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Heavy Metal Rheumatology (9.23.2022)

Sep 23, 2022

Below are this week’s highlights from RheumNow, as discussed by Dr. Jack Cush. Thanks to all of you for your kind comments and great reviews of our weekly podcast. Please let us know how we can improve by emailing me or recording your suggestion using the "Ask Cush Anything" link on our website

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Cancer Risk with Scleroderma

Sep 22, 2022

Spanish Scleroderma Registry examined a large cohort of systemic sclerosis (SSc) patients showing an increased cancer risk, especially breast, lung, hematologic and colorectal cancer.

The registry included 1930 patients with SSc and were compared to a matched general population to derive the

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Is PMR the Next Indication for Tocilizumab?

Sep 21, 2022

About half of patients with steroid-dependent polymyalgia rheumatica (PMR) were able to get off steroids altogether when they were started on tocilizumab (Actemra) infusions, which also improved disease control in most cases, a randomized phase III trial showed.

In a 24-week study, 49

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Clinical Profiles Seen with NXP-2 Antibodies

Sep 20, 2022

A recent review of the myositis associated autoantibody NXP-2 profiles its clinical associations with dermatomyositis (DM), calcinosis, severe myositis and, in some reports, with cancer.

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CD19 CAR T Cell Therapy in SLE (9.16.2022)

Sep 16, 2022

The big news this week: the approval of deucravacitinib (a new class of drug?) for psoriasis; the 2022 ACR guidance on glucocorticoid-induced osteoporosis; a national poll of older adults over the age of 50 who claimed self-reported or doctor-diagnosed arthritis; and much more. Let's review

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Does Methotrexate Use Lead to Melanoma?

Sep 15, 2022

A systematic review suggests that low-dose methotrexate (MTX) use is associated with an increased melanoma risk, but the absolute risk increase could be considered negligible.

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Voclosporin Efficacy and Safety in Lupus Nephritis

Sep 05, 2022

An integrated analysis of two pivotal trials of voclosporin, a calcineurin inhibitor, in lupus nephritis patients saw significant improvement in complete renal responses (CRR) at one year.

at 23.7 mg twice daily in combination with mycophenolate mofetil (MMF) and oral glucocorticoids

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Goofy But True

Sep 02, 2022

Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on

  1. After historic drop in 2020 (COVID), life expectancy in USA dropped again,

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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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EULAR/ACR Classification in MDA5+ Myositis Patients

The diagnosis of idiopathic inflammatory myopathies (IIMs) can be informed by the 2017 EULAR/ACR classification criteria, but their utility in patients with clinically amyopathic dermatomyositis (CADM) and anti–melanoma differentiation–associated protein 5 (anti–MDA-5)–positive IIM is less

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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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STING/IFN Activation Promotes ANCA-Associated Vasculitis Progression

Aug 29, 2022

Research presented in the Journal of Experimental Medicine shows that ANCA-associated vasculitis (AAV) may be propagated by pathogenic mechanisms triggering cGAS/STING/IRF3-dependent IFN-I release.

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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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Rituximab Efficacy in Systemic Sclerosis

Aug 18, 2022

The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.

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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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Cytomegalovirus Increases Thromboembolism Risk in ANCA-associated Vasculitis

Aug 11, 2022

Infection may play an important role in the genesis of vasculitis and ANCA seropositivity; this report suggests that past cytomegalovirus infection may be a risk in the occurrence of venous thromboembolism (VTE) in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis. 

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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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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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Nintedinib’s Durable Efficacy in Systemic Sclerosis

Jul 26, 2022

Patients with interstitial lung disease (ILD) related to systemic sclerosis continued to see less progression when treated with nintedanib (Ofev) in the pivotal 100-week SENSCIS trial, researchers said.

Among participants who remained on the drug until the protocol had them stop,

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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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Fever Pitch (7.15.2022)

Jul 15, 2022

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on

  1. Ustekinumab (IL-12/23i) phase 2 study was successful in #SLE; but the phase 3 LOTUS study of 512 pts, UST was NOT superior to PBO (SRI-4 44% v

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Still’s Disease FAQs

Jul 14, 2022

What is the classic 'triad' of Still's disease? Does it affect males and females equally? What are typical lab findings? Which drugs are effective at treating Still's, and as importantly, which ones are not? What about complications? Read on for these and other FAQs regarding Still's disease.

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#idboardreview #meded #idmeded #IDtwitter #dermtwitter #MedTwitter Infectious differential diagnosis of rash involving palms & soles