Scleroderma/Raynauds

How to assess ILD in your patients? Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis. All patients with CTD may develop ILD but it is more common (% of patients with https://t.co/UXdvPJCqDi
Dr. John Cush @RheumNow( View Tweet )
Why shall we screen all patients with SSc for ILD? Focusing screening strategy on patients « at risk » misses 25% of patients with ILD ILD being the main cause of mortality in SSc @RheumNow #APLAR25 https://t.co/djzCTdZoVb

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Aurelie Najm @AurelieRheumo( View Tweet )
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RheumNow Podcast – Ro, Ro, Ro52 (9.12.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are there benefits to diet or vegan diets? What's the effect of menopause on CTD?  Ro52 makes a big entrance with all our ILD coverage this month.

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How to assess ILD in your patients?

Janet Pope, MD, MPH, FRCPC

Have a high index of suspicion in your patients with connective tissue disease (especially systemic sclerosis, inflammatory myositis), and rheumatoid arthritis.

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Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Dr. John Cush @RheumNow( View Tweet )
ERS/EULAR guidelines for CTD-related interstitial lung disease The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have released clinical practice guidelines for evaluating and managing connective tissue diseases (CTD) https://t.co/2mmxsor4ND
Dr. John Cush @RheumNow( View Tweet )
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PAH diagnosis and management in the context of CTD ILD

Aurelie Najm, MD, PhD

Pulmonary arterial hypertension (PAH) is a serious complication of connective tissue disorders. Approximately 25% of patients with PAH have an underlying CTD, making CTD-PAH the second most common cause of PAH. During the session on Management of Lung Complications in CTD at APLAR 2025, Prof.

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SPRING-SIR Italian registry of systemic sclerosis: 1917 SSc pts, 56% had GI Sx, assoc w/ longer Dz duration, more severe Dz, diffuse SSc, ILD, digital ulcers, telangiectasias, & tobacco. In 211 very early SSc, 41% GI Sxs (most esophageal), w/ puffy fingers, & dyspnea. https://t.co/l2hStwavuu
Dr. John Cush @RheumNow( View Tweet )
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ERS/EULAR guidelines for CTD-related interstitial lung disease

Jack Cush, MD

The European Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have published clinical practice guidelines for the evaluation and management of connective tissue diseases (CTD) associated interstitial lung disease (ILD) in two simultaneous publications in

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SSc-ILD ABs & LESSONS: 30% of won't progress. Triple negatives (ATA, ACA, ARA) wont progress. Males & diffuse dz > predictive than Abs. Great read on if Abs are biomarkers to predict Rx effect. https://t.co/YcZt4aAvL0 https://t.co/wOknKRfRHf

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Dr. John Cush @RheumNow( View Tweet )
Study of 607 systemic sclerosis (SSc) pts finds Pulm arterial HTN (PAH) in 77 (12.7%). While early immunosuppression didnt reduce odds of PAH (OR 0.74, p=0.495), early mycophenolate was protective(OR 0.12; p=0.048). Only HCQ use signif. improved survival (HR 0.04; p= 0.004). https://t.co/DbsJVZ16Zd
Dr. John Cush @RheumNow( View Tweet )
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September to Remember (9.5.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from RheumNow. This week - unemployment, diagnosing Sjogren's and a lot of ILD.

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MUC5 mutations not in SSc-ILD. Study of 2363 SSc-ILD, 3526 SSc w/o ILD & 15076 controls. They found no assoc w/ MUC5B promoter variant & SSc-ILD. (Suggesting ILD pathogenic mechanisms differ between RA and SSc) https://t.co/bBq52X0Mwq https://t.co/eu1IpaXGL8

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Dr. John Cush @RheumNow( View Tweet )
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Teaching You How to Think… (8.15.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports and press clippings from the past week on RheumNow. Positive results in a Sjogren's trial, to PT or not to PT, and  aphorisms to live by.

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Retrospective UK study of CPRD dataset (2012-2023) found 22 829 incident CTD Dx (81% F). Over time incidence SLE & Systemic Sclerosis fell, Sjogrens & MCTD stable, & IIM rose 3.23–4.31/100K. IIM had highest mortality (28/1000 py), followed by SSc, SLE, MCTD; lowest SjD (9.7)

Dr. John Cush @RheumNow( View Tweet )

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Repurposing & Pipeline (8.8.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, reports, pipeline and drug repurposing on this week’s podcast.

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Pipeline of drugs being developed for Scleroderma by these companies - Bayer, Novartis, GSK, Boehringer Ingelheim, Celgene Corp., Johnson & Johnson, Prometic, Cytori arGentis - either as fusion proteins, peptides, small molecule, mAb, Polymern& Gene therapy https://t.co/dWRcQ1a3GU
Dr. John Cush @RheumNow( View Tweet )
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CKD & Osteoporosis Rx Revisited (7.25.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal and FDA updates from this past week on RheumNow.com.

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Clinical Associations with Anti-RNA Polymerase III Antibodies A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome https://t.co/p1KVUFPJvN
Dr. John Cush @RheumNow( View Tweet )
US CDC study of age-standardized mortality rate (ASMR) from 1990-2020, there were 39,496 deaths related to scleroderma (SSc) & and 5,163 from SSc w/ renal failure. Deaths lower in males (22%) than females w/ renal failure (78%). Mortality rate of SSc w? renal failure was https://t.co/OT3BHt3E85
Dr. John Cush @RheumNow( View Tweet )
antibody (Keep)

Clinical Associations with Anti-RNA Polymerase III Antibodies

Jack Cush, MD

A systematic review of anti-RNA polymerase III antibodies (ARA) in systemic sclerosis (SSc) patients finds ARA positivity in only 9% of SSc patients, but come with a higher risk of many potentially worrisome outcomes.

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NHANES, Numbers, & Risk (7.18.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com along with interesting case questions from "Ask Cush Anything".

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Hmmm Really? (7.11.2025)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week - some obvious, other new thoughts and some - hmmm, reallly?

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ICYMI: Clinical and Therapeutic Challenges in Connective Tissue Disease and ILD

Mrinalini Dey, MD

Connective tissue diseases (CTDs) and interstitial lung disease (ILD) represent a challenging intersection of systemic autoimmunity and progressive respiratory impairment. Research presented at EULAR 2025 continues to highlight the importance of CTD-ILD and the evolving landscape of therapeutic

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JAMA Clinical Challenge - 34-yoF with Forearm Pain and Stiffness. 1 yr of progressive skin tightening over forearms, tibia, LOM of fingers & elbows. Denied DM, Raynauds. Worse after tennis, better w/ steroids. Increased ANA, eosinophils, CRP, aldolase - your Dx? https://t.co/5VrE4OpZ4N
Dr. John Cush @RheumNow( View Tweet )

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