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Pediatric Rheum

In 551 juvenile myositis pts, 36% had myositis assoc Abs (MAA); 13% had >1 MAA. MAA+ pts had more overlap dz (18 vs 6%, p<.001) & assoc w/ Raynauds (OR 2.44), ILD (OR 3.43), chronic Dz (OR 1.72), mortality (OR 3.76). # MAAs was assoc w/ mortality (OR 1.83) https://t.co/BXhasmel3Z
Dr. John Cush @RheumNow( View Tweet )
Feb 18, 2024
Adult vs Juvenile DM by @susanshenoi at #RWCS24 @RWCSmtg @RheumNow Adults tend to have myalgia, arthralgia, raynauds vs kids with skin ulcerations and vasculopathy https://t.co/1DW2kJsLfa
Dr. Rachel Tate @uptoTate( View Tweet )
Feb 16, 2024
Dr. @susanshenoi reviews IIM in juveniles vs adults. Some highlights: *IBM only in adults *PM more common in adults See picture for additional pearls #RWCS24 @RWCSmtg @RheumNow https://t.co/onUEwkKXBN
Dr. Rachel Tate @uptoTate( View Tweet )
Feb 16, 2024

VITAL Info on Autoimmune Disease (2.9.2024)

Feb 09, 2024

Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".




  1. Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts,

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Best Treatments for COVID-Related MIS-C

Jan 24, 2024

The RECOVERY trial focused on pediatric MIS-C patients treated with immunomodulators and anti-cytokine therapy demonstrated the benefits of first-line therapy with intravenous methylprednisolone or second-line tocilizumab in children refractory to initial treatment. Neither IV immunoglobulin

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Tic-Borne Disorders Causing Chronic Arthritis?

Jan 16, 2024

Findings from a population based cross-sectional study suggests that while up to 20% of patients have antibodies to tick-borne exposures, only a minority reported musculoskeletal symptoms. 



Lyme disease is one of many tick-borne diseases (TBDs) that may include spotted fever group

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SLE: A Mutated Gene and TLR7 Overexpression

EurekAlert!
Jan 12, 2024

A group of researchers lead by Min Ae Lee-Kirsch from the Department of Pediatrics, Medical Faculty, TUD Dresden University of Technology (Germany), studied four patients from two families who developed symptoms of SLE in the first years of life. As familial occurrence of SLE in young

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2023 Rheumatology Year in Review

Jan 12, 2024

Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.  



2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.  



Below is

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StillsNow Podcast December 2023 - ACR23 Highlights

Dec 29, 2023

Dr. Jack Cush reviews selected AOSD & systemic JIA abstracts from the ACR 2023 Annual meeting held in San Diego, November 12th thru 16th.




  1. Abstract 0761. EULAR / PreS Recommendations for the Diagnosis and Management of Systemic Juvenile Idiopathic Arthritis (sJIA) and

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Best of 2023: EULAR/ACR Guidance on Haemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome

Dec 27, 2023

A EULAR/American College of Rheumatology task force has established evidence based, up-to-date guidance and expert opinion on the evaluation, management and monitoring of patients with Haemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS), with the primary intent to 

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FDA Approves the first Actemra biosimilar- called tocilizumab-bavi (Tofidence) or BIIB800 (during development). This IV FORMULATION is approved for use in active RA, polyarticular JIA and systemic JIA. https://t.co/AJD4uOS9hz https://t.co/8bmyTUWyFs https://t.co/6IYjk0XUJq https://t.co/OfjdvJZciB
Dr. John Cush @RheumNow( View Tweet )
Dec 21, 2023

Is MTX Safe in the Elderly? (12.1.2023)

Dec 01, 2023

Dr. Jack Cush reviews this past week's news and journal reports from RheumNow.com. Good news is that nearly 99% of adult rheumatology positions matched! But the challenge is that 45% of pediatric fellowship programs and 39% of pediatric rheum slots were unfilled in the 2024 NRMP match.

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Do We Stop or Continue Treatment?

Nov 20, 2023

Remission had been a dream, an elusive concept. But then, with the introduction of biologics, conventional synthetic and targeted synthetic DMARDS, patients are able to live longer and with a better quality of life. While these therapeutics have been helpful, they are expensive and carry

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JAKi and TYK2i: What to use and when?

You can see that the JAKi/TYK2i have both approved or potential seropositive and seronegative indications. There are also improvements in PsO for the class and studies in CTDs. So, it is difficult to know which to choose.

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Assessment of MAP kinase pathway gene expression prior to tx may aid in identification of polyarticular course JIA patients that could exhibit poor response to tofacitinib. It may be helpful in personalized tx algorithm! #ACR23 Abs #0830 https://t.co/Z8pykbG7x5 @rheumnow https://t.co/ANZr8aVrVB
Dr. Rachel Tate ( View Tweet )
Nov 13, 2023
STOP-JIA study data from Abs #0831 suggest improved effectiveness with early combination tx vs step up and biologic first tx at the 2-3 yr timeframe for pJIA pts. More data needed to optimize outcomes/tx for these children. https://t.co/vWL5J4FPbo #ACR23 @rheumnow https://t.co/5iJpwglhPu
Dr. Rachel Tate ( View Tweet )
Nov 13, 2023
Good Treatment review of biologics (IL-1, IL-6) in systemic JIA (Stills) including complications of #MAS and lung disease; also info on horizon therapies like JAK inhibitors and IL-18 targeting and novel biomarkers (calgranulins, IL-18 and CXCL9) https://t.co/Cbd7bKdIbb https://t.co/d9tn9fmSAy
Dr. John Cush @RheumNow( View Tweet )
Nov 12, 2023
Things for me to take back to the clinic in looking after JIA patients, Sadun R, #ACR23 @RheumNow https://t.co/YkiP4GZG19
Dr. Antoni Chan ( View Tweet )
Nov 11, 2023
New clinical skill to use in the clinic. Auscultate at the TMJ for crepitus and measure the maximal incisal opening in JIA, Sadun R, #ACR23 @RheumNow https://t.co/8koZRCZYoP
Dr. Antoni Chan ( View Tweet )
Nov 11, 2023

ACR Convergence Preview (11.10.2023)

Nov 10, 2023

Dr. Jack Cush reviews this past week's news on RheumNow.com and suggests a learning plan for those wanting to consume the upcoming ACR Convergence 2023 meeting. 




  1. 2023 Medscaped Female Compensation Survey asked What percentage would again chose their specialty ? Top 5

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Anakinra Effective in Systemic JIA, Irrespective of HLA-DRB1 and IL1RN Variants A prospective study of first line use anakinra in systemic juvenile idiopathic arthritis (sJIA) proved to be effective and without potentially allergic lung reactions. https://t.co/MRFwrCXIlQ https://t.co/Su3nMs4CNW
Dr. John Cush @RheumNow( View Tweet )
Nov 08, 2023

Late Should Not Be Less (11.3.2023)

Nov 03, 2023

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week on RheumNow.com.




  1. Study of LATE-onset RA (>65y), shows DMARD initiation is low in LORA;  despite current clinical practice guidelines recommending early aggressive Rx. Among 3,373

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FDA has approved Abatacept to Treat Juvenile Psoriatic Arthritis (JPsA) in patients aged 2 to 17 years. (JPsA) in patients aged 2 to 17 years. This expands the current indications for ABA use in RA, poly JIA, PsA, and GVHD. https://t.co/eAc8Dsyc3b https://t.co/uHJqhEvuPG
Dr. John Cush @RheumNow( View Tweet )
Nov 01, 2023
Anifrolumab was studied in 7 adolescents w/ resistant #DLE (discoid); given 6 monthly IV doses. All had signif decreases in skin CLASI-A scores (72%) at 1 month (P =.01), sustained at 6-mo F/U. SLEDAI-2K score also decr by 7 pts; 1 had HSV-1 reactivation https://t.co/Nc0IN1Rsao https://t.co/XeAB99YZMF
Dr. John Cush @RheumNow( View Tweet )
Oct 18, 2023
Hepatotoxicity related to Anakinra has been reported in pediatric rheumatology patients. LFT elevations have been reported with IL-1 inhibition, even after excluding LFTs from the inflamm Dx, other drugs, MAS, etc. Here are 3 case reports. https://t.co/6ZxIcHbUEd https://t.co/Cx0kbn7JU2
Dr. John Cush @RheumNow( View Tweet )
Oct 15, 2023