criteria) while others can be classified as autoinflammatory diseases (AID) and some may be unclassifiable, clinically or genetically.

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Disease Activity Scoring in Adult-onset Still's disease

Aug 30, 2022

Still's disease in adults (AOSD) or children (sJIA) can have dramatic symptom severity, making it easy to gauge disease activity and response to therapy, especially at the outset. However, a validated measure of disease activity has not been agreed (for clinical trial and treatment assessments

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Record Use of Marijuana and Hallucinogens in Young Adults

Aug 24, 2022

The NY Times reports that a recent survey of drug use indicates that daily consumption of marijuana among young adults nearly doubled in the last decade. This is coupled with growing mainstream acceptance of cannabis and hallucinogenic compounds.

A national survey conducted by the

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Managing JDM with Calcinosis

Aug 19, 2022

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

  1. CDC report of fungal infx in US 2019 - coccidioidomycosis (20,061), histoplasmosis (1,124) & blastomycosis (240

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Has insurance moved to a new tactic to intimidate doctors from appeals? I was expecting to do a peer to peer to get #Xeljanz approved, they put me on the phone with a courtroom judge to make me swear I am telling the truth about why the medicine is needed for the patient.

JUNIPERA Study - Secukinumab in Juvenile PsA & ERA

Aug 16, 2022

JUNIPERA study evaluated secukinumab (SEC) in children with enthesitis-related arthritis (ERA) and juvenile psoriatic arthritis (JPsA) and was found to be safe and effective in patients with active ERA and JPsA who previous failed to respond to conventional therapy.

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Hit Parade Review (8.12.2022)

Aug 12, 2022

We've got a lot to discuss this week: psoriasis; fatigue; sleep; sural nerve biopsies; uveitis and SpA; diet and RA; tofacitinib and the ORAL surveillance study; what not to take with mycophenolate - and more. In what order should these items be discussed? This week the run down is based on

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CARRA Registry study of Kids who D/C DMARDs or biologics but flared & restarted meds: the recapture rate was 55% overall (47% oligoarthritis, 69% systemic JIA. By 12 mos 67% of children achieved inactive dz - better odds w/ restarting biologics (OR 2.74)

JAK Inhibitors in Difficult Still’s Disease

Aug 05, 2022

A small retrospective study suggests that patients with difficult to treat adult-onset Still's disease (AOSD) or sytemic juvenile idiopathic arthritis (sJIA) may respond well to JAK inhibitor (JAKi) agents - presumable by blocking pro-inflammatory cytokines, notably IL-6 and IFN.

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ACR guidance

ACR Updated Guideline on Vaccinations for Rheumatic Patients

Aug 04, 2022

The ACR has posted a new ACR Clinical Practice Guideline Summary providing recommendations on the use of vaccinations for children and adults with rheumatic and musculoskeletal diseases (RMDs).

This guideline builds on past

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The FDA has extended its indications for ustekinumab (Stelara) for use in pediatric psoriatic arthritis aged 6 years and older. Pediatric PsA makes up 6% of all pediatric inflammatory arthritis pts.
Belimumab (Benlysta) has been FDA approved for use in pediatric patients with active lupus nephritis who are receiving standard lupus therapy. The approval in kids is for the IV formulation only; SC belimumab is for SLE and LN in adults
TNR: Still's Now Journal Club - Pivotal Trials in SJIA & AOSD Approved Meds This week's Stills disease Journal Club features expert panelists Drs. Olga Petryna, Daniel Lovell, Hermine Brunner and Jack Cush.

Not Still’s – Now What?

Jul 29, 2022

Your patient doesn't meet criteria for Still’s disease (AOSD or sJIA), now what should you do or consider?

What you do or consider next can be addressed according to the stage of current disease: A) Hospitalized Febrile Disease, or B) Outpatient “Still’s” Disease.

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Rheumatic Causes for Fever of Unknown Origin

Jul 27, 2022

Fever of unknown origin (FUO) represents a diagnostic challenge to many physicians and while cancer and infectious causes need to be excluded, rheumatic disorders are amongst the most common causes of FUO.

A recent metanalysisi of the medical literature from 2002 to 2021, included

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Early, Aggressive and Seropositive (7.22.2022)

Jul 22, 2022

Dr. Jack Cush covers the news and journal reports from the past week on This week we have Insights NAFLD, overdose deaths, septic arthritis, refractory stills, & when MTX doesn’t work.

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