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PMR

PMR - a Risk Factor for Recalcitrant Giant Cell Arteritis? Despite the clinical similarities and treatment differences between giant cell arteritis (GCA polymyalgia rheumatica (PMR), confusion exists regarding the impact of overlapping disorders. https://t.co/Slnq68YQgh https://t.co/nCYswGmlCk
Dr. John Cush @RheumNow( View Tweet )

PMR - a Risk Factor for Recalcitrant Giant Cell Arteritis?

Despite the clinical similarities and treatment differences between  giant cell arteritis (GCA polymyalgia rheumatica (PMR), confusion exists regarding the impact of overlapping disorders. A large cohort study shows that GCA patients with PMR symptoms are

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PMR has distinct patterns on MRI shoulder, possibly helping Dx. #EULAR2024 OP0248 @drdavidliew also @bmj_rmdopen https://t.co/0J3xUmb9yt where they say: "Similar to our prior findings... the target of inflammation in PMR is the outer covering of a tendon, the peritendineum" https://t.co/AzWkg3z2vR
Dr. John Cush @RheumNow( View Tweet )

Choices in GCA

There are a number of diseases where new biologic and targeted synthetic therapeutic options are coming online, and the temptation will be to consider them all equally. GCA is one of those diseases.

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PMR has distinct patterns on MRI shoulder, possibly helping diagnosis. #EULAR2024 OP0248 @RheumNow also @bmj_rmdopen https://t.co/pS5kO5OQRW where they say: "Similar to our prior findings... the target of inflammation in PMR is the outer covering of a tendon, the peritendineum" https://t.co/5pu1Xiku3h
David Liew @drdavidliew( View Tweet )
PMR patients get too much steroid. Data across 27 million people in England, n=39,438 with PMR. The blue are getting more pred than guidelines. Like everything in rheum: we need to be giving less pred, not more. Lumping PMR in with GCA won’t help. #EULAR2024 POS0411 @RheumNow https://t.co/bsi3lrAafm
David Liew @drdavidliew( View Tweet )
Enjoyed the #PolymyalgiaRheumatica session at #EULAR2024? Make sure to download our first atlas imaging article, where @drceowen, @drdavidliew et al. characterise PMR using whole-body PET/CT 👀 ➡️ https://t.co/tbu0DgAFIS https://t.co/W06YbYyjRx
Rheumatology & Rheumatology Advances in Practice @RheumJnl( View Tweet )
#EULAR2024 POS1420 A cohort study with 1/3 each with GCA, PMR and GCA+PMR found that at 6mth, 16% of patients had new diabetes/diabetes worsened. Worse in GCA+PMR group with the greatest GC accumulation. Call for better GC-sparing strategy @RheumNow https://t.co/ex7u83bVfj
Md Yuzaiful Md Yusof @Yuz6Yusof( View Tweet )
Predicting who will develop ▶️#GCA In #Swedish study with #PMR ⬆️ in HIGH ESR/CRP ⬆️female ⬇️ if hip pain/stiffness Not all sig 1 mo after #prednisone started Only 9% with #polymyalgia #rheumatica developed #GCA ? ⬇️GCA % in PMR over time #POS0411 @eular_org @RheumNow https://t.co/UMhxlYd0Pv
Janet Pope @Janetbirdope( View Tweet )
Leflunomide for #PMR? ✅ #Leflunomide FAR more effective than #MTX in #polymyalgia #rheumatica V fast withdrawal of #prednisone #LEF ~4 to 5 months #MTX 30 mos! ⬇️flares w LEF 😮 #EULAR2024 @RheumNow @eular_org @SebaUltraTrail https://t.co/2hk0yMH6gY
Janet Pope @Janetbirdope( View Tweet )

"Don't You Know Who I am?" (5.17.2024)

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?

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National French study finds post COVID Vaccine the IR of PMR (179 cases; RR 7.1/mill) & GCA (54 cases; RR 2.1 /million) were reported 7-10d post vax. These #s are below population incidence rates (1-20/mill for GCA) https://t.co/XvaoWhqs2g https://t.co/BFDy2WKcLx
Dr. John Cush @RheumNow( View Tweet )
337 PMR pts studied by FDG PET, followed 6 mos - 9% (31) had subclinical vasculitis (GCA) - 21 had isolated LG vessel - 3 isolated cranial vasculitis - 7 both cranial & LG vessel vasculitis. Steroid use higher w/ subclinical vasculitis, but not relapse https://t.co/uwXf4ucVnQ https://t.co/AOacTnQZaS
Dr. John Cush @RheumNow( View Tweet )

1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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337 PMR pts studied by FDG PET, followed 6 mos - 9% (31) had subclinical vasculitis (GCA) - 21 had isolated LG vessel - 3 isolated cranial vasculitis - 7 both cranial & LG vessel vasculitis. Steroid use higher w/ subclinical vasculitis, but not relapse https://t.co/QyRFwY45eU https://t.co/rg1WSBeMFl
Dr. John Cush @RheumNow( View Tweet )
Should all patients with #polymyalgia rheumatics be screened for #giantcellarteriitis with vascular #ultrasound? A recent viewpoint summarizes the evidence: 📊prevalence of subclinical GCA may be as high as 25% https://t.co/UL6gWRdE5R https://t.co/EAlRyNNWYt
Annals of the Rheumatic Diseases @ARD_BMJ( View Tweet )

2023 Rheumatology Year in Review

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.  

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ICYMI: When PMR Strikes Young, It Hits Hard https://t.co/rUuPnbcgCY https://t.co/AMpqGCJhIa
Dr. John Cush @RheumNow( View Tweet )

2023 Rheumatology Year in Review

Here is my top 10 list (in no particular order) of 2023 advances, game-changers, and developments that changed, or will soon change, rheumatologic practices.

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Full Read review of #PMR in Lancet: - Start @ 12·5–25mg prednisone qd - Remission in most but, relapses in 40–60% - Onset sudden; AM stiffness predominates; Shoulders>Pelvic ~50% have distal MSK Sxs - US: look for B/L sub-acromial/deltoid bursitis https://t.co/NwrbdMMdLU https://t.co/eRls0fLMJs
Dr. John Cush @RheumNow( View Tweet )
Best of 2023: PMR: glad or bad tidings? “Life was turned upside down overnight” – PMR patient. https://t.co/l7jZei5Kfm https://t.co/Ct3qlHd34P
Dr. John Cush @RheumNow( View Tweet )
When should we be starting therapy in GCA and PMR? The problem with having therapies that work is that you then have to figure out what to do with them. You cannot hide behind the ambiguity of therapeutic inadequacy. https://t.co/oRWTeH5Q9h https://t.co/BbswdffoKM
Dr. John Cush @RheumNow( View Tweet )
Full read BMJ ovverview of PMR - PMR Clinically recognized 1957 - Is it a uniquie vs overlap entity - Is there subclinical GCA in PMR? - Is PMR for PCPs? https://t.co/0BKGdt5Kxf https://t.co/sfAZoYyVan
Dr. John Cush @RheumNow( View Tweet )
2023 EULAR #PMR referral recommendations: 1 Suspected/Dx pts: consider Rheum eval 2 Do full Hx+PE+Labs before referral 3 Refer Severe Sx PMR to rapid access 4 Defer steroids til rapid Rheum eval 5 Rheum Dx PMR w? +steroid response can be Rx by PCP https://t.co/42bL8BL3QJ https://t.co/ffpKoKXZJM
Dr. John Cush @RheumNow( View Tweet )
Biologics as First-line Therapy for PMR and GCA? Dr. Eric Dein talks with Dr. Philip Seo, one of two panelists for the Great Debate: Should PMR and GCA Be Treated with Advanced Therapies at Disease Onset? https://t.co/eezZkBr8x7 https://t.co/D0dTSkjsNS https://t.co/nBlFyKNkHM
Dr. John Cush @RheumNow( View Tweet )