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Scleroderma/Raynauds

CD19 CAR T-Cell Therapy in Autoimmune Disease

Feb 22, 2024

The NEJM has published the results of CD19 B cell depletion (by CAR-T cell therapy) in autoimmune disease patients, demonstrating it to be feasible, safe, and efficacious.



The rationale to CD19 CAR-T cell transfer is to reset aberrant autoimmunity via deep depletion of B cells with

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Study of 43 SSc patients w/ gangrene shows Smoking Hx ; positive-ACA, ANCA, APL Abs & high ESR were independent risk factors for digital gangrenes in SSc. Vasculitis and macrovascular disease may contribute to the progression of digital gangrene https://t.co/3DY2Hx19s0 https://t.co/BfXANmckwF
Dr. John Cush @RheumNow( View Tweet )
Feb 18, 2024
Marketing analysis of systemic sclerosis prevalence estimates, from 7 major countries, ~150,000 SSc pts in 2022 (47% from US; 20% Japan; 10% UK). https://t.co/0zJFdq05Xd https://t.co/HWM3LNtHbS
Dr. John Cush @RheumNow( View Tweet )
Feb 16, 2024
Full read overview of SJOGRENS SYNDROME, which can be Primary SS or Secondary (15% in SLE, 20% RA, & 30% systemic sclerosis). SS Organ involvement: - CNS 2-17% - Renal <=10% - ILD 10-20% -MSK 45-56% https://t.co/RElOFfP2xr https://t.co/aJI041VCuE
Dr. John Cush @RheumNow( View Tweet )
Feb 12, 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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Inflammatory Arthritis in Systemic Sclerosis is Problematic

Feb 08, 2024

Inflammatory arthritis (IA) is a common manifestation in systemic sclerosis (SSc), affecting nearly one-third of patients.



A prospective study of SSc patients enrolled in the Australian Scleroderma Cohort Study assessed the frequency and the associations of IA with SSc and serological

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Dead Words Eulogy

Jan 26, 2024

The trouble with rheumatology may be the words we live by. Welcome to the eulogy for rheumatology 'dead words'. We're here today to celebrate the loss of rheumatology past. These are dead words in rheumatology, words fortified unfortunately by history and habit. The lexicon of rheumatology is

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NVC in 1356 #SSc registry pts classified as early, active or‘late. Late pattern seen in 40%: signific. assoc w/ dcSSc (OR=1.96), ILD (OR=1.29), renal crisis (OR=3.46), digital ulcer (OR=1.29), &amp; topoisomerase I Abs (OR=1.39) https://t.co/RgET0HbImf https://t.co/Ex3nKto6JW
Dr. John Cush @RheumNow( View Tweet )
Dec 18, 2023

CBT or Naltrexone in Fibromyalgia (12.8.2023)

Dec 08, 2023

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.  Be sure to catch the early registration break for 2024 RheumNow Live.




  1. Palmoplantar pustulosis (PPP) is difficult to treat; w/ few reports of JAKi efficacy.

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Polands disease study (sarcoidosis 78.6K; #AOSD 3294; systemic sclerosis 35.5K) betw 2009-2018. Avg hospitalization was 5.39 days sarcoidosis, 6.22 days scleroderma, & 7.44 days for Still’s (latter decr 11.7 to 5.8, betw 2008-2014) https://t.co/OcNzt7IKC5 https://t.co/uPcbOyizQN

Dr. John Cush @RheumNow( View Tweet )
Dec 07, 2023
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 https://t.co/Z8pIAZYaC0 https://t.co/ErRsD9Msn1
Dr. John Cush @RheumNow( View Tweet )
Dec 01, 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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Trajectory of FVC in Systemic sclerosis associated ILD in open label SENSCIS study Decline in FVC over 52 weeks decreased by 57% on nintedanib But am I also just seeing a study FVC decline even with nintedanib? @RheumNow #ACR23 Abs#2594 https://t.co/3h4mhm0ceU
Robert B Chao, MD ( View Tweet )
Nov 15, 2023
1st Large real world observational head to head study on tx of Systemic sclerosis - ILD No difference in treatment effectiveness of FVC change between tocilizumab, rituximab, mycophenolate and cyclophosphamide! @RheumNow #ACR23 Abs#2596 #ACRBest https://t.co/GaSnZSCcnZ
Robert B Chao, MD ( View Tweet )
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 https://t.co/TEdeGHuzpi
Robert B Chao, MD ( View Tweet )
Nov 15, 2023
Continued interest on CAR-T cells in systemic sclerosis! 6 mo f/up data on 3 pts who received CAR-T cell treatment - stable dz overall Skin findings improved in all 3 pts Previous finger ulcerations resolved Lung function stable in 2 pts, improved in 1 @RheumNow #ACR23 Abs#2598

Robert B Chao, MD ( View Tweet )

Nov 15, 2023
#ACR23 Abs 2598 show data on 1st 3 CD19 CAR-T treated SSc pts. Tx well tolerated and dz stabilized off tx x 6 months. Promising, but more data needed for further evaluation. https://t.co/RAKhT6Eygn @rheumnow

Dr. Rachel Tate ( View Tweet )

Nov 15, 2023
Part 2: Clinical Year in Review #ACR23 https://t.co/Yb8Xh2UKFY
Mithu Maheswaranathan, MD ( View Tweet )
Nov 14, 2023
🚩Adjunct therapy to treat vasculopathy of MDA5-DM ⭐️Botox heals digital ulcerations and improves Raynaud's (slide 1) Dr. Katherine Shaw injects Botox for healing recalcitrant ulcerated Gottron's papules (example patient failed nifedipine, sildenafil, pentoxyfylline & while on… https://t.co/4XCvRrzeTL https://t.co/yxUCzS30W1
Meral K. El Ramahi, MD @MeralElRamahiMD( View Tweet )
Nov 14, 2023
A#L06 #ACR23 @RheumNow Refractory juv SSc 6m-2y after autolog Stem Cell Tx - 5 patients HAQ VAS improved 75% (48-99%) All: mRSS MCID by 6 mo, 87% aver improvement, sustained at 2y GI: GIT mean 55% improvement, 1 unchanged FVC stable, DLCO improv >10% in 2, 5-10% in 2 #ACRBest https://t.co/cc6YToVEO5
Eric Dein ( View Tweet )
Nov 14, 2023
World's largest jSSc cohort: djSSc pts had more severe dz vs ljSSc pts. DjSSc pts w/ more cutaneous, vascular, MSK involvement vs ljSSc pts w/ more cardiac involvement. No significant differences in ILD, PAH, GI involvement. #ACR23 Abs #1623 https://t.co/czAH0hpY2a @rheumnow https://t.co/RcfAJORXY3
Dr. Rachel Tate ( View Tweet )
Nov 13, 2023
#ACR23 Scleroderma renal Crisis (SRC) May precede skin involvement also. RISK FACTORS • Early diffuse skin disease - 2-3 years from SSc onset, median 8 months • Anti-RNA polymerase III (60%) • Use of corticosteroids - >15 mg/d or low doses for longer time https://t.co/RSIxEXLdX7
Aditya Burje @AdityaBurje( View Tweet )
Nov 12, 2023
#ACR23 #ReviewCourse - By Dr. Francesco Boin. Systemic Sclerosis Screening for Organ Involvement. This slide is a true "take home slide" @ACRheum #ACRambassador https://t.co/4FVYWJjHyV
Anne Troldborg ( View Tweet )
Nov 12, 2023
💡Screen pts with Ssc for ILD with HRCT at diagnosis. 💡“MCTD” may meet criteria for Ssc dont look away at the positive U1RNP! 💡Kidney biopsy in SRC =Time is of the essence. 💡Cardiac involvement is 2nd cause of mortality screen with echo annually. @fboinMD #ACR23 @RheumNow https://t.co/yp3yjqqeQv
Adela Castro @AdelaCastro222( View Tweet )
Nov 12, 2023
Assessment of organ involvement in scleroderma by Boin F, a great example of great clearly presented slides #ACR23 @RheumNow https://t.co/zMwY1NGpYI
Dr. Antoni Chan ( View Tweet )
Nov 11, 2023